New Zealand Mycology Reference Laboratory, LabPLUS, Auckland City Hospital, Auckland, New Zealand.
New Zealand Mycology Reference Laboratory, LabPLUS, Auckland City Hospital, Auckland, New Zealand.
J Glob Antimicrob Resist. 2018 Sep;14:72-77. doi: 10.1016/j.jgar.2018.02.014. Epub 2018 Feb 24.
We reviewed the antifungal susceptibility testing results of local yeast isolates (2001-2015) to record the impact of recently updated interpretive criteria and epidemiological cut-off values (ECVs) for yeast species.
Susceptibility testing was performed using Sensititre YeastOne. The results were interpreted following CLSI criteria or YeastOne-derived ECVs.
A total of 2345 isolates were tested; 62.0% were from sterile body sites or tissue. Application of new CLSI interpretative criteria for fluconazole increased the proportion of non-susceptible isolates of Candida parapsilosis, Candida tropicalis and Candida glabrata (P≤0.03 for all species). For voriconazole, the greatest increase was for C. tropicalis (P<0.0001). Application of new CLSI interpretive criteria for caspofungin increased the proportion of non-susceptible isolates for C. glabrata and Pichia kudriavzevii (P<0.0001 for both). The new amphotericin ECV (≤2mg/L) did not reveal any non-wild-type (non-WT) isolates in the five species covered. YeastOne itraconazole ECVs detected 2%, 5% and 6% non-WT isolates for P. kudriavzevii, C. tropicalis and C. glabrata, respectively. No itraconazole non-WT isolates of Clavispora lusitaniae were detected.
Whilst most results are similar to other large surveys of fungal susceptibility, the new CLSI interpretive criteria significantly altered the proportion of non-susceptible isolates to fluconazole, voriconazole and caspofungin for several Candida spp. Application of CLSI and YeastOne-derived ECVs revealed the presence of a low proportion of non-WT isolates for many species. The results serve as a baseline to monitor the susceptibility of Candida and other yeast species in New Zealand over time.
我们回顾了当地酵母分离株（2001-2015 年）的抗真菌药敏试验结果，以记录最近更新的酵母种属解释标准和折点（ECV）对抗真菌药敏试验结果的影响。
使用 Sensititre YeastOne 进行药敏试验。结果根据 CLSI 标准或 YeastOne 衍生的 ECV 进行解释。
共检测了 2345 株分离株；62.0%来自无菌部位或组织。新的 CLSI 解释标准应用于氟康唑增加了近平滑念珠菌、热带念珠菌和光滑念珠菌非敏感性分离株的比例（所有种属的 P 值均≤0.03）。对于伏立康唑，最大的增加是热带念珠菌（P<0.0001）。新的 CLSI 解释标准应用于卡泊芬净增加了光滑念珠菌和毕赤酵母非敏感性分离株的比例（两者的 P 值均<0.0001）。新的两性霉素 ECV（≤2mg/L）在涵盖的五种种属中均未发现非野生型（非-WT）分离株。YeastOne 伊曲康唑 ECV 检测到毕赤酵母、热带念珠菌和光滑念珠菌的非-WT 分离株分别为 2%、5%和 6%。未检测到克利夫兰纳酵母的伊曲康唑非-WT 分离株。
虽然大多数结果与其他大型真菌药敏调查相似，但新的 CLSI 解释标准显著改变了几种念珠菌属对氟康唑、伏立康唑和卡泊芬净的非敏感性分离株的比例。CLSI 和 YeastOne 衍生的 ECV 的应用揭示了许多种属存在低比例的非-WT 分离株。这些结果为监测新西兰一段时间内念珠菌和其他酵母种属的敏感性提供了基线。
