title: Quality control and reference guidelines for CLSI broth microdilution susceptibility method (M 38-A document) for amphotericin B, itraconazole, posaconazole, and voriconazole.
abstract: Although standard conditions are available for testing the susceptibilities of filamentous fungi to antifungal agents by the Clinical and Laboratory Standards Institute (CLSI; formerly National Committee for Clinical Laboratory Standards) broth microdilution assay, quality control (QC) MIC limits have not been established for any mold-agent combination. This multicenter (eight-center) study documented the reproducibility of tests for one isolate of Paecilomyces variotii ATCC MYA-3630 and 11 other mold isolates (three isolates of Aspergillus fumigatus; two isolates of A. terreus; one isolate each of A. flavus, A. nidulans, Fusarium moniliforme, and F. solani; and two isolates of Scedosporium apiospermum) by the CLSI reference broth microdilution method (M 38-A document). Control limits (amphotericin B, 1 to 4 microg/ml; itraconazole, 0.06 to 0.5 microg/ml; posaconazole, 0.03 to 0.25 microg/ml; voriconazole, 0.015 to 0.12 microg/ml) for the selected QC P. variotii ATCC MYA-3630 were established by the analysis of replicate MIC results. Reference isolates and corresponding MIC ranges were also established for 6 of the 12 molds evaluated. MIC limits were not proposed for the other five molds tested due to low testing reproducibility for these isolates.
authors.affiliation: VCU Medical Center, Richmond, VA 23298-0049, USA. avingrof@hsc.vcu.edu
authors.forename: A
authors.initials: A
authors.lastname: Espinel-Ingroff
authors.forename: A
authors.initials: A
authors.lastname: Fothergill
authors.forename: M
authors.initials: M
authors.lastname: Ghannoum
authors.forename: E
authors.initials: E
authors.lastname: Manavathu
authors.forename: L
authors.initials: L
authors.lastname: Ostrosky-Zeichner
authors.forename: M
authors.initials: M
authors.lastname: Pfaller
authors.forename: M
authors.initials: M
authors.lastname: Rinaldi
authors.forename: W
authors.initials: W
authors.lastname: Schell
authors.forename: T
authors.initials: T
authors.lastname: Walsh
mesh_terms: D000666:Amphotericin B / Q000494:pharmacology*; D000935:Antifungal Agents / Q000494:pharmacology*; D025141:Drug Resistance, Fungal; D005658:Fungi / Q000145:classification / Q000187:drug effects*; D006801:Humans; D017964:Itraconazole / Q000494:pharmacology*; D008826:Microbial Sensitivity Tests / Q000592:standards; D010143:Paecilomyces / Q000187:drug effects; D011743:Pyrimidines / Q000494:pharmacology*; D011786:Quality Control; D014230:Triazoles / Q000494:pharmacology*; D065819:Voriconazole
chemical_list: D000935:Antifungal Agents; D011743:Pyrimidines; D014230:Triazoles; D017964:Itraconazole; C101425:posaconazole; D000666:Amphotericin B; D065819:Voriconazole