Department of Microbiology, Faculty of Medicine and Dentistry, Palacky University, Olomouc, Czech Republic
Laboratory of Medical Mycology, Department of Parasitology, Mycology and Mycobacteriology Prague, Public Health Institute in Usti nad Labem, Prague, Czech Republic.
Antimicrob Agents Chemother. 2018 Mar 27;62(4). doi: 10.1128/AAC.01927-17. Print 2018 Apr.
Cryptic species of , including the species complex, are increasingly reported to be causes of invasive aspergillosis. Their identification is clinically relevant, as these species frequently have intrinsic resistance to common antifungals. We evaluated the susceptibilities of 90 environmental and clinical isolates from the species complex, identified by DNA sequencing of the calmodulin gene, to seven antifungals (voriconazole, posaconazole, itraconazole, amphotericin B, anidulafungin, micafungin, and caspofungin) using the reference European Committee on Antimicrobial Susceptibility Testing (EUCAST) method. The majority of species demonstrated elevated MICs of voriconazole (geometric mean [GM] MIC, 4.46 mg/liter) and itraconazole (GM MIC, 9.85 mg/liter) and had variable susceptibility to amphotericin B (GM MIC, 2.5 mg/liter). Overall, the MICs of posaconazole and the minimum effective concentrations of echinocandins were low. The results obtained by the EUCAST method were compared with the results obtained with Sensititre YeastOne (YO) panels. Overall, there was 67% agreement (95% confidence interval [CI], 62 to 72%) between the results obtained by the EUCAST method and those obtained with YO panels when the results were read at 48 h and 82% agreement (95% CI, 78 to 86%) when the results were read at 72 h. There was a significant difference in agreement between antifungals; agreement was high for amphotericin B, voriconazole, and posaconazole (70 to 86% at 48 h and 88 to 93% at 72 h) but was very low for itraconazole (37% at 48 h and 57% at 72 h). The agreement was also variable between species, with the maximum agreement being observed for isolates (85 and 93% at 48 and 72 h, respectively). Elevated MICs of voriconazole and itraconazole were cross-correlated, but there was no correlation between the other azoles tested.
越来越多的研究报告表明，包括 种复合体在内的隐种是侵袭性曲霉病的病原体。这些种的鉴定具有临床相关性，因为它们通常对常用抗真菌药物具有固有耐药性。我们评估了 90 株来自 种复合体的环境和临床分离株对 7 种抗真菌药物（伏立康唑、泊沙康唑、伊曲康唑、两性霉素 B、阿尼芬净、米卡芬净和卡泊芬净）的敏感性，这些分离株是通过钙调蛋白基因的 DNA 测序鉴定的，采用参考欧洲抗菌药物敏感性试验委员会（EUCAST）方法。大多数种对伏立康唑（几何均数[GM]MIC，4.46 毫克/升）和伊曲康唑（GM MIC，9.85 毫克/升）的 MIC 值升高，并且对两性霉素 B 的敏感性不同（GM MIC，2.5 毫克/升）。总体而言，泊沙康唑和棘白菌素的最低有效浓度较低。EUCAST 方法获得的结果与 Sensititre YeastOne（YO）试剂盒获得的结果进行了比较。总体而言，EUCAST 方法和 YO 试剂盒在 48 小时和 72 小时读取结果时，结果的一致性分别为 67%（95%置信区间[CI]，62 至 72%）和 82%（95%CI，78 至 86%）。抗真菌药物之间的一致性存在显著差异；两性霉素 B、伏立康唑和泊沙康唑的一致性较高（48 小时时为 70%至 86%，72 小时时为 88%至 93%），而伊曲康唑的一致性非常低（48 小时时为 37%，72 小时时为 57%）。种间的一致性也存在差异，最大一致性见于 种（48 小时和 72 小时时分别为 85%和 93%）。伏立康唑和伊曲康唑的 MIC 值升高呈交叉相关，但所测试的其他唑类药物之间没有相关性。
