title: Susceptibility of Candida spp. isolated from blood cultures as evaluated using the M27-A3 and new M27-S4 approved breakpoints.
abstract: The high mortality rates associated with candidemia episodes and the emergence of resistance to antifungal agents necessitate the monitoring of the susceptibility of fungal isolates to antifungal treatments. The new, recently approved, species-specific clinical breakpoints (SS-CBPs)(M27-S4) for evaluating susceptibility require careful interpretation and comparison with the former proposals made using the M27-A3 breakpoints, both from CLSI. This study evaluated the susceptibility of the different species of Candida that were isolated from candidemias based on these two clinical breakpoints. Four hundred and twenty-two isolates were identified and, among them, C. parapsilosis comprised 46.68%, followed by C. albicans (35.78%), C. tropicalis (9.71%), C. glabrata (3.55%), C. lusitaniae (1.65%), C. guilliermondii (1.65%) and C. krusei (0.94%). In accordance with the M27-A3 criteria, 33 (7.81%) non-susceptible isolates were identified, of which 16 (3.79%) were resistant to antifungal agents. According to SS-CBPs, 80 (18.95%) isolates were non-susceptible, and 10 (2.36%) of these were drug resistant. When the total number of non-susceptible isolates was considered, the new SS-CBPs detected 2.4 times the number of isolates that were detected using the M27-A3 interpretative criteria. In conclusion, the detection of an elevated number of non-susceptible species has highlighted the relevance of evaluating susceptibility tests using new, species-specific clinical breakpoints (SS-CBPs), which could impact the profile of non-susceptible Candida spp. to antifungal agents that require continuous susceptibility monitoring.
authors.affiliation: Post-Graduate Program in Pharmaceutical Sciences, Health Science Center, Federal University of Santa Maria, Santa Maria, RS, Brazil.
authors.forename: Edileusa Rosa dos
authors.initials: ER
authors.lastname: Santos
authors.affiliation: University Hospital of Santa Maria, Santa Maria, RS, Brazil.
authors.forename: Camila F
authors.initials: CF
authors.lastname: Dal Forno
authors.affiliation: Post-Graduate Program in Pharmaceutical Sciences, Health Science Center, Federal University of Santa Maria, Santa Maria, RS, Brazil.
authors.forename: Mari Glei
authors.initials: MG
authors.lastname: Hernandez
authors.affiliation: Post-Graduate Program in Pharmaceutical Sciences, Health Science Center, Federal University of Santa Maria, Santa Maria, RS, Brazil.
authors.forename: Thaís Felli
authors.initials: TF
authors.lastname: Kubiça
authors.affiliation: Post-Graduate Program in Pharmaceutical Sciences, Health Science Center, Federal University of Santa Maria, Santa Maria, RS, Brazil.
authors.forename: Tarcieli P
authors.initials: TP
authors.lastname: Venturini
authors.affiliation: Post-Graduate Program in Pharmaceutical Sciences, Health Science Center, Federal University of Santa Maria, Santa Maria, RS, Brazil.
authors.forename: Francieli
authors.initials: F
authors.lastname: Chassot
authors.affiliation: Departament of Microbiology and Parasitology, Federal University of Santa Maria, Santa Maria, RS, Brazil.
authors.forename: Janio M
authors.initials: JM
authors.lastname: Santurio
authors.affiliation: Post-Graduate Program in Pharmaceutical Sciences, Health Science Center, Federal University of Santa Maria, Santa Maria, RS, Brazil.
authors.forename: Sydney Hartz
authors.initials: SH
authors.lastname: Alves
mesh_terms: D000935:Antifungal Agents / Q000494:pharmacology*; D002175:Candida / Q000145:classification / Q000187:drug effects*; D058387:Candidemia / Q000382:microbiology; D006801:Humans; D008826:Microbial Sensitivity Tests / Q000379:methods*
chemical_list: D000935:Antifungal Agents