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MULTICENTER, INTERNATIONAL STUDY OF MIC/MEC DISTRIBUTIONS FOR DEFINITION OF EPIDEMIOLOGICAL CUTOFF VALUES FOR SPOROTHRIX SPECIES IDENTIFIED BY MOLECULAR METHODS
A. Espinel-Ingroff,a D. P. B. Abreu,b R. Almeida-Paes,c R. S. N. Brilhante,d A. Chakrabarti,e A. Chowdhary,f F. Hagen,g S. Córdoba,h G. M. Gonzalez,i N. P. Govender,j J. Guarro,k E. M. Johnson,l S. E. Kidd,m S. A. Pereira,c A. M. Rodrigues,n S. Rozental,o M. W. Szeszs,p R. Ballesté Alaniz,q A. Bonifaz,r L. X. Bonfietti,p L. P. Borba-Santos,o J. Capilla,k A. L. Colombo,n M. Dolande,s M. G. Isla,h M. S. C. Melhem,p A. C. Mesa-Arango,t M. M. E. Oliveira,c M. M. Panizo,s Z. Pires de Camargo,n R. M. Zancope-Oliveira,c J. F. Meis,g J. Turnidgeu VCU Medical Center, Richmond, Virginia, USAa; Universidade Federal Rural do Rio de Janeiro, Seropédica, Brazilb; Fundação Oswaldo Cruz-Fiocruz, Instituto Nacional de Infectologia Evandro Chagas, Laboratório de Micologia, Rio de Janeiro, RJ, Brazilc; Specialized Medical Mycology Center, Federal University of Ceará, Fortaleza-CE, Brazild; Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, Indiae; Department of Medical Mycology, Vallabhbhai Patel Chest Institute, University of Delhi, Delhi, Indiaf; Canisius Wilhelmina Hospital, Centre of Expertise in Mycology, Nijmegen, The Netherlandsg; Departamento Micologia; Instituto Nacional de Enfermedades Infecciosas Dr. C. G. Malbrán, Buenos Aires, Argentinah; Universidad Autonóma de Nuevo León, Monterrey, Nuevo León, Méxicoi; National Institute for Communicable Diseases and University of the Witwatersrand, Johannesburg, South Africaj; Mycology Unit Medical School, Universitat Rovira i Virgili, Reus, Spaink ; Mycology Reference Laboratory, Public Health England, Bristol, United Kingdoml ; National Mycology Reference Centre, SA Pathology, Adelaide, Australiam; Universidade Federal de São Paulo, São Paulo, Braziln; Instituto de Biofísica, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazilo; Instituto Adolfo Lutz, Araçatuba, Rio Claro Laboratories, São Paulo, Brazilp; Departamento de Laboratorio Clínico, Hospital de Clínicas Dr. M. Quintela, Facultad de Medicina, Universidad de la República, Montevideo, Uruguayq; Hospital General de Mexico, Mexico City, Mexicor; Instituto Nacional de Higiene Rafael Rangel, Caracas, Venezuelas ; Grupo de Investigación Dermatológica, Universidad de Antioquía, Medellín, Colombiat ; University of Adelaide, Adelaide, Australiau.
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Clinical and Laboratory Standards Institute (CLSI) conditions for testing the susceptibilities of pathogenic Sporothrix species to antifungal agents are based on a collaborative study that evaluated five clinically relevant isolates of Sporothrixschenckii sensu lato and some antifungal agents. With the advent of molecular identification, there are two basic needs: to confirm the suitability of these testing conditions for all agents and Sporothrix species and to establish species-specific epidemiologic cutoff values (ECVs) or breakpoints (BPs) for the species. We collected available CLSI MICs/minimal effective concentrations (MECs) of amphotericin B, five triazoles, terbinafine, flucytosine, and caspofungin for 301 Sporothrix schenckii sensu stricto, 486 S. brasiliensis, 75 S. globosa, and 13 S. mexicana molecularly identified isolates. Data were obtained in 17 independent laboratories (Australia, Europe, India, South Africa, and South and North America) using conidial inoculum suspensions and 48 to 72 h of incubation at 35°C. Sufficient and suitable data (modal MICs within 2-fold concentrations) allowed the proposal of the following ECVs for S. schenckii and S. brasiliensis, respectively: amphotericin B, 4 and 4 μg/ml; itraconazole, 2 and 2 μg/ml; posaconazole, 2 and 2 μg/ml; and voriconazole, 64 and 32 μg/ml. Ketoconazole and terbinafine ECVs for S. brasiliensis were 2 and 0.12 μg/ml, respectively. Insufficient or unsuitable data precluded the calculation of ketoconazole and terbinafine (or any other antifungal agent) ECVs for S. schenckii, as well as ECVs for S. globosa and S. mexicana These ECVs could aid the clinician in identifying potentially resistant isolates (non-wild type) less likely to respond to therapy.
Editor
American Society for Microbiology
Referência
ESPINEL-INGROFF, A. et al. Multicenter, International Study of MIC/ MEC distributions for definition of epidemiological cutoff values for Sporothrix species identified by molecular methods. Antimicrobial Agents and Chemotherapy, v. 61, n. 10, p. 1-8, Oct. 2017.DOI
10.1128/AAC.01057-17ISSN
0066-4804Notas
Almeida-Paes, R. - Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Micologia. Rio de Janeiro, RJ, Brazil. Oliveira, M. M. E. - Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Micologia. Rio de Janeiro, RJ, Brazil. Zancope-Oliveira, R. M. - Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Micologia. Rio de Janeiro, RJ, Brazil.A. Espinel-Ingroff,a D. P. B. Abreu,b R. Almeida-Paes,c R. S. N. Brilhante,d A. Chakrabarti,e A. Chowdhary,f F. Hagen,g S. Córdoba,h G. M. Gonzalez,i N. P. Govender,j J. Guarro,k E. M. Johnson,l S. E. Kidd,m S. A. Pereira,c A. M. Rodrigues,n S. Rozental,o M. W. Szeszs,p R. Ballesté Alaniz,q A. Bonifaz,r L. X. Bonfietti,p L. P. Borba-Santos,o J. Capilla,k A. L. Colombo,n M. Dolande,s M. G. Isla,h M. S. C. Melhem,p A. C. Mesa-Arango,t M. M. E. Oliveira,c M. M. Panizo,s Z. Pires de Camargo,n R. M. Zancope-Oliveira,c J. F. Meis,g J. Turnidgeu VCU Medical Center, Richmond, Virginia, USAa; Universidade Federal Rural do Rio de Janeiro, Seropédica, Brazilb; Fundação Oswaldo Cruz-Fiocruz, Instituto Nacional de Infectologia Evandro Chagas, Laboratório de Micologia, Rio de Janeiro, RJ, Brazilc; Specialized Medical Mycology Center, Federal University of Ceará, Fortaleza-CE, Brazild; Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, Indiae; Department of Medical Mycology, Vallabhbhai Patel Chest Institute, University of Delhi, Delhi, Indiaf; Canisius Wilhelmina Hospital, Centre of Expertise in Mycology, Nijmegen, The Netherlandsg; Departamento Micologia; Instituto Nacional de Enfermedades Infecciosas Dr. C. G. Malbrán, Buenos Aires, Argentinah; Universidad Autonóma de Nuevo León, Monterrey, Nuevo León, Méxicoi; National Institute for Communicable Diseases and University of the Witwatersrand, Johannesburg, South Africaj; Mycology Unit Medical School, Universitat Rovira i Virgili, Reus, Spaink ; Mycology Reference Laboratory, Public Health England, Bristol, United Kingdoml ; National Mycology Reference Centre, SA Pathology, Adelaide, Australiam; Universidade Federal de São Paulo, São Paulo, Braziln; Instituto de Biofísica, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazilo; Instituto Adolfo Lutz, Araçatuba, Rio Claro Laboratories, São Paulo, Brazilp; Departamento de Laboratorio Clínico, Hospital de Clínicas Dr. M. Quintela, Facultad de Medicina, Universidad de la República, Montevideo, Uruguayq; Hospital General de Mexico, Mexico City, Mexicor; Instituto Nacional de Higiene Rafael Rangel, Caracas, Venezuelas ; Grupo de Investigación Dermatológica, Universidad de Antioquía, Medellín, Colombiat ; University of Adelaide, Adelaide, Australiau.
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