Ben-Ami Ronen, Hilerowicz Yuval, Novikov Anna, Giladi Michael
Infectious Diseases Unit, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Diagn Microbiol Infect Dis. 2014 Jun;79(2):209-13. doi: 10.1016/j.diagmicrobio.2014.02.008. Epub 2014 Feb 24.
Interpretive criteria for Candida susceptibility testing were recently revised with the establishment of species-specific epidemiological cutoff values (ECV). To assess the effect of modified cutoff values on Candida glabrata resistance rates and agreement between testing methods, we tested the susceptibility of 598 clinical isolates to fluconazole, itraconazole, voriconazole, posaconazole, caspofungin, and amphotericin B using CLSI M27-A3 and E-test methods. The caspofungin MICs clustered above the ECV and below the CLSI cutoff (MIC50, 0.5 μg/mL). Applying the ECV reduced the proportion of itraconazole-nonsusceptible strains from 83% to 0.3% but minimally affected resistance rates of other drugs. Categorical agreement between broth microdilution and E-test was increased for itraconazole and reduced for voriconazole and caspofungin. The current caspofungin ECV may not reproducibly differentiate resistant and susceptible C. glabrata strains in hospitals with varying MIC distributions.
随着念珠菌药敏试验特定菌种流行病学截断值（ECV）的确定，念珠菌药敏试验的解释标准最近进行了修订。为评估修改后的截断值对光滑念珠菌耐药率以及检测方法之间一致性的影响，我们使用CLSI M27 - A3和E-test方法检测了598株临床分离株对氟康唑、伊曲康唑、伏立康唑、泊沙康唑、卡泊芬净和两性霉素B的敏感性。卡泊芬净的最低抑菌浓度（MIC）集中在ECV之上且低于CLSI截断值（MIC50为0.5μg/mL）。应用ECV使伊曲康唑不敏感菌株的比例从83%降至0.3%，但对其他药物的耐药率影响极小。肉汤微量稀释法和E-test法之间伊曲康唑的分类一致性增加，而伏立康唑和卡泊芬净的分类一致性降低。在具有不同MIC分布的医院中，当前卡泊芬净的ECV可能无法可靠地区分光滑念珠菌的耐药菌株和敏感菌株。
