title: Comparison of the broth microdilution (BMD) method of the European Committee on Antimicrobial Susceptibility Testing and the Clinical Laboratory Standards Institute BMD method for non-Candida albicans and non-C. tropicalis bloodstream isolates from eleven tertiary hospitals in São Paulo state, Brazil.
abstract: We aim in this study to provide levels of susceptibility of 162 bloodstream isolates of non-Candida albicans and non-C. tropicalis species from a sentinel program conducted in 11 hospitals in Brazil. Additionally, we compared the broth microdilution (BMD) method of the European Committee of Susceptibility Testing (EUCAST) with Clinical Laboratory Standards Institute (CLSI) BMD method for fluconazole, itraconazole, voriconazole, and amphotericin B. The study included 103 C. parapsilosis, 38 C. glabrata, 8 C. orthopsilosis, and 7 C. krusei isolates, and single isolates of Pichia anomala, C. famata, C. lusitaniae, C. kefyr, C. guilliermondii, and C. metapsilosis. Of note, we observed cross-resistance between fluconazole and voriconazole for two isolates being one C. parapsilosis and one C. glabrata. Good essential agreement (EA) was observed between the EUCAST and the CLSI results for C. parapsilosis and for fluconazole, itraconazole, voriconazole, and amphotericin B, respectively: 98%, 99%, 98%, and 97%. Otherwise, for C. glabrata, the EA for fluconazole was 84.2% and for voriconazole 89.4%. Because data from Brazil are scarce, our results contribute to the consolidation of the database of candidemia agents and monitoring of trends in the profile of drug resistance.
authors.affiliation: Adolfo Lutz Institute, Coordination of Disease Control, Secretary of Health, Government of São Paulo State, Brazil.
authors.forename: Sonia U
authors.initials: SU
authors.lastname: Purisco
authors.forename: Marilena A
authors.initials: MA
authors.lastname: Martins
authors.forename: Maria W
authors.initials: MW
authors.lastname: Szeszs
authors.forename: Dulcilena M
authors.initials: DM
authors.lastname: Castro e Silva
authors.forename: Sandra R B S
authors.initials: SR
authors.lastname: Pukinskas
authors.forename: Lucas X
authors.initials: LX
authors.lastname: Bonfietti
authors.forename: Andres A
authors.initials: AA
authors.lastname: Baez
authors.forename: Marcia S C
authors.initials: MS
authors.lastname: Melhem
mesh_terms: D000666:Amphotericin B / Q000494:pharmacology; D000935:Antifungal Agents / Q000494:pharmacology; D001769:Blood / Q000382:microbiology; D001938:Brazil; D002175:Candida / Q000145:classification / Q000187:drug effects* / Q000302:isolation & purification*; D058387:Candidemia / Q000188:drug therapy / Q000382:microbiology; D004271:DNA, Fungal / Q000235:genetics; D025141:Drug Resistance, Fungal / Q000187:drug effects*; D015725:Fluconazole / Q000494:pharmacology; D006801:Humans; D017964:Itraconazole / Q000494:pharmacology; D008826:Microbial Sensitivity Tests / Q000379:methods*; D010843:Pichia / Q000145:classification / Q000187:drug effects / Q000302:isolation & purification; D011743:Pyrimidines / Q000494:pharmacology; D062606:Tertiary Care Centers; D014230:Triazoles / Q000494:pharmacology; D065819:Voriconazole
chemical_list: D000935:Antifungal Agents; D004271:DNA, Fungal; D011743:Pyrimidines; D014230:Triazoles; D017964:Itraconazole; D000666:Amphotericin B; D015725:Fluconazole; D065819:Voriconazole