Susceptibility to XXXX of Candida spp. strains isolated in Italy assessed by European Committee for Antimicrobial Susceptibility Testing and Clinical Laboratory Standards Institute broth microdilution methods.

@entity1331 @entity1 @entity9841 @entity25928 @entity6923 @entity7408 @entity18203 @entity7409 @entity5132 @entity5626 @entity11794
BACKGROUND: The @entity5626 are recommended as first-line therapy for @entity6923 , but drug resistance, especially among @entity7408 , is becoming more frequent. We investigated the antifungal susceptibility of @entity25928 , @entity11794 , and @entity1331 against 584 isolates of Candida spp. (bloodstream, other sterile sites) collected from @entity1 admitted to an Italian university hospital between 2000 and 2013. The susceptibility was evaluated using the broth microdilution method according to both the European Committee for Antimicrobial Susceptibility Testing (EUCAST EDef 7.2) and the Clinical Laboratory Standards Institute (CLSI M27-A3). The echinocandin susceptibilities were assessed on the basis of the species-specific clinical breakpoints proposed by the EUCAST version 6.1 and CLSI M27-S4 documents. The two methods were comparable by assessing essential agreement (EA), categorical agreement (CA), and Spearman's correlation analysis (rho, r). RESULTS: The modal minimum inhibitory concentrations (MICs;  g     mL   (-1)) values by both methods (EUCAST/CLSI) for @entity25928 , @entity11794 , and @entity1331 for each species were, respectively, as follows: @entity5132 , 0.03/0.12, 0.016/0.5, and 0.016/0.008; @entity7409 complex, 2/1, 2/2, and 2/1; @entity9841 , 0.06/0.12, 0.06/0.12, and 0.06/0.12; @entity7408 complex, 0.03/0.25, 0.06/0.12, and 0.03/0.06; @entity18203 , 2/1, 2/2, and 2/2; and C. krusei, 0.06/0.12, 0.12/0.5, and 0.06/0.12. The overall resistance rates for EUCAST/CLSI were as follows: @entity25928 , 2.5/0.9  %; @entity11794 , breakpoint not available/3.8  %; @entity1331 , 2.7/1.5  %. @entity7408 complex was the least susceptible to all three @entity5626 , and the percentages of resistant isolates by EUCAST/CLSI were as follows: @entity25928 , 13.5/2.7 %; @entity11794 , breakpoint not available/16.2  %; @entity1331 , 18.9/13.5 %. The overall EA was 93  % for @entity1331 , 92  % for @entity25928 , and 90  % for @entity11794 . The CA was >90  % for all organism-drug combinations with the exception of @entity7408 and @entity25928 (89  %). Spearman's rho for EUCAST/CLSI was 0.89 (p   <   0.001) for @entity11794 , 0.85 (p   <   0.001) for @entity25928 , and 0.83 for @entity1331 (p   <   0.001). CONCLUSIONS: Independent of the procedure applied, no alarming resistance to the tested agents was found, although a reduced susceptibility was detected for @entity7408 complex. The EUCAST and CLSI methods produce similar MICs, indicating that using one method or the other should not result in susceptibilities different enough to affect treatment decisions.
