Division of Hygiene and Medical Microbiology, Medical University of Innsbruck, Innsbruck, Austria
Division of Hygiene and Medical Microbiology, Medical University of Innsbruck, Innsbruck, Austria.
Antimicrob Agents Chemother. 2017 Jul 25;61(8). doi: 10.1128/AAC.00512-17. Print 2017 Aug.
species were tested for susceptibility to caspofungin, anidulafungin, and micafungin in order to evaluate the roles of Etest and Sensititre YeastOne in antifungal susceptibility testing for daily routines and to survey resistance. A total of 104 species isolates detected from blood cultures were investigated. With EUCAST broth microdilution as the reference method, essential agreement (EA), categorical agreement (CA), very major errors (VME), major errors (ME), and minor (MIN) errors were assessed by reading MICs at 18, 24, and 48 h. By use of EUCAST broth microdilution and species-specific clinical breakpoints (CBPs), echinocandin resistance was not detected during the study period. Using EUCAST CBPs, MIC readings at 24 h for the Etest and Sensititre YeastOne resulted in CA levels of 99% and 93% for anidulafungin and 99% and 97% for micafungin. Using revised CLSI CBPs for caspofungin, CA levels were 92% and 99% for Etest and Sensititre YeastOne. The Etest proved an excellent, easy-to-handle alternative method for testing susceptibility to anidulafungin and micafungin. Due to misclassifications, the Etest is less suitable for testing susceptibility to caspofungin (8% of isolates falsely tested resistant). The CA levels of Sensititre YeastOne were 93% and 97% for anidulafungin and micafungin (24 h) by use of EUCAST CBPs and increased to 100% for both antifungals if CLSI CBPs were applied and to 100% and 99% if Sensititre YeastOne epidemiological cutoff values (ECOFFs) were applied. No one echinocandin could be demonstrated to be superior to another Since resistance was lacking among our isolates, we cannot derive any recommendation from accurate resistance detection by the Etest and Sensititre YeastOne.
为了评估 Etest 和 Sensititre YeastOne 在日常抗真菌药敏试验中的作用,并调查耐药性,对来自血培养的 104 株 种分离株进行了卡泊芬净、阿尼芬净和米卡芬净的药敏试验。以 EUCAST 肉汤微量稀释法为参考方法,评估了在 18、24 和 48 h 读取 MIC 时的主要协议(EA)、分类协议(CA)、重大误差(VME)、主要误差(ME)和次要误差(MIN)。在研究期间,未发现棘白菌素耐药性。使用 EUCAST 临床折点(CBPs),Etest 和 Sensititre YeastOne 在 24 h 的 MIC 读数对阿尼芬净和米卡芬净的 CA 水平分别为 99%和 93%,对棘白菌素为 99%和 97%。使用修订后的 CLSI CBPs 进行卡泊芬净检测,Etest 和 Sensititre YeastOne 的 CA 水平分别为 92%和 99%。Etest 是一种极好的、易于操作的替代方法,用于检测阿尼芬净和米卡芬净的敏感性。由于分类错误,Etest 不太适合检测卡泊芬净的敏感性(8%的分离株被错误地检测为耐药)。如果使用 CLSI CBPs,则使用 EUCAST CBPs 时 Sensititre YeastOne 的 CA 水平分别为 93%和 97%,对于两种抗真菌药物均为 100%;如果使用 Sensititre YeastOne 流行病学截断值(ECOFFs),则分别为 100%和 99%。我们的 种分离株中没有一种棘白菌素可以被证明优于另一种。由于我们的分离株缺乏耐药性,因此我们无法从 Etest 和 Sensititre YeastOne 的准确耐药性检测中得出任何建议。