title: International Evaluation of MIC Distributions and Epidemiological Cutoff Value (ECV) Definitions for Fusarium Species Identified by Molecular Methods for the CLSI Broth Microdilution Method.
abstract: The CLSI epidemiological cutoff values (ECVs) of antifungal agents are available for various Candida spp., Aspergillus spp., and the Mucorales. However, those categorical endpoints have not been established for Fusarium spp., mostly due to the difficulties associated with collecting sufficient CLSI MICs for clinical isolates identified according to the currently recommended molecular DNA-PCR-based identification methodologies. CLSI MIC distributions were established for 53 Fusarium dimerum species complex (SC), 10 F. fujikuroi, 82 F. proliferatum, 20 F. incarnatum-F. equiseti SC, 226 F. oxysporum SC, 608 F. solani SC, and 151 F. verticillioides isolates originating in 17 laboratories (in Argentina, Australia, Brazil, Canada, Europe, Mexico, and the United States). According to the CLSI guidelines for ECV setting, ECVs encompassing ≥97.5% of pooled statistically modeled MIC distributions were as follows: for amphotericin B, 4 μg/ml (F. verticillioides) and 8 μg/ml (F. oxysporum SC and F. solani SC); for posaconazole, 2 μg/ml (F. verticillioides), 8 μg/ml (F. oxysporum SC), and 32 μg/ml (F. solani SC); for voriconazole, 4 μg/ml (F. verticillioides), 16 μg/ml (F. oxysporum SC), and 32 μg/ml (F. solani SC); and for itraconazole, 32 μg/ml (F. oxysporum SC and F. solani SC). Insufficient data precluded ECV definition for the other species. Although these ECVs could aid in detecting non-wild-type isolates with reduced susceptibility to the agents evaluated, the relationship between molecular mechanisms of resistance (gene mutations) and MICs still needs to be investigated for Fusarium spp.
authors.affiliation: VCU Medical Center, Richmond, Virginia, USA avingrof@vcu.edu.
authors.forename: A
authors.initials: A
authors.lastname: Espinel-Ingroff
authors.affiliation: Universidade Federal de São Paulo, São Paulo, Brazil.
authors.forename: A L
authors.initials: AL
authors.lastname: Colombo
authors.affiliation: Instituto Nacional de Enfermedades Infecciosas "Dr. C. G. Malbrán," Buenos Aires, Argentina.
authors.forename: S
authors.initials: S
authors.lastname: Cordoba
authors.affiliation: Institut National de Santé Publique du Québec, Laboratoire de Santé Publique du Québec, Sainte-Anne-de-Bellevue, Quebec, Canada.
authors.forename: P J
authors.initials: PJ
authors.lastname: Dufresne
authors.affiliation: Provincial Laboratory, Alberta Health Services, Edmonton, Canada.
authors.forename: J
authors.initials: J
authors.lastname: Fuller
authors.affiliation: University Hospitals Case Medical Center and Case Western Reserve University, Cleveland, Ohio, USA.
authors.forename: M
authors.initials: M
authors.lastname: Ghannoum
authors.affiliation: Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, Mexico.
authors.forename: G M
authors.initials: GM
authors.lastname: Gonzalez
authors.affiliation: Facultat de Medicina, IISPV, URV, Reus, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Guarro
authors.affiliation: National Mycology Reference Centre, SA Pathology, Adelaide, Australia.
authors.forename: S E
authors.initials: SE
authors.lastname: Kidd
authors.affiliation: Department of Medical Microbiology and Infectious Diseases, Canisius Wilhelmina Hospital and Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: J F
authors.identifier: http://orcid.org/0000-0003-3253-6080
authors.initials: JF
authors.lastname: Meis
authors.affiliation: The Instituto Adolfo Lutz Reference Center, São Paulo, Brazil.
authors.forename: T M S C
authors.initials: TM
authors.lastname: Melhem
authors.affiliation: Hospital General Universitario Gregorio Marañón, School of Medicine-Universidad Complutense, Madrid, Spain.
authors.forename: T
authors.initials: T
authors.lastname: Pelaez
authors.affiliation: JMI Laboratories, North Liberty, Iowa, USA.
authors.forename: M A
authors.initials: MA
authors.lastname: Pfaller
authors.affiliation: Mycology Department, The Instituto Adolfo Lutz Reference Center, São Paulo, Brazil.
authors.forename: M W
authors.initials: MW
authors.lastname: Szeszs
authors.affiliation: Grupo Fleury, São Paulo, Brazil.
authors.forename: J P
authors.initials: JP
authors.lastname: Takahaschi
authors.affiliation: Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy.
authors.forename: A M
authors.identifier: http://orcid.org/0000-0003-2093-8250
authors.initials: AM
authors.lastname: Tortorano
authors.affiliation: University of Texas Health Science Center, San Antonio, Texas, USA.
authors.forename: N P
authors.initials: NP
authors.lastname: Wiederhold
authors.affiliation: University of Adelaide, Adelaide, Australia.
authors.forename: J
authors.initials: J
authors.lastname: Turnidge
mesh_terms: D000569:Americas; D000935:Antifungal Agents / Q000494:pharmacology*; D026141:Drug Resistance, Multiple, Fungal; D005060:Europe; D005670:Fusarium / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification; D006801:Humans; D008826:Microbial Sensitivity Tests / Q000379:methods*; D016133:Polymerase Chain Reaction / Q000379:methods
chemical_list: D000935:Antifungal Agents