VCU Medical Center, Richmond, Virginia, USA.
Antimicrob Agents Chemother. 2013 Aug;57(8):3823-8. doi: 10.1128/AAC.00636-13. Epub 2013 May 28.
Epidemiological cutoff values (ECVs) were established for the new triazole isavuconazole and Aspergillus species wild-type (WT) MIC distributions (organisms in a species-drug combination with no detectable acquired resistance mechanisms) that were defined with 855 Aspergillus fumigatus, 444 A. flavus, 106 A. nidulans, 207 A. niger, 384 A. terreus, and 75 A. versicolor species complex isolates; 22 Aspergillus section Usti isolates were also included. CLSI broth microdilution MIC data gathered in Europe, India, Mexico, and the United States were aggregated to statistically define ECVs. ECVs were 1 μg/ml for the A. fumigatus species complex, 1 μg/ml for the A. flavus species complex, 0.25 μg/ml for the A. nidulans species complex, 4 μg/ml for the A. niger species complex, 1 μg/ml for the A. terreus species complex, and 1 μg/ml for the A. versicolor species complex; due to the small number of isolates, an ECV was not proposed for Aspergillus section Usti. These ECVs may aid in detecting non-WT isolates with reduced susceptibility to isavuconazole due to cyp51A (an A. fumigatus species complex resistance mechanism among the triazoles) or other mutations.
建立了新的三唑类药物伊曲康唑和曲霉属野生型(WT)MIC 分布的流行病学截断值(ECVs),这些分布是通过 855 株烟曲霉、444 株黄曲霉、106 株构巢曲霉、207 株黑曲霉、384 株土曲霉和 75 株彩绒革盖菌复合种的分离株以及 22 株曲霉属 Usti 分离株来定义的。汇总了来自欧洲、印度、墨西哥和美国的 CLSI 肉汤微量稀释 MIC 数据,以统计方式定义 ECVs。烟曲霉复合种的 ECV 为 1μg/ml,黄曲霉复合种的 ECV 为 1μg/ml,构巢曲霉复合种的 ECV 为 0.25μg/ml,黑曲霉复合种的 ECV 为 4μg/ml,土曲霉复合种的 ECV 为 1μg/ml,彩绒革盖菌复合种的 ECV 为 1μg/ml;由于分离株数量较少,因此未提出 Aspergillus section Usti 的 ECV。这些 ECVs 可能有助于检测由于 cyp51A(三唑类药物中烟曲霉复合种的一种耐药机制)或其他突变而导致对伊曲康唑敏感性降低的非 WT 分离株。