MIC Distributions and Evaluation of Fungicidal Activity for Amphotericin B, Itraconazole, Voriconazole, Posaconazole and Caspofungin and 20 Species of Pathogenic Filamentous Fungi Determined Using the CLSI Broth Microdilution Method

Andrew M Borman; Mark Fraser; Michael D Palmer; Adrien Szekely; Marian Houldsworth; Zoe Patterson; Elizabeth M Johnson

doi:10.3390/jof3020027

MIC Distributions and Evaluation of Fungicidal Activity for Amphotericin B, Itraconazole, Voriconazole, Posaconazole and Caspofungin and 20 Species of Pathogenic Filamentous Fungi Determined Using the CLSI Broth Microdilution Method

J Fungi (Basel). 2017 May 31;3(2):27. doi: 10.3390/jof3020027.

Authors

Andrew M Borman¹, Mark Fraser², Michael D Palmer³, Adrien Szekely⁴, Marian Houldsworth⁵, Zoe Patterson⁶, Elizabeth M Johnson⁷

Affiliations

¹ Public Health England United Kingdom, Mycology Reference Laboratory, Myrtle Road, Bristol BS2 8EL, UK. andrew.borman@phe.gov.uk.
² Public Health England United Kingdom, Mycology Reference Laboratory, Myrtle Road, Bristol BS2 8EL, UK. mark.fraser@phe.gov.uk.
³ Public Health England United Kingdom, Mycology Reference Laboratory, Myrtle Road, Bristol BS2 8EL, UK. michael.palmer@phe.gov.uk.
⁴ Public Health England United Kingdom, Mycology Reference Laboratory, Myrtle Road, Bristol BS2 8EL, UK. adrien.szekely@phe.gov.uk.
⁵ Public Health England United Kingdom, Mycology Reference Laboratory, Myrtle Road, Bristol BS2 8EL, UK. marian.houldsworth@phe.gov.uk.
⁶ Public Health England United Kingdom, Mycology Reference Laboratory, Myrtle Road, Bristol BS2 8EL, UK. zoe.patterson@phe.gov.uk.
⁷ Public Health England United Kingdom, Mycology Reference Laboratory, Myrtle Road, Bristol BS2 8EL, UK. elizabeth.johnson@phe.gov.uk.

Abstract

For filamentous fungi (moulds), species-specific interpretive breakpoints and epidemiological cut-off values (ECVs) have only been proposed for a limited number of fungal species-antifungal agent combinations, with the result that clinical breakpoints are lacking for most emerging mould pathogens. In the current study, we have compiled minimum inhibitory concentration (MIC) data for 4869 clinical mould isolates and present full MIC distributions for amphotericin B, itraconazole, voriconazole, posaconazole, and caspofungin with these isolates which comprise 20 species/genera. In addition, we present the results of an assessment of the fungicidal activity of these same five antifungal agents against a panel of 123 mould isolates comprising 16 of the same species.

Keywords: ECVs; amphotericin B; caspofungin; filamentous fungi; fungicidal; itraconazole; posaconazole; susceptibility testing; voriconazole; wild-type distributions.