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[Susceptibility to fluconazole of clinical interest yeasts: new breakpoints]

Lidia García-Agudo1, Pedro García-Martos, Pilar Marín-Casanova

  • 1Servicio de Microbiología y Parasitología, Hospital Universitario Puerta del Mar, Spain.

Revista Espanola De Quimioterapia : Publicacion Oficial De La Sociedad Espanola De Quimioterapia
|January 11, 2013
PubMed
Abstract

Insights

New fluconazole susceptibility breakpoints from Pfaller et al. show decreased susceptibility in Candida species, particularly Candida albicans, compared to Clinical and Laboratory Standards Institute (CLSI) criteria. This impacts antifungal resistance monitoring.

Area of Science:

  • Medical Mycology
  • Antimicrobial Susceptibility Testing
  • Infectious Diseases

Background:

  • Proposed new breakpoints for fluconazole susceptibility testing by Pfaller et al. for Candida albicans, C. parapsilosis, and C. tropicalis.
  • Comparison with existing breakpoints from the Clinical and Laboratory Standards Institute (CLSI) is needed.

Purpose of the Study:

  • To evaluate variations in Candida species' sensitivity to fluconazole using new proposed breakpoints.
  • To compare these variations against established CLSI breakpoints.

Main Methods:

  • Analysis of 112 Candida strains (49 C. albicans, 40 C. parapsilosis, 23 C. tropicalis).
  • Fluconazole susceptibility testing using the Sensititre YeastOne method.
  • Determination of minimum inhibitory concentrations (MICs) using both CLSI and Pfaller et al. breakpoints.

Main Results:

  • Under CLSI criteria, all isolates were susceptible to fluconazole.
  • Using Pfaller et al. criteria, 97% of strains remained susceptible, with 3 C. albicans strains (6%) showing dose-dependent susceptibility.
  • A decrease in the number of fluconazole-susceptible strains was observed with the new breakpoints, especially for C. albicans.

Conclusions:

  • The new breakpoints recommended by Pfaller et al. and EUCAST lead to a reduction in fluconazole-susceptible Candida strains compared to CLSI criteria.
  • This highlights the clinical significance of updated breakpoints for accurate antifungal susceptibility interpretation.

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