title: Establishment and Use of Epidemiological Cutoff Values for Molds and Yeasts by Use of the Clinical and Laboratory Standards Institute M57 Standard.
abstract: Breakpoints are used to predict whether an antifungal agent will be clinically effective against a particular fungal isolate. They are based on a combination of MIC values, pharmacokinetic/pharmacodynamic values, and clinical outcome data. For many fungus-antifungal combinations, these data might never be available. For these combinations, epidemiological cutoff values (ECVs) provide a methodology for categorizing isolates as either wild type (WT) or non-WT. In this review, we define ECVs, explain how they are generated using the CLSI methodology in standard M57, and describe how they can be used in clinical practice.
authors.affiliation: Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA gyi2@cdc.gov.
authors.forename: Shawn R
authors.initials: SR
authors.lastname: Lockhart
authors.affiliation: Center for Medical Mycology, University Hospitals Cleveland Medical Center and Case Western Reserve University, Cleveland, Ohio, USA.
authors.forename: Mahmoud A
authors.initials: MA
authors.lastname: Ghannoum
authors.affiliation: Division of Infectious Diseases and International Health, Departments of Medicine and Pathology, Duke University, Durham, North Carolina, USA.|Clinical Microbiology Laboratory, Departments of Medicine and Pathology, Duke University, Durham, North Carolina, USA.
authors.forename: Barbara D
authors.initials: BD
authors.lastname: Alexander
mesh_terms: D000935:Antifungal Agents / Q000494:pharmacology*; D041221:Candida glabrata / Q000187:drug effects*; D002177:Candidiasis / Q000188:drug therapy* / Q000453:epidemiology; D003453:Cryptococcosis / Q000188:drug therapy* / Q000453:epidemiology; D003455:Cryptococcus neoformans / Q000187:drug effects*; D025141:Drug Resistance, Fungal / Q000502:physiology*; D006801:Humans; D008826:Microbial Sensitivity Tests / Q000379:methods; D016896:Treatment Outcome
chemical_list: D000935:Antifungal Agents
keywords: ECV; breakpoint; epidemiological cutoff value