1887

Abstract

The rising rates of invasive fungal infections caused by non- and the increasing emergence of antifungal resistance complicate the management of invasive candidiasis. Accurate and timely antifungal susceptibility testing is critical to targeting antifungal therapy. The purpose of this study was to compare commercially available susceptibility testing methods using prospectively collected isolates. Susceptibility testing was performed on 74 isolates collected from July 2014 to March 2015 using broth microdilution according to the Clinical and Laboratory Standards Institute method, Etest, Vitek 2 (YS-05) and Sensititre. Essential agreement and categorical agreement (CA) were assessed using the reference method. Of the 34 total blood isolates collected, comprised only 38 % (13) of the spp. with being nearly as prevalent (29 %, 10). CA using Etest was 86 % for fluconazole, 72 % for caspofungin, 98 % for micafungin and 97 % for anidulafungin. Vitek 2 CA was 90 % for fluconazole and 98 % for caspofungin. Sensititre CA was 93 % for fluconazole, 98 % for caspofungin, 98 % for micafungin and 100 % for anidulafungin. Although our study tested a small population of isolates, our results were variable by method. When implementing antifungal susceptibility testing, clinicians should be aware of the strengths and limitations of each testing method.

Loading

Article metrics loading...

/content/journal/jmm/10.1099/jmm.0.000383
2016-12-16
2024-12-03
Loading full text...

Full text loading...

/deliver/fulltext/jmm/65/12/1445.html?itemId=/content/journal/jmm/10.1099/jmm.0.000383&mimeType=html&fmt=ahah

References

  1. Alexander B. D., Byrne T. C., Smith K. L., Hanson K. E., Anstrom K. J., Perfect J. R., Reller L. B. 2007; Comparative evaluation of Etest and Sensititre YeastOne panels against the Clinical and Laboratory Standards Institute M27-A2 reference broth microdilution method for testing Candida susceptibility to seven antifungal agents. J Clin Microbiol 45:698706 [View Article][PubMed]
    [Google Scholar]
  2. Alexander B. D., Johnson M. D., Pfeiffer C. D., Jiménez-Ortigosa C., Catania J., Booker R., Castanheira M., Messer S. A., Perlin D. S. et al. 2013; Increasing echinocandin resistance in Candida glabrata: clinical failure correlates with presence of FKS mutations and elevated minimum inhibitory concentrations. Clin Infect Dis 56:17241732 [View Article][PubMed]
    [Google Scholar]
  3. Alp S., Sancak B., Hascelik G., Arikan S. 2009; Influence of different susceptibility testing methods and media on determination of the relevant fluconazole minimum inhibitory concentrations for heavy trailing Candida isolates with low-high phenotype. Mycoses 53:475480 [View Article]
    [Google Scholar]
  4. Andes D. R., Safdar N., Baddley J. W., Playford G., Reboli A. C., Rex J. H., Sobel J. D., Pappas P. G., Kullberg B. J. Mycoses Study Group 2012; Impact of treatment strategy on outcomes in patients with candidemia and other forms of invasive candidiasis: a patient-level quantitative review of randomized trials. Clin Infect Dis 54:11101122 [View Article][PubMed]
    [Google Scholar]
  5. Arendrup M. C., Pfaller M. A. Danish Fungaemia Study Group 2012; Caspofungin Etest susceptibility testing of Candida species: risk of misclassification of susceptible isolates of C. glabrata and C. krusei when adopting the revised CLSI caspofungin breakpoints. Antimicrob Agents Chemother 56:39653968 [View Article][PubMed]
    [Google Scholar]
  6. Arendrup M. C., Dzajic E., Jensen R. H., Johansen H. K., Kjaeldgaard P., Knudsen J. D., Kristensen L., Leitz C., Lemming L. E. et al. 2013; Epidemiological changes with potential implication for antifungal prescription recommendations for fungaemia: data from a nationwide fungaemia surveillance programme. Clin Microbiol Infect 19:E343E353 [View Article][PubMed]
    [Google Scholar]
  7. Beyda N. D., John J., Kilic A., Alam M. J., Lasco T. M., Garey K. W. 2014; FKS mutant Candida glabrata: risk factors and outcomes in patients with candidemia. Clin Infect Dis 59:819825 [View Article][PubMed]
    [Google Scholar]
  8. Bustamante B., Martins M. A., Bonfietti L. X., Szeszs M. W., Jacobs J., Garcia C., Melhem M. S. 2014; Species distribution and antifungal susceptibility profile of Candida isolates from bloodstream infections in Lima, Peru. J Med Microbiol 63:855860 [View Article][PubMed]
    [Google Scholar]
  9. Castanheira M., Messer S. A., Jones R. N., Farrell D. J., Pfaller M. A. 2014; Activity of echinocandins and triazoles against a contemporary (2012) worldwide collection of yeast and moulds collected from invasive infections. Int J Antimicrob Agents 44:320326 [View Article][PubMed]
    [Google Scholar]
  10. CLSI 2008 Reference Method for Broth Dilution Antifungal Susceptibility Testing of Yeasts, 3rd edn.M27A3 Wayne, PA: Clinical and Laboratory Standards Institute;
    [Google Scholar]
  11. CLSI 2012 Reference Method for Broth Dilution Antifungal Susceptibility Testing of Yeasts; 4th Informational Supplement, M27-S4 Wayne, PA: Clinical and Laboratory Standards Institute;
    [Google Scholar]
  12. Cuenca-Estrella M., Gomez-Lopez A., Alastruey-Izquierdo A., Bernal-Martinez L., Cuestra I., Buitrago M. J., Rodriguez-Tudela J. L. 2010; Comparison of the Vitek 2 antifungal susceptibility system with the Clinical and Laboratory Standards Institute (CLSI) and European Committee on Antimicrobial Susceptibility Testing (EUCAST) broth microdilution reference methods and with the Sensititre YeastOne and Etest techniques for in vitro detection of antifungal resistance in yeast isolates. J Clin Microbiol 48:17821786
    [Google Scholar]
  13. Eschenauer G. A., Nguyen M. H., Shoham S., Vazquez J. A., Morris A. J., Pasculle W. A., Kubin C. J., Klinker K. P., Carver P. L. et al. 2014; Real-world experience with echinocandin MICs against Candida species in a multicenter study of hospitals that routinely perform susceptibility testing of bloodstream isolates. Antimicrob Agents Chemother 58:18971906 [View Article][PubMed]
    [Google Scholar]
  14. Espinel-Ingroff A., Arendrup M. C., Pfaller M. A., Bonfietti L. X., Bustamante B., Canton E., Chryssanthou E., Cuenca-Estrella M., Dannaoui E. et al. 2013; Interlaboratory variability of caspofungin MICs for Candida spp. using CLSI and EUCAST methods: should the clinical laboratory be testing this agent?. Antimicrob Agents Chemother 57:58365842 [View Article][PubMed]
    [Google Scholar]
  15. Espinel-Ingroff A., Alvarez-Fernandez M., Cantón E., Carver P. L., Chen S. C., Eschenauer G., Getsinger D. L., Gonzalez G. M., Govender N. P. et al. 2015; Multicenter study of epidemiological cutoff values and detection of resistance in Candida spp. to anidulafungin, caspofungin, and micafungin using the Sensititre YeastOne colorimetric method. Antimicrob Agents Chemother 59:67256732 [View Article][PubMed]
    [Google Scholar]
  16. EUCAST 2016 Antifungal Agents; Breakpoint Tables for Interpretation of MICs. Version 8. European Committee on Antimicrobial Susceptibility Testing
  17. Magill S. S., Edwards J. R., Bamberg W., Beldavs Z. G., Dumyati G., Kainer M. A., Lynfield R., Maloney M., McAllister-Hollod L. et al. 2014; Multistate point-prevalence survey of health care-associated infections. N Engl J Med 370:11981208 [View Article][PubMed]
    [Google Scholar]
  18. Pappas P. G., Kauffman C. A., Andes D. R., Clancy C. J., Marr K. A., Ostrosky-Zeichner L., Reboli A. C., Schuster M. G., Vazquez J. A. et al. 2016; Clinical practice guideline for the management of candidiasis: 2016 update by the Infectious Diseases Society of America. Clin Infect Dis 62:e1-50 [View Article][PubMed]
    [Google Scholar]
  19. Peterson J. F., Pfaller M. A., Diekema D. J., Rinaldi M. G., Riebe K. M., Ledeboer N. A. 2011; Multicenter comparison of the Vitek 2 antifungal susceptibility test with the CLSI broth microdilution reference method for testing caspofungin, micafungin, and posaconazole against Candida spp. J Clin Microbiol 49:17651771 [View Article][PubMed]
    [Google Scholar]
  20. Pfaller M. A., Diekema D. J., Messer S. A., Boyken L., Huynh H., Hollis R. J. 2002; Clinical evaluation of a frozen commercially prepared microdilution panel for antifungal susceptibility testing of seven antifungal agents, including the new triazoles posaconazole, ravuconazole, and voriconazole. J Clin Microbiol 40:16941697 [View Article][PubMed]
    [Google Scholar]
  21. Pfaller M. A., Jones R. N. Microbiology Resource Committee, College of American Pathologists 2006; Performance accuracy of antibacterial and antifungal susceptibility test methods: report from the College of American Pathologists Microbiology Surveys Program (2001–2003). Arch Pathol Lab Med 130:767778 [View Article][PubMed]
    [Google Scholar]
  22. Pfaller M. A., Andes D. R., Diekema D. J., Horn D. L., Reboli A. C., Rotstein C., Franks B., Azie N. E. 2014; Epidemiology and outcomes of invasive candidiasis due to non-albicans species of Candida in 2,496 patients: data from the Prospective Antifungal Therapy (PATH) registry 2004-2008. PLoS One 9:e101510 [View Article][PubMed]
    [Google Scholar]
  23. Posteraro B., Martucci R., La Sorda M., Fiori B., Sanglard D., De Carolis E., Florio A. R., Fadda G., Sanguinetti M. 2009; Reliability of the Vitek 2 yeast susceptibility test for detection of in vitro resistance to fluconazole and voriconazole in clinical isolates of Candida albicans and Candida glabrata . J Clin Microbiol 47:19271930 [View Article][PubMed]
    [Google Scholar]
  24. Posteraro B., Spanu T., Fiori B., De Maio F., De Carolis E., Giaquinto A., Prete V., De Angelis G., Torelli R. et al. 2015; Antifungal susceptibility profiles of bloodstream yeast isolates by Sensititre YeastOne over nine years at a large Italian teaching hospital. Antimicrob Agents Chemother 59:39443955 [View Article][PubMed]
    [Google Scholar]
  25. Reboli A. C., Rotstein C., Pappas P. G., Chapman S. W., Kett D. H., Kumar D., Betts R., Wible M., Goldstein B. P. et al. 2007; Anidulafungin versus fluconazole for invasive candidiasis. N Engl J Med 356:24722482 [View Article][PubMed]
    [Google Scholar]
  26. Shields R. K., Nguyen M. H., Press E. G., Updike C. L., Clancy C. J. 2013; Caspofungin MICs correlate with treatment outcomes among patients with Candida glabrata invasive candidiasis and prior echinocandin exposure. Antimicrob Agents Chemother 57:35283535 [View Article][PubMed]
    [Google Scholar]
  27. Siopi M., Tsala M., Siafakas N., Zerva L., Meletiadis J. 2015; Evaluation of the “dip effect” phenomenon in antifungal susceptibility testing of Candida spp. against echinocandins by use of gradient concentration strips. J Clin Microbiol 53:36543659 [View Article]
    [Google Scholar]
  28. Tortorano A. M., Prigitano A., Lazzarini C., Passera M., Deiana M. L., Cavinato S., De Luca C., Grancini A., Lo Cascio G. et al. 2013; A 1-year prospective survey of candidemia in Italy and changing epidemiology over one decade. Infection 41:655662 [View Article][PubMed]
    [Google Scholar]
  29. Wang E., Farmakiotis D., Yang D., McCue D. A., Kantarjian H. M., Kontoyiannis D. P., Mathisen M. S. 2015; The ever-evolving landscape of candidaemia in patients with acute leukaemia: non-susceptibility to caspofungin and multidrug resistance are associated with increased mortality. J Antimicrob Chemother 70:23622368 [View Article][PubMed]
    [Google Scholar]
  30. Wisplinghoff H., Bischoff T., Tallent S. M., Seifert H., Wenzel R. P., Edmond M. B. 2004; Nosocomial bloodstream infections in US hospitals: analysis of 24,179 cases from a prospective nationwide surveillance study. Clin Infect Dis 39:309317 [View Article][PubMed]
    [Google Scholar]
/content/journal/jmm/10.1099/jmm.0.000383
Loading
/content/journal/jmm/10.1099/jmm.0.000383
Loading

Data & Media loading...

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error