Method-dependent epidemiological cutoff values for detection of triazole resistance in Candida and Aspergillus species for the Sensititre Yeastone colorimetric broth and etest agar diffusion methods

A. Espinel-Ingroff, J. Turnidge, A. Alastruey-Izquierdo, F. Botterel, E. Canton, C. Castro, Y. C. Chen, Y. Chen, E. Chryssanthou, E. Dannaoui, G. Garcia-Effron, G. M. Gonzalez, N. P. Govender, J. Guinea, S. Kidd, M. Lackner, C. Lass-Flörl, M. J. Linares-Sicilia, L. López-Soria, R. MagoboT. Pelaez, G. Quindós, M. A. Rodriguez-Iglesia, M. A. Ruiz, F. Sánchez-Reus, M. Sanguinetti, R. Shields, P. Szweda, A. Tortorano, N. L. Wengenack, S. Bramati, C. Cavanna, C. DeLuca, M. Gelmi, A. Grancini, G. Lombardi, J. Meletiadis, C. E. Negri, M. Passera, J. Peman, A. Prigitano, E. Sala, M. Tejada

Research output: Contribution to journalArticle

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Abstract

Although the Sensititre Yeast-One (SYO) and Etest methods are widely utilized, interpretive criteria are not available for triazole susceptibility testing of Candida or Aspergillus species. We collected fluconazole, itraconazole, posaconazole, and voriconazole SYO and Etest MICs from 39 laboratories representing all continents for (method/agent-dependent) 11,171 Candida albicans, 215 C. dubliniensis, 4,418 C. glabrata species complex, 157 C. guilliermondii (Meyerozyma guilliermondii), 676 C. krusei (Pichia kudriavzevii), 298 C. lusitaniae (Clavispora lusitaniae), 911 C. parapsilosis sensu stricto, 3,691 C. parapsilosis species complex, 36 C. metapsilosis, 110 C. orthopsilosis, 1,854 C. tropicalis, 244 Saccharomyces cerevisiae, 1,409 Aspergillus fumigatus, 389 A. flavus, 130 A. nidulans, 233 A. Niger, and 302 A. terreus complex isolates. SYO/Etest MICs for 282 confirmed non-wild-type (non-WT) isolates were included: ERG11 (C. albicans), ERG11 and MRR1 (C. parapsilosis), cyp51A (A. fumigatus), and CDR2 and CDR1 overexpression (C. albicans and C. glabrata, respectively). Interlaboratory modal agreement was superior by SYO for yeast species and by the Etest for Aspergillus spp. Distributions fulfilling CLSI criteria for epidemiological cutoff value (ECV) definition were pooled, and we proposed SYO ECVs for S. cerevisiae and 9 yeast and 3 Aspergillus species and Etest ECVs for 5 yeast and 4 Aspergillus species. The posaconazole SYO ECV of 0.06 g/ml for C. albicans and the Etest itraconazole ECV of 2 g/ml for A. fumigatus were the best predictors of non-WT isolates. These findings support the need for method-dependent ECVs, as, overall, the SYO appears to perform better for susceptibility testing of yeast species and the Etest appears to perform better for susceptibility testing of Aspergillus spp. Further evaluations should be conducted with more Candida mutants.

Original languageEnglish
Article numbere01651-18
JournalAntimicrobial Agents and Chemotherapy
Volume63
Issue number1
DOIs
Publication statusPublished - Jan 1 2019

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Disk Diffusion Antimicrobial Tests
Epidemiologic Methods
Triazoles
Aspergillus
Candida
Agar
Yeasts
Candida albicans
Aspergillus fumigatus
Itraconazole
Saccharomyces cerevisiae
Niger
Pichia
Fluconazole

Keywords

  • Antifungal resistance
  • Aspergillus spp
  • Candida albicans
  • Candida glabrata
  • Etest method ECVs
  • Etest MICs for fungal mutants
  • SYO method ECVs
  • SYO MICs for fungal mutants
  • Triazole ECVs

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)
  • Infectious Diseases

Cite this

Method-dependent epidemiological cutoff values for detection of triazole resistance in Candida and Aspergillus species for the Sensititre Yeastone colorimetric broth and etest agar diffusion methods. / Espinel-Ingroff, A.; Turnidge, J.; Alastruey-Izquierdo, A.; Botterel, F.; Canton, E.; Castro, C.; Chen, Y. C.; Chen, Y.; Chryssanthou, E.; Dannaoui, E.; Garcia-Effron, G.; Gonzalez, G. M.; Govender, N. P.; Guinea, J.; Kidd, S.; Lackner, M.; Lass-Flörl, C.; Linares-Sicilia, M. J.; López-Soria, L.; Magobo, R.; Pelaez, T.; Quindós, G.; Rodriguez-Iglesia, M. A.; Ruiz, M. A.; Sánchez-Reus, F.; Sanguinetti, M.; Shields, R.; Szweda, P.; Tortorano, A.; Wengenack, N. L.; Bramati, S.; Cavanna, C.; DeLuca, C.; Gelmi, M.; Grancini, A.; Lombardi, G.; Meletiadis, J.; Negri, C. E.; Passera, M.; Peman, J.; Prigitano, A.; Sala, E.; Tejada, M.

In: Antimicrobial Agents and Chemotherapy, Vol. 63, No. 1, e01651-18, 01.01.2019.

Research output: Contribution to journalArticle

Espinel-Ingroff, A, Turnidge, J, Alastruey-Izquierdo, A, Botterel, F, Canton, E, Castro, C, Chen, YC, Chen, Y, Chryssanthou, E, Dannaoui, E, Garcia-Effron, G, Gonzalez, GM, Govender, NP, Guinea, J, Kidd, S, Lackner, M, Lass-Flörl, C, Linares-Sicilia, MJ, López-Soria, L, Magobo, R, Pelaez, T, Quindós, G, Rodriguez-Iglesia, MA, Ruiz, MA, Sánchez-Reus, F, Sanguinetti, M, Shields, R, Szweda, P, Tortorano, A, Wengenack, NL, Bramati, S, Cavanna, C, DeLuca, C, Gelmi, M, Grancini, A, Lombardi, G, Meletiadis, J, Negri, CE, Passera, M, Peman, J, Prigitano, A, Sala, E & Tejada, M 2019, 'Method-dependent epidemiological cutoff values for detection of triazole resistance in Candida and Aspergillus species for the Sensititre Yeastone colorimetric broth and etest agar diffusion methods', Antimicrobial Agents and Chemotherapy, vol. 63, no. 1, e01651-18. https://doi.org/10.1128/AAC.01651-18
Espinel-Ingroff, A. ; Turnidge, J. ; Alastruey-Izquierdo, A. ; Botterel, F. ; Canton, E. ; Castro, C. ; Chen, Y. C. ; Chen, Y. ; Chryssanthou, E. ; Dannaoui, E. ; Garcia-Effron, G. ; Gonzalez, G. M. ; Govender, N. P. ; Guinea, J. ; Kidd, S. ; Lackner, M. ; Lass-Flörl, C. ; Linares-Sicilia, M. J. ; López-Soria, L. ; Magobo, R. ; Pelaez, T. ; Quindós, G. ; Rodriguez-Iglesia, M. A. ; Ruiz, M. A. ; Sánchez-Reus, F. ; Sanguinetti, M. ; Shields, R. ; Szweda, P. ; Tortorano, A. ; Wengenack, N. L. ; Bramati, S. ; Cavanna, C. ; DeLuca, C. ; Gelmi, M. ; Grancini, A. ; Lombardi, G. ; Meletiadis, J. ; Negri, C. E. ; Passera, M. ; Peman, J. ; Prigitano, A. ; Sala, E. ; Tejada, M. / Method-dependent epidemiological cutoff values for detection of triazole resistance in Candida and Aspergillus species for the Sensititre Yeastone colorimetric broth and etest agar diffusion methods. In: Antimicrobial Agents and Chemotherapy. 2019 ; Vol. 63, No. 1.
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abstract = "Although the Sensititre Yeast-One (SYO) and Etest methods are widely utilized, interpretive criteria are not available for triazole susceptibility testing of Candida or Aspergillus species. We collected fluconazole, itraconazole, posaconazole, and voriconazole SYO and Etest MICs from 39 laboratories representing all continents for (method/agent-dependent) 11,171 Candida albicans, 215 C. dubliniensis, 4,418 C. glabrata species complex, 157 C. guilliermondii (Meyerozyma guilliermondii), 676 C. krusei (Pichia kudriavzevii), 298 C. lusitaniae (Clavispora lusitaniae), 911 C. parapsilosis sensu stricto, 3,691 C. parapsilosis species complex, 36 C. metapsilosis, 110 C. orthopsilosis, 1,854 C. tropicalis, 244 Saccharomyces cerevisiae, 1,409 Aspergillus fumigatus, 389 A. flavus, 130 A. nidulans, 233 A. Niger, and 302 A. terreus complex isolates. SYO/Etest MICs for 282 confirmed non-wild-type (non-WT) isolates were included: ERG11 (C. albicans), ERG11 and MRR1 (C. parapsilosis), cyp51A (A. fumigatus), and CDR2 and CDR1 overexpression (C. albicans and C. glabrata, respectively). Interlaboratory modal agreement was superior by SYO for yeast species and by the Etest for Aspergillus spp. Distributions fulfilling CLSI criteria for epidemiological cutoff value (ECV) definition were pooled, and we proposed SYO ECVs for S. cerevisiae and 9 yeast and 3 Aspergillus species and Etest ECVs for 5 yeast and 4 Aspergillus species. The posaconazole SYO ECV of 0.06 g/ml for C. albicans and the Etest itraconazole ECV of 2 g/ml for A. fumigatus were the best predictors of non-WT isolates. These findings support the need for method-dependent ECVs, as, overall, the SYO appears to perform better for susceptibility testing of yeast species and the Etest appears to perform better for susceptibility testing of Aspergillus spp. Further evaluations should be conducted with more Candida mutants.",
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T1 - Method-dependent epidemiological cutoff values for detection of triazole resistance in Candida and Aspergillus species for the Sensititre Yeastone colorimetric broth and etest agar diffusion methods

AU - Espinel-Ingroff, A.

AU - Turnidge, J.

AU - Alastruey-Izquierdo, A.

AU - Botterel, F.

AU - Canton, E.

AU - Castro, C.

AU - Chen, Y. C.

AU - Chen, Y.

AU - Chryssanthou, E.

AU - Dannaoui, E.

AU - Garcia-Effron, G.

AU - Gonzalez, G. M.

AU - Govender, N. P.

AU - Guinea, J.

AU - Kidd, S.

AU - Lackner, M.

AU - Lass-Flörl, C.

AU - Linares-Sicilia, M. J.

AU - López-Soria, L.

AU - Magobo, R.

AU - Pelaez, T.

AU - Quindós, G.

AU - Rodriguez-Iglesia, M. A.

AU - Ruiz, M. A.

AU - Sánchez-Reus, F.

AU - Sanguinetti, M.

AU - Shields, R.

AU - Szweda, P.

AU - Tortorano, A.

AU - Wengenack, N. L.

AU - Bramati, S.

AU - Cavanna, C.

AU - DeLuca, C.

AU - Gelmi, M.

AU - Grancini, A.

AU - Lombardi, G.

AU - Meletiadis, J.

AU - Negri, C. E.

AU - Passera, M.

AU - Peman, J.

AU - Prigitano, A.

AU - Sala, E.

AU - Tejada, M.

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Although the Sensititre Yeast-One (SYO) and Etest methods are widely utilized, interpretive criteria are not available for triazole susceptibility testing of Candida or Aspergillus species. We collected fluconazole, itraconazole, posaconazole, and voriconazole SYO and Etest MICs from 39 laboratories representing all continents for (method/agent-dependent) 11,171 Candida albicans, 215 C. dubliniensis, 4,418 C. glabrata species complex, 157 C. guilliermondii (Meyerozyma guilliermondii), 676 C. krusei (Pichia kudriavzevii), 298 C. lusitaniae (Clavispora lusitaniae), 911 C. parapsilosis sensu stricto, 3,691 C. parapsilosis species complex, 36 C. metapsilosis, 110 C. orthopsilosis, 1,854 C. tropicalis, 244 Saccharomyces cerevisiae, 1,409 Aspergillus fumigatus, 389 A. flavus, 130 A. nidulans, 233 A. Niger, and 302 A. terreus complex isolates. SYO/Etest MICs for 282 confirmed non-wild-type (non-WT) isolates were included: ERG11 (C. albicans), ERG11 and MRR1 (C. parapsilosis), cyp51A (A. fumigatus), and CDR2 and CDR1 overexpression (C. albicans and C. glabrata, respectively). Interlaboratory modal agreement was superior by SYO for yeast species and by the Etest for Aspergillus spp. Distributions fulfilling CLSI criteria for epidemiological cutoff value (ECV) definition were pooled, and we proposed SYO ECVs for S. cerevisiae and 9 yeast and 3 Aspergillus species and Etest ECVs for 5 yeast and 4 Aspergillus species. The posaconazole SYO ECV of 0.06 g/ml for C. albicans and the Etest itraconazole ECV of 2 g/ml for A. fumigatus were the best predictors of non-WT isolates. These findings support the need for method-dependent ECVs, as, overall, the SYO appears to perform better for susceptibility testing of yeast species and the Etest appears to perform better for susceptibility testing of Aspergillus spp. Further evaluations should be conducted with more Candida mutants.

AB - Although the Sensititre Yeast-One (SYO) and Etest methods are widely utilized, interpretive criteria are not available for triazole susceptibility testing of Candida or Aspergillus species. We collected fluconazole, itraconazole, posaconazole, and voriconazole SYO and Etest MICs from 39 laboratories representing all continents for (method/agent-dependent) 11,171 Candida albicans, 215 C. dubliniensis, 4,418 C. glabrata species complex, 157 C. guilliermondii (Meyerozyma guilliermondii), 676 C. krusei (Pichia kudriavzevii), 298 C. lusitaniae (Clavispora lusitaniae), 911 C. parapsilosis sensu stricto, 3,691 C. parapsilosis species complex, 36 C. metapsilosis, 110 C. orthopsilosis, 1,854 C. tropicalis, 244 Saccharomyces cerevisiae, 1,409 Aspergillus fumigatus, 389 A. flavus, 130 A. nidulans, 233 A. Niger, and 302 A. terreus complex isolates. SYO/Etest MICs for 282 confirmed non-wild-type (non-WT) isolates were included: ERG11 (C. albicans), ERG11 and MRR1 (C. parapsilosis), cyp51A (A. fumigatus), and CDR2 and CDR1 overexpression (C. albicans and C. glabrata, respectively). Interlaboratory modal agreement was superior by SYO for yeast species and by the Etest for Aspergillus spp. Distributions fulfilling CLSI criteria for epidemiological cutoff value (ECV) definition were pooled, and we proposed SYO ECVs for S. cerevisiae and 9 yeast and 3 Aspergillus species and Etest ECVs for 5 yeast and 4 Aspergillus species. The posaconazole SYO ECV of 0.06 g/ml for C. albicans and the Etest itraconazole ECV of 2 g/ml for A. fumigatus were the best predictors of non-WT isolates. These findings support the need for method-dependent ECVs, as, overall, the SYO appears to perform better for susceptibility testing of yeast species and the Etest appears to perform better for susceptibility testing of Aspergillus spp. Further evaluations should be conducted with more Candida mutants.

KW - Antifungal resistance

KW - Aspergillus spp

KW - Candida albicans

KW - Candida glabrata

KW - Etest method ECVs

KW - Etest MICs for fungal mutants

KW - SYO method ECVs

KW - SYO MICs for fungal mutants

KW - Triazole ECVs

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