Ferran Sánchez-Reus, E. Sala, Javier Pemán, Nelesh P. Govender, Anna Prigitano, Anna Grancini, Emilia Cantón, Ana Espinel-Ingroff, M. Passera, Gloria M. González, A.M. Tortorano, Guillermo Garcia-Effron, Piotr Szweda, John D. Turnidge, Guillermo Quindós, Eric Dannaoui, M. Tejada, M.A. Ruiz, C. DeLuca, Leyre López-Soria, Jesús Guinea, R. Magobo, S. Bramati, Teresa Peláez, Yee-Chun Chen, M.A. Rodriguez-Iglesia, Françoise Botterel, Nancy L. Wengenack, J. Meletiadis, C. Cavanna, G. Lombardi, Cornelia Lass-Flörl, Sarah E. Kidd, Ana Alastruey-Izquierdo, Michaela Lackner, Ryan K. Shields, Maurizio Sanguinetti, Erja Chryssanthou, C. E. Negri, Y. Chen, Carmen Barroso Castro, M. Gelmi, and María José Linares-Sicilia
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. Fil: Espinel-Ingroff, A.. Virginia Commonwealth University Medical Center; Fil: Turnidge, J.. University of Adelaide; Australia Fil: Alastruey-Izquierdo, A.. Centro Nacional de Microbiologia; Fil: Botterel, F.. Mycologie; Fil: Canton, Eduardo. Instituto de Investigación Sanitaria la Fe; Fil: Castro, C.. Hospital Universitario de Valme; Fil: Chen, Y.-C.. National Taiwan University Hospital; Fil: Chen, Y.. Public Health Ontario; Fil: Chryssanthou, E.. Karolinska University Hospital; Fil: Dannaoui, E.. Universite Paris Descartes; Fil: Garcia, Guillermo Manuel. Universidad Nacional del Litoral; Argentina Fil: Gonzalez, G.M.. Universidad Autónoma de Nuevo León; Fil: Govender, N.P.. University of the Witwatersrand; Sudáfrica Fil: Guinea, J.. Hospital General Universitario Gregorio Marañon; Fil: Kidd, S.. National Mycology Reference Centre; Fil: Lackner, M.. Medizinische Universitat Innsbruck; Fil: Lass-Flörl, C.. Medizinische Universitat Innsbruck; Fil: Linares-Sicilia, M.J.. Universidad de Cordoba, Facultad de Medicina; Fil: López-Soria, L.. Hospital Universitario Cruces; Fil: Magobo, R.. Universite Paris Descartes; Fil: Pelaez, T.. Hospital Universitario Central de Asturias; Fil: Quindós, G.. Universidad del Pais Vasco - Euskal Herriko Unibertsitatea, Campus Bizkaia; Fil: Rodriguez-Iglesia, M.A.. Universidad de Cádiz; España Fil: Ruiz, M.A.. Instituto de Investigación Sanitaria Aragón; Fil: Sánchez-Reus, F.. Hospital de la Santa Creu I Sant Pau; Fil: Sanguinetti, M.. Università Cattolica del Sacro Cuore, Rome; Fil: Shields, R.. University of Pittsburgh at Johnstown; Estados Unidos. University of Pittsburgh; Estados Unidos Fil: Szweda, P.. Gdan´ Sk University Of Technology; Fil: Tortorano, A.. Università degli Studi di Milano; Italia Fil: Wengenack, N.L.. Mayo Clinic In Rochester, Minnesota; Fil: Bramati, S.. Azienda Ospedaliera San Gerardo Monza; Fil: Cavanna, C.. Fondazione Irccs Policlinico San Matteo; Fil: DeLuca, C.. Humanitas Research Hospital; Fil: Gelmi, M.. Spedali Civili Di Brescia; Fil: Grancini, A.. Ospedale Maggiore Policlinico Milano; Fil: Lombardi, G.. Ospedale Niguarda, Milan; Fil: Meletiadis, J.. University Of Athens Medical School; Fil: Negri, C.E.. Universidade Federal de Sao Paulo; Fil: Passera, M.. Microbiology Institute; Fil: Peman, J.. Hospital Universitari I Politècnic la Fe; Fil: Prigitano, A.. Università degli Studi di Milano; Italia Fil: Sala, E.. Asst Lariana; Fil: Tejada, M.. Irccs Policlinico San Donato