Title
Posaconazole MIC distributions for aspergillus fumigatus species complex by four methods: Impact of cyp51a mutations on estimation of epidemiological cutoff values
Date Issued
01 April 2018
Access level
open access
Resource Type
journal article
Author(s)
Espinel-Ingroff A.
Turnidge J.
Alastruey-Izquierdo A.
Dannaoui E.
Garcia-Effron G.
Guinea J.
Kidd S.
Pelaez T.
Sanguinetti M.
Meletiadis J.
Botterel F.
Chen Y.C.
Chakrabarti A.
Chowdhary A.
Chryssanthou E.
Córdoba S.
Gonzalez G.M.
Guarro J.
Johnson E.M.
Kus J.V.
Lass-Flörl C.
Linares-Sicilia M.J.
Martín-Mazuelos E.
Negri C.E.
Pfaller M.A.
Tortorano A.M.
Universidad Peruana Cayetano Heredia
Publisher(s)
American Society for Microbiology
Abstract
Estimating epidemiological cutoff endpoints (ECVs/ECOFFS) may be hindered by the overlap of MICs for mutant and nonmutant strains (strains harboring or not harboring mutations, respectively). Posaconazole MIC distributions for theAspergillus fumigatus species complex were collected from 26 laboratories (in Australia, Canada, Europe, India, South and North America, and Taiwan) and published studies. Distributions that fulfilled CLSI criteria were pooled and ECVs were estimated. The sensitivity of three ECV analytical techniques (the ECOFFinder, normalized resistance interpretation [NRI], derivatization methods) to the inclusion of MICs for mutants was examined for three susceptibility testing methods (the CLSI, EUCAST, and Etest methods). The totals of posaconazole MICs for nonmutant isolates (isolates with no known cyp51A mutations) and mutant A. fumigatus isolates were as follows: by the CLSI method, 2,223 and 274, respectively; by the EUCAST method, 556 and 52, respectively; and by Etest, 1,365 and 29, respectively. MICs for 381 isolates with unknown mutational status were also evaluated with the Sensititre Yeast- One system (SYO). We observed an overlap in posaconazole MICs among nonmutants and cyp51A mutants. At the commonly chosen percentage of the modeled wild-type population (97.5%), almost all ECVs remained the same when the MICs for nonmutant and mutant distributions were merged: ECOFFinder ECVs, 0.5 μg/ml for the CLSI method and 0.25 μg/ml for the EUCAST method and Etest; NRI ECVs, 0.5 μg/ml for all three methods. However, the ECOFFinder ECV for 95% of the nonmutant population by the CLSI method was 0.25 μg/ml. The tentative ECOFFinder ECV with SYO was 0.06 μg/ml (data from 3/8 laboratories). Derivatization ECVs with or without mutant inclusion were either 0.25 μg/ml (CLSI, EUCAST, Etest) or 0.06 μg/ml (SYO). It appears that ECV analytical techniques may not be vulnerable to overlap between presumptive wild-type isolates and cyp51A mutants when up to 11.6% of the estimated wild-type population includes mutants.
Volume
62
Issue
4
Language
English
OCDE Knowledge area
Medicina tropical Epidemiología Biología celular, Microbiología
Scopus EID
2-s2.0-85044502384
PubMed ID
Source
Antimicrobial Agents and Chemotherapy
ISSN of the container
0066-4804
Sponsor(s)
Isolates: The isolates evaluated were recovered from deep infections, sterile and other sites (mostly [>90%] bronchoalveolar lavage fluids, sputum, and other respiratory related clinical specimens) at the following medicalcenters:VCU Medical Center, Richmond, VA, USA; Mycology Reference Laboratory, National Centre for Microbiology, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain; Hôpital Européen Georges Pompidou, Paris, France; Laboratorio de Micología y Diagnóstico Molecular-Facultad de Bioquímica y Ciencias Biológicas-Universidad Nacional del Litoral, Consejo Nacional de Investigaciones Científicas y Tecnológicas (CONICET), CCT, Santa Fe, Argentina; Servicio de Microbiología Clínica y Enfermedades Infecciosas-VIH, Hospital General Universitario Gregorio Marañon, and Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; National Mycology Reference Centre, SA Pathology, Adelaide, Australia; Servicio de Microbiología, Hospital Universitario Central de Asturias, Asturias, Spain; Institute of Microbiology, Università Cattolica del Sacro Cuore, Rome, Italy; Département de Bactériologie Virologie Hygiène Mycologie Parasitologie, Créteil, France;Instituto de Medicina Tropical Alexander von Humboldt-Universidad Peruana Cayetano Heredia, Lima, Peru;Department of Medical Microbiology, Postgraduate Institute of Medical Education & Research, Chandigarh, India; Department of Medical Mycology, Vallabhbhai Patel Chest Institute, University of Delhi, Delhi, India; Klinisk mikrobiologi, Karolinska, Universitetlaboratoriet, Karolinska, Universitetssjukhuset, Stockholm, Sweden; Instituto Nacional deEnfermedades Infecciosas “Dr. C. G. Malbrán”, Buenos Aires, Argentina; Universidad Autonóma de Nuevo León, Monterrey, Nuevo León, México; Mycology Unit Medical School, Universitat Rovira i Virgili, Reus, Spain; Mycology Reference Laboratory, Public Health England, Bristol, UK; Public Health Ontario, Ontario, Canada; National Mycology Reference Centre, Division of Hygiene and Medical Microbiology, Medical University of Innsbruck, Reference Laboratory, National Centre for Microbiology, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain;4Université Paris-Descartes, Faculté de Médecine, APHP, Hôpital Européen Georges Pompidou, Unité de Parasitologie-Mycologie, Service de Microbiologie, Paris, France; 5Laboratorio de Micología y Diagnóstico Molecular-Facultad de Bioquímica y Ciencias Biológicas-Universidad Nacional del Litoral, Consejo Nacional de Investigaciones CientíficasyTecnológicas (CONICET), CCT, Santa Fe, Argentina;6Servicio de Microbiología Clínica y Enfermedades Infecciosas-VIH, Hospital General Universitario Gregorio Marañon, and Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; 7National Mycology Reference Centre, Microbiology & Infectious Diseases, SA Pathology, Adelaide, Australia; 8Servicio de Microbiología, Hospital Universitario Central de Asturias, Asturias, Spain; 9Institute of Microbiology, Università Cattolicadel Sacro Cuore, Rome,Italy; 10Clinical Microbiology Laboratory, Attikon Hospital, Medical School, National and Kapodistrian, University of Athens; Athens, Greece; 11Département de Bactériologie Virologie Hygiène Mycologie Parasitologie, Créteil, France;12Instituto de MedicinaTropicalAlexander von Humboldt-Universidad Peruana Cayetano Heredia, Lima, Peru; 13Department of Internal Medicine, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan; 14Department of Medical Microbiology, Postgraduate Institute of Medical Education & Research, Chandigarh, India; 15Department of Medical Mycology, Vallabhbhai Patel Chest Institute, University of Delhi, Delhi, India; 16Klinisk mikrobiologi, Karolinska, Universitetlaboratoriet, Karolinska, Universitetssjukhuset, Stockholm, Sweden; 17Instituto Nacional de Enfermedades Infecciosas “Dr. C. G. Malbrán”, Buenos Aires, Argentina; 18Universidad Autonóma de Nuevo León, Monterrey, Nuevo León, México; 19Mycology Unit Medical School, Universitat Rovira i Virgili, Reus, Spain; 20Mycology Reference Laboratory, Public Health England, Bristol, UK; 21Public Health Ontario, Ontario, Canada;
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