Use of micafungin as a surrogate marker to predict susceptibility and resistance to caspofungin among 3,764 clinical isolates of Candida by use of CLSI methods and interpretive criteria

Michael A Pfaller; Shawn A Messer; Daniel J Diekema; Ronald N Jones; Mariana Castanheira

doi:10.1128/JCM.02481-13

Back

Use of micafungin as a surrogate marker to predict susceptibility and resistance to caspofungin among 3,764 clinical isolates of Candida by use of CLSI methods and interpretive criteria

Journal article

Open access

Peer reviewed

Use of micafungin as a surrogate marker to predict susceptibility and resistance to caspofungin among 3,764 clinical isolates of Candida by use of CLSI methods and interpretive criteria

Michael A Pfaller, Shawn A Messer, Daniel J Diekema, Ronald N Jones and Mariana Castanheira

Journal of clinical microbiology, Vol.52(1), pp.108-114

01/2014

DOI: 10.1128/JCM.02481-13

PMCID: PMC3911432

PMID: 24153129

Files and links (1)

url

https://doi.org/10.1128/JCM.02481-13View

Published (Version of record) Open Access

Abstract

Due to unacceptably high interlaboratory variation in caspofungin MIC values, we evaluated the use of micafungin as a surrogate marker to predict the susceptibility of Candida spp. to caspofungin using reference methods and species-specific interpretive criteria. The MIC results for 3,764 strains of Candida (eight species), including 73 strains with fks mutations, were used. Caspofungin MIC values and species-specific interpretive criteria were compared with those of micafungin to determine the percent categorical agreement (%CA) and very major error (VME), major error (ME), and minor error rates as well as their ability to detect fks mutant strains of Candida albicans (11 mutants), Candida tropicalis (4 mutants), Candida krusei (3 mutants), and Candida glabrata (55 mutants). Overall, the %CA was 98.8% (0.2% VMEs and MEs, 0.8% minor errors) using micafungin as the surrogate marker. Among the 60 isolates of C. albicans (9 isolates), C. tropicalis (5 isolates), C. krusei (2 isolates), and C. glabrata (44 isolates) that were nonsusceptible (either intermediate or resistant) to both caspofungin and micafungin, 54 (90.0%) contained a mutation in fks1 or fks2. An additional 10 C. glabrata mutants, two C. albicans mutants, and one mutant each of C. tropicalis and C. krusei were classified as susceptible to both antifungal agents. Using the epidemiological cutoff values (ECVs) of 0.12 μg/ml for caspofungin and 0.03 μg/ml for micafungin to differentiate wild-type (WT) from non-WT strains of C. glabrata, 80% of the C. glabrata mutants were non-WT for both agents (96% concordance). Micafungin may serve as an acceptable surrogate marker for the prediction of susceptibility and resistance of Candida to caspofungin.

Antifungal Agents - pharmacology

Candida - genetics

Lipopeptides - pharmacology

Humans

Biomarkers

Candida - drug effects

Fungal Proteins - genetics

Mutation

Drug Resistance, Fungal

Microbial Sensitivity Tests - methods

Echinocandins - pharmacology

Details

Title: Subtitle: Use of micafungin as a surrogate marker to predict susceptibility and resistance to caspofungin among 3,764 clinical isolates of Candida by use of CLSI methods and interpretive criteria
Creators: Michael A Pfaller - JMI Laboratories, North Liberty, Iowa, USA
Shawn A Messer
Daniel J Diekema
Ronald N Jones
Mariana Castanheira
Resource Type: Journal article
Publication Details: Journal of clinical microbiology, Vol.52(1), pp.108-114
Publisher: United States
DOI: 10.1128/JCM.02481-13
PMID: 24153129
PMCID: PMC3911432
ISSN: 1098-660X
eISSN: 1098-660X
Language: English
Date published: 01/2014
Academic Unit: Infectious Diseases; Epidemiology; Pathology; Internal Medicine
Record Identifier: 9983986270902771

Metrics

23 Record Views

44 Times Cited - Web of Science

See more details