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Spectrophotometric reading of EUCAST antifungal susceptibility testing of Aspergillus fumigatus

Authors: Meletiadis, J.; Mortensen, K.L.; Verweij, P.E.; Mouton, J.W.; Mouton, J.W.; Arendrup, M.C.;

Spectrophotometric reading of EUCAST antifungal susceptibility testing of Aspergillus fumigatus

Abstract

Given the increasing number of antifungal drugs and the emergence of resistant Aspergillus isolates, objective, automated and high-throughput antifungal susceptibility testing is important. The EUCAST E.Def 9.3 reference method for MIC determination of Aspergillus species relies on visual reading. Spectrophotometric reading was not adopted because of concern that non-uniform filamentous growth might lead to unreliable and non-reproducible results. We therefore evaluated spectrophotometric reading for the determination of MICs of antifungal azoles against Aspergillus fumigatus.Eighty-eight clinical isolates of A. fumigatus were tested against four medical azoles (posaconazole, voriconazole, itraconazole, isavuconazole) and one agricultural azole (tebuconazole) with EUCAST E.Def 9.3. The visually determined MICs (complete inhibition of growth) were compared with spectrophotometrically determined MICs and essential (±1 twofold dilution) and categorical (susceptible/intermediate/resistant or wild-type/non-wild-type) agreement was calculated. Spectrophotometric data were analysed with regression analysis using the Emax model, and the effective concentration corresponding to 5% (EC5) was estimated.Using the 5% cut-off, high essential (92%-97%) and categorical (93%-99%) agreement (<6% errors) was found between spectrophotometric and visual MICs. The EC5 also correlated with the visually determined MICs with an essential agreement of 83%-96% and a categorical agreement of 90%-100% (<5% errors).Spectrophotometric determination of MICs of antifungal drugs may increase objectivity, and allow automation and high-throughput of EUCAST E.Def 9.3 antifungal susceptibility testing of Aspergillus species.

Countries
Netherlands, Denmark, Netherlands, Greece, Netherlands
Keywords

Medical Microbiology - Radboud University Medical Center, Antifungal Agents, Genotype, Microbial Sensitivity Tests, Fungal Proteins, Cytochrome P-450 Enzyme System, Drug Resistance, Fungal, Aspergillosis, Humans, EUCAST, Radboudumc 4: lnfectious Diseases and Global Health RIMLS: Radboud Institute for Molecular Life Sciences, Dose-Response Relationship, Drug, Spectrophotometric, Aspergillus fumigatus, Triazoles, EMC MM-04-28-01, High-Throughput Screening Assays, Aspergillus, Spectrophotometry, Mutation, Radboudumc 4: lnfectious Diseases and Global Health RIHS: Radboud Institute for Health Sciences, Antifungal susceptibility

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    popularity
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    Top 10%
    influence
    This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
    Top 10%
    impulse
    This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
    Top 10%
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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
22
Top 10%
Top 10%
Top 10%
Green
hybrid