Lo Shih-Hao, Tseng Yi-Ting, Chen Yee-Chun, Ho Mao-Wang, Lee Chen-Hsiang, Lu Po-Liang, Lin Shang-Yi
Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
J Clin Microbiol. 2025 Jun 11;63(6):e0031925. doi: 10.1128/jcm.00319-25. Epub 2025 May 12.
This study aimed to evaluate the activity of isavuconazole and ravuconazole against clinical isolates. Additionally, we assessed the performance of the Sensititre YeastOne (SYO) assay compared to the reference Clinical and Laboratory Standards Institute (CLSI) broth microdilution (BMD) method for antifungal susceptibility testing. A total of 267 clinical isolates were collected from multiple centers in Taiwan between 2008 and 2020. The MIC values for amphotericin B, fluconazole, itraconazole, posaconazole, and voriconazole obtained using the CLSI BMD were compared to those determined using SYO. Among the seven antifungal agents tested using the CLSI BMD method, isolates ( = 224) exhibited significantly higher MICs for fluconazole, voriconazole, isavuconazole, and ravuconazole compared to non-. isolates ( = 43) ( < 0.05). Across all isolates, voriconazole demonstrated the lowest geometric mean (GM) MIC (0.06 mg/L). For , the MIC₅₀, MIC₉₀, and GM MICs for posaconazole, isavuconazole, and ravuconazole were within ±1 twofold dilution, while mode MICs showed slightly greater variation (MIC₅₀, MIC₉₀, mode, and GM MICs were 0.25, 0.5, 0.5, and 0.28 mg/L; 0.12, 0.5, 0.12, and 0.17 mg/L; and 0.25, 0.5, 0.25, and 0.21 mg/L, respectively). The consistency of the MIC measurements between the SYO and CLSI BMD methods was assessed for amphotericin B, fluconazole, itraconazole, posaconazole, and voriconazole. The highest agreement within ±1 twofold dilution for isolates was observed for posaconazole (94.2%). The essential agreement within ±2 twofold dilutions between both methods for all drugs was >97%. In conclusion, isavuconazole and ravuconazole demonstrated favorable activity against clinical isolates, while the SYO assay showed good concordance with the CLSI BMD method.IMPORTANCEInvasive infections caused by species pose significant therapeutic challenges, primarily due to their intrinsic resistance to echinocandins and the limited availability of effective treatment options. This study provides essential data on the activity of newer azoles and comprehensively evaluates the performance and concordance of the Sensititre YeastOne (SYO) and CLSI broth microdilution (BMD) methods. The current study analyzed 267 clinical isolates collected from multicenter settings in Taiwan. Our results demonstrate that both isavuconazole and ravuconazole exhibit favorable activities against species. For , the essential agreement between the SYO and CLSI BMD methods exceeded 97% for all tested antifungal agents, indicating that the SYO method exhibits good concordance for most species. Further investigations are warranted to validate these findings and to assess their clinical implications.
本研究旨在评估艾沙康唑和雷夫康唑对临床分离株的活性。此外，我们将Sensititre YeastOne（SYO）检测方法与参考的临床和实验室标准协会（CLSI）肉汤微量稀释（BMD）方法在抗真菌药敏试验中的表现进行了评估。2008年至2020年期间，从台湾多个中心共收集了267株临床分离株。将使用CLSI BMD方法获得的两性霉素B、氟康唑、伊曲康唑、泊沙康唑和伏立康唑的MIC值与使用SYO测定的结果进行比较。在使用CLSI BMD方法测试的七种抗真菌药物中，与非[具体类型未提及]分离株（n = 43）相比，[具体类型未提及]分离株（n = 224）对氟康唑﹑伏立康唑、艾沙康唑和雷夫康唑表现出显著更高的MIC值（P < 0.05）。在所有分离株中，伏立康唑显示出最低的几何平均（GM）MIC（0.06 mg/L）。对于[具体类型未提及]分离株，泊沙康唑、艾沙康唑和雷夫康唑的MIC₅₀、MIC₉₀和GM MIC在±1倍稀释范围内，而众数MIC的变化略大（MIC₅₀、MIC₉₀、众数和GM MIC分别为0.25、0.5、0.5和0.28 mg/L；0.12、0.5、0.12和0.17 mg/L；以及0.25、0.5、0.25和0.21 mg/L）。对两性霉素B、氟康唑、伊曲康唑、泊沙康唑和伏立康唑评估了SYO和CLSI BMD方法之间MIC测量的一致性。对于[具体类型未提及]分离株，在±1倍稀释范围内，泊沙康唑的一致性最高（94.2%）。两种方法对所有药物在±2倍稀释范围内的基本一致性>97%。总之，艾沙康唑和雷夫康唑对临床[具体类型未提及]分离株表现出良好的活性，而SYO检测方法与CLSI BMD方法显示出良好的一致性。
由[具体类型未提及]物种引起的侵袭性感染带来了重大的治疗挑战，主要是由于它们对棘白菌素的固有耐药性以及有效治疗选择的有限性。本研究提供了关于新型唑类药物活性的重要数据，并全面评估了Sensititre YeastOne（SYO）和CLSI肉汤微量稀释（BMD）方法的性能和一致性。当前研究分析了从台湾多中心收集的267株临床[具体类型未提及]分离株。我们的结果表明，艾沙康唑和雷夫康唑对[具体类型未提及]物种均表现出良好的活性。对于[具体类型未提及]物种，SYO和CLSI BMD方法之间对所有测试抗真菌药物的基本一致性超过97%，表明SYO方法对大多数[具体类型未提及]物种表现出良好的一致性。有必要进行进一步研究以验证这些发现并评估其临床意义。
