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首页> 外文期刊>Journal of Clinical Microbiology >Correlation of MIC with Outcome for Candida Species Tested against Caspofungin, Anidulafungin, and Micafungin: Analysis and Proposal for Interpretive MIC Breakpoints
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Correlation of MIC with Outcome for Candida Species Tested against Caspofungin, Anidulafungin, and Micafungin: Analysis and Proposal for Interpretive MIC Breakpoints

机译：针对卡泊芬净，阿尼芬净和米卡芬净测试的念珠菌种类的MIC与结果的相关性：解释性MIC断裂点的分析和建议

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The CLSI Antifungal Subcommittee followed the M23-A2 “blueprint” to develop interpretive MIC breakpoints for anidulafungin, caspofungin, and micafungin against Candida species. MICs of ≤2 μg/ml for all three echinocandins encompass 98.8 to 100% of all clinical isolates of Candida spp. without bisecting any species group and represent a concentration that is easily maintained throughout the dosing period. Data from phase III clinical trials demonstrate that the standard dosing regimens for each of these agents may be used to treat infections due to Candida spp. for which MICs are as high as 2 μg/ml. An MIC predictive of resistance to these agents cannot be defined based on the data from clinical trials due to the paucity of isolates for which MICs exceed 2 μg/ml. The clinical data set included only three isolates from patients treated with an echinocandin (caspofungin) for which the MICs were >2 μg/ml (two C. parapsilosis isolates at 4 μg/ml and one C. rugosa isolate at 8 μg/ml). Based on these data, the CLSI subcommittee has decided to recommend a “susceptible only” breakpoint MIC of ≤2 μg/ml due to the lack of echinocandin resistance in the population of Candida isolates thus far. Isolates for which MICs exceed 2 μg/ml should be designated “nonsusceptible” (NS). For strains yielding results suggestive of an NS category, the organism identification and antimicrobial-susceptibility test results should be confirmed. Subsequently, the isolates should be submitted to a reference laboratory that will confirm the results by using a CLSI reference dilution method.
机译：CLSI抗真菌小组委员会遵循了M23-A2“蓝图”，以开发针对 Candida 物种的阿尼芬净，卡泊芬净和米卡芬净的解释性MIC断裂点。所有三种棘球and素的MIC≤2μg/ ml，占 Candida spp所有临床分离株的98.8％至100％。不会将任何物种分组一分为二，并且代表在整个给药期间内容易保持的浓度。来自III期临床试验的数据表明，每种药物的标准给药方案均可用于治疗因 Candida spp引起的感染。 MIC高达2μg/ ml。由于来自MICs超过2μg/ ml的分离株很少，因此无法根据临床试验的数据确定对这些药物耐药的MIC。临床数据集仅包括来自棘轮菌素（卡泊芬净）治疗的患者的三种分离株，其MICs> 2μg/ ml（两个 C。parapsilosis 分离株4μg/ ml和一个皱纹梭状芽孢杆菌分离物的浓度为8μg/ ml）。根据这些数据，CLSI小组委员会已决定建议≤2μg/ ml的“仅易感”断点MIC，因为到目前为止 Candida 分离株中缺乏棘皮菌素抗性。 MIC超过2μg/ ml的分离物应指定为“不敏感”（NS）。对于产生提示为NS类别的结果的菌株，应确认生物体鉴定和抗微生物药敏试验结果。随后，应将分离物提交给参考实验室，该实验室将使用CLSI参考稀释方法确认结果。

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