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Multicentre validation of a EUCAST method for the antifungal susceptibility testing of microconidia-forming dermatophytes

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Harvard

Arendrup, MC, Jørgensen, KM, Guinea, J, Lagrou, K, Chryssanthou, E, Hayette, M-P, Barchiesi, F, Lass-Flörl, C, Hamal, P, Dannaoui, E, Chowdhary, A & Meletiadis, J 2020, 'Multicentre validation of a EUCAST method for the antifungal susceptibility testing of microconidia-forming dermatophytes', The Journal of antimicrobial chemotherapy, bind 75, nr. 7, s. 1807-1819. https://doi.org/10.1093/jac/dkaa111

APA

Arendrup, M. C., Jørgensen, K. M., Guinea, J., Lagrou, K., Chryssanthou, E., Hayette, M-P., Barchiesi, F., Lass-Flörl, C., Hamal, P., Dannaoui, E., Chowdhary, A., & Meletiadis, J. (2020). Multicentre validation of a EUCAST method for the antifungal susceptibility testing of microconidia-forming dermatophytes. The Journal of antimicrobial chemotherapy, 75(7), 1807-1819. https://doi.org/10.1093/jac/dkaa111

CBE

Arendrup MC, Jørgensen KM, Guinea J, Lagrou K, Chryssanthou E, Hayette M-P, Barchiesi F, Lass-Flörl C, Hamal P, Dannaoui E, Chowdhary A, Meletiadis J. 2020. Multicentre validation of a EUCAST method for the antifungal susceptibility testing of microconidia-forming dermatophytes. The Journal of antimicrobial chemotherapy. 75(7):1807-1819. https://doi.org/10.1093/jac/dkaa111

MLA

Vancouver

Author

Arendrup, Maiken Cavling ; Jørgensen, Karin Meinike ; Guinea, Jesus ; Lagrou, Katrien ; Chryssanthou, Erja ; Hayette, Marie-Pierre ; Barchiesi, Francesco ; Lass-Flörl, Cornelia ; Hamal, Petr ; Dannaoui, Eric ; Chowdhary, Anuradha ; Meletiadis, Joseph. / Multicentre validation of a EUCAST method for the antifungal susceptibility testing of microconidia-forming dermatophytes. I: The Journal of antimicrobial chemotherapy. 2020 ; Bind 75, Nr. 7. s. 1807-1819.

Bibtex

@article{a1b683578a1948ad933561f540103baf,
title = "Multicentre validation of a EUCAST method for the antifungal susceptibility testing of microconidia-forming dermatophytes",
abstract = "OBJECTIVES: Terbinafine resistance is increasingly reported in Trichophyton, rendering susceptibility testing particularly important in non-responding cases. We performed a multicentre evaluation of six EUCAST-based methods.METHODS: Ten laboratories susceptibility tested terbinafine, itraconazole, voriconazole and amorolfine against a blinded panel of 38 terbinafine WT and target gene mutant isolates. E.Def 9.3.1 modifications included: medium with/without addition of chloramphenicol and cycloheximide (CC), incubation at 25°C to 28°C for 5-7 days and three MIC endpoints [visually and spectrophotometrically (90%/50% inhibition)], generating 7829 MICs. Quality control (QC) strains were Aspergillus flavus ATCC 204304 and CNM-CM1813. Eyeball, ECOFFinder (where ECOFF stands for epidemiological cut-off) and derivatization WT upper limits (WT-ULs), very major errors (VMEs; mutants with MICs ≤WT-ULs) and major errors (MEs; WT isolates with MICs >WT-ULs) were determined.RESULTS: MICs fell within the QC ranges for ATCC 204304/CNM-CM1813 for 100%/96% (voriconazole) and 84%/84% (itraconazole), respectively. Terbinafine MICs fell within 0.25-1 mg/L for 96%/92%, suggesting high reproducibility. Across the six methods, the number of terbinafine MEs varied from 2 to 4 (2.6%-5.2%) for Trichophyton rubrum and from 0 to 2 (0%-2.0%) for Trichophyton interdigitale. Modes for WT and mutant populations were at least seven 2-fold dilutions apart in all cases. Excluding one I121M/V237I T. rubrum mutant and two mixed WT/mutant T. interdigitale specimens, the numbers of VMEs were as follows: T. rubrum: CC visual, 1/67 (1.5%); CC spectrophotometric 90% inhibition, 3/59 (5.1%); and CC spectrophotometric 50% inhibition, 1/67 (1.5%); and T. interdigitale: none. Voriconazole and amorolfine MICs were quite uniform, but trailing growth complicated determination of itraconazole visual and spectrophotometric 90% inhibition MIC.CONCLUSIONS: Although none of the laboratories was experienced in dermatophyte testing, error rates were low. We recommend the CC spectrophotometric 50% inhibition method and provide QC ranges and WT-ULs for WT/non-WT classification.",
author = "Arendrup, {Maiken Cavling} and J{\o}rgensen, {Karin Meinike} and Jesus Guinea and Katrien Lagrou and Erja Chryssanthou and Marie-Pierre Hayette and Francesco Barchiesi and Cornelia Lass-Fl{\"o}rl and Petr Hamal and Eric Dannaoui and Anuradha Chowdhary and Joseph Meletiadis",
note = "{\textcopyright} The Author(s) 2020. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For permissions, please email: journals.permissions@oup.com.",
year = "2020",
month = jul,
day = "1",
doi = "10.1093/jac/dkaa111",
language = "English",
volume = "75",
pages = "1807--1819",
journal = "Journal of Antimicrobial Chemotherapy",
issn = "0305-7453",
publisher = "Oxford University Press",
number = "7",

}

RIS

TY - JOUR

T1 - Multicentre validation of a EUCAST method for the antifungal susceptibility testing of microconidia-forming dermatophytes

AU - Arendrup, Maiken Cavling

AU - Jørgensen, Karin Meinike

AU - Guinea, Jesus

AU - Lagrou, Katrien

AU - Chryssanthou, Erja

AU - Hayette, Marie-Pierre

AU - Barchiesi, Francesco

AU - Lass-Flörl, Cornelia

AU - Hamal, Petr

AU - Dannaoui, Eric

AU - Chowdhary, Anuradha

AU - Meletiadis, Joseph

N1 - © The Author(s) 2020. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For permissions, please email: journals.permissions@oup.com.

PY - 2020/7/1

Y1 - 2020/7/1

N2 - OBJECTIVES: Terbinafine resistance is increasingly reported in Trichophyton, rendering susceptibility testing particularly important in non-responding cases. We performed a multicentre evaluation of six EUCAST-based methods.METHODS: Ten laboratories susceptibility tested terbinafine, itraconazole, voriconazole and amorolfine against a blinded panel of 38 terbinafine WT and target gene mutant isolates. E.Def 9.3.1 modifications included: medium with/without addition of chloramphenicol and cycloheximide (CC), incubation at 25°C to 28°C for 5-7 days and three MIC endpoints [visually and spectrophotometrically (90%/50% inhibition)], generating 7829 MICs. Quality control (QC) strains were Aspergillus flavus ATCC 204304 and CNM-CM1813. Eyeball, ECOFFinder (where ECOFF stands for epidemiological cut-off) and derivatization WT upper limits (WT-ULs), very major errors (VMEs; mutants with MICs ≤WT-ULs) and major errors (MEs; WT isolates with MICs >WT-ULs) were determined.RESULTS: MICs fell within the QC ranges for ATCC 204304/CNM-CM1813 for 100%/96% (voriconazole) and 84%/84% (itraconazole), respectively. Terbinafine MICs fell within 0.25-1 mg/L for 96%/92%, suggesting high reproducibility. Across the six methods, the number of terbinafine MEs varied from 2 to 4 (2.6%-5.2%) for Trichophyton rubrum and from 0 to 2 (0%-2.0%) for Trichophyton interdigitale. Modes for WT and mutant populations were at least seven 2-fold dilutions apart in all cases. Excluding one I121M/V237I T. rubrum mutant and two mixed WT/mutant T. interdigitale specimens, the numbers of VMEs were as follows: T. rubrum: CC visual, 1/67 (1.5%); CC spectrophotometric 90% inhibition, 3/59 (5.1%); and CC spectrophotometric 50% inhibition, 1/67 (1.5%); and T. interdigitale: none. Voriconazole and amorolfine MICs were quite uniform, but trailing growth complicated determination of itraconazole visual and spectrophotometric 90% inhibition MIC.CONCLUSIONS: Although none of the laboratories was experienced in dermatophyte testing, error rates were low. We recommend the CC spectrophotometric 50% inhibition method and provide QC ranges and WT-ULs for WT/non-WT classification.

AB - OBJECTIVES: Terbinafine resistance is increasingly reported in Trichophyton, rendering susceptibility testing particularly important in non-responding cases. We performed a multicentre evaluation of six EUCAST-based methods.METHODS: Ten laboratories susceptibility tested terbinafine, itraconazole, voriconazole and amorolfine against a blinded panel of 38 terbinafine WT and target gene mutant isolates. E.Def 9.3.1 modifications included: medium with/without addition of chloramphenicol and cycloheximide (CC), incubation at 25°C to 28°C for 5-7 days and three MIC endpoints [visually and spectrophotometrically (90%/50% inhibition)], generating 7829 MICs. Quality control (QC) strains were Aspergillus flavus ATCC 204304 and CNM-CM1813. Eyeball, ECOFFinder (where ECOFF stands for epidemiological cut-off) and derivatization WT upper limits (WT-ULs), very major errors (VMEs; mutants with MICs ≤WT-ULs) and major errors (MEs; WT isolates with MICs >WT-ULs) were determined.RESULTS: MICs fell within the QC ranges for ATCC 204304/CNM-CM1813 for 100%/96% (voriconazole) and 84%/84% (itraconazole), respectively. Terbinafine MICs fell within 0.25-1 mg/L for 96%/92%, suggesting high reproducibility. Across the six methods, the number of terbinafine MEs varied from 2 to 4 (2.6%-5.2%) for Trichophyton rubrum and from 0 to 2 (0%-2.0%) for Trichophyton interdigitale. Modes for WT and mutant populations were at least seven 2-fold dilutions apart in all cases. Excluding one I121M/V237I T. rubrum mutant and two mixed WT/mutant T. interdigitale specimens, the numbers of VMEs were as follows: T. rubrum: CC visual, 1/67 (1.5%); CC spectrophotometric 90% inhibition, 3/59 (5.1%); and CC spectrophotometric 50% inhibition, 1/67 (1.5%); and T. interdigitale: none. Voriconazole and amorolfine MICs were quite uniform, but trailing growth complicated determination of itraconazole visual and spectrophotometric 90% inhibition MIC.CONCLUSIONS: Although none of the laboratories was experienced in dermatophyte testing, error rates were low. We recommend the CC spectrophotometric 50% inhibition method and provide QC ranges and WT-ULs for WT/non-WT classification.

U2 - 10.1093/jac/dkaa111

DO - 10.1093/jac/dkaa111

M3 - Journal article

C2 - 32303059

VL - 75

SP - 1807

EP - 1819

JO - Journal of Antimicrobial Chemotherapy

JF - Journal of Antimicrobial Chemotherapy

SN - 0305-7453

IS - 7

ER -

ID: 62342549