TABLE 2.
Essential agreement between ETdir, CLSI, and ETsd for the MICs of six antifungal agents
| Species | No. of strainsa | Procedure | Essential agreement (% of MICs within ±2 log2)b |
|||||
|---|---|---|---|---|---|---|---|---|
| Fluconazole (24 h/48 h) | Voriconazole | Posaconazole | Isavuconazole | Amphotericin B | Caspofungin | |||
| C. albicans | 81 | ETdir vs CLSIc | 44.4/71.6 | 76.6 | 61.7 | 79.1 | 39.5 | 83.9 |
| ETdir vs ETsdd | 88.9 | 80.2 | 59.3 | 79 | 83.9 | 86.4 | ||
| ETsd vs CLSIc | 72.8/69 | 87.7 | 87.7 | 92.6 | 69.1 | 90.1 | ||
| C. glabrata | 66 | ETdir vs CLSIc | 84.8/60.6 | 86.4 | 25.7 | 45.5 | 77.3 | 97 |
| ETdir vs ETsdd | 81.8 | 84.8 | 63.6 | 71.2 | 50 | 98.5 | ||
| ETsd vs CLSIc | 51.5/72.7 | 89.5 | 44.5 | 56.1 | 77.3 | 95.5 | ||
| C. parapsilosis | 62 | ETdir vs CLSIc | 75.8/90.3 | 91.9 | 74.2 | 93.5 | 32.3 | 87.1 |
| ETdir vs ETsdd | 92 | 93.5 | 87.2 | 92 | 70.9 | 100 | ||
| ETsd vs CLSIc | 46.6/85.5 | 96.8 | 77.4 | 95.2 | 64.5 | 88.7 | ||
| C. krusei | 31 | ETdir vs CLSIc | 10/83.9 | 96.8 | 90.3 | 77.4 | 64.5 | 93.5 |
| ETdir vs ETsdd | 96.8 | 93.6 | 96.8 | 100 | 96.8 | 100 | ||
| ETsd vs CLSIc | 10/71 | 96.8 | 93.5 | 100 | 67.7 | 87.1 | ||
| C. tropicalis | 17 | ETdir vs CLSIc | 64.8/58.8 | 52.9 | 58.8 | 29.4 | 47.1 | 82.4 |
| ETdir vs ETsdd | 88.2 | 64.7 | 58.8 | 52.9 | 88.2 | 94.1 | ||
| ETsd vs CLSIc | 64.7/82.3 | 76.5 | 76.5 | 70.6 | 94.1 | 88.2 | ||
| Candida spp.e | 6 | ETdir vs CLSIc | 66.6/66.6 | 66.6 | 50 | 66.7 | 16.7 | 83.3 |
| ETdir vs ETsdd | 66.6 | 83.3 | 83.3 | 83.3 | 66.6 | 83.3 | ||
| ETsd vs CLSIc | 83.3/66.6 | 83.3 | 50 | 66.7 | 66.7 | 100 | ||
| Mixedf | 4 | ETdir vs CLSIc | 75/75 | 100 | 100 | 100 | 25 | 50 |
| ETdir vs ETsdd | 50 | 75 | 50 | 75 | 100 | 75 | ||
| ETsd vs CLSIc | 75/100 | 100 | 50 | 50 | 75 | 100 | ||
| Cryptococcus spp. | 30 | ETdir vs CLSIc | 96.7g | 100 | 16.7 | 90 | 50 | 100 |
| ETdir vs ETsdd | 96.3 | 90 | 93.3 | 90 | 36.7 | 96.7 | ||
| ETsd vs CLSIc | 90 | 93.3 | 43.3 | 86.7 | 0 | 96.7 | ||
| Other yeastsh | 31 | ETdir vs CLSIc | 53.9/64.5 | 67.7 | 58 | 74.1 | 67.7 | 87.1 |
| ETdir vs ETsdd | 70.9 | 64.5 | 62.7 | 64.5 | 58.1 | 90.3 | ||
| ETsd vs CLSIc | 64.5/83.8 | 74.1 | 64.5 | 74.2 | 64.5 | 87.1 | ||
| Total | 328 | ETdir vs CLSIc | 59.2/75 | 83.5 | 55.2 | 72.9 | 55.5 | 89.3 |
| ETdir vs ETsdd | 86.9 | 84.1 | 72.9 | 80.2 | 69.5 | 94.2 | ||
| ETsd vs CLSIc | 63/79.8 | 89.3 | 70.9 | 80 | 64.3 | 91.5 | ||
ETdir MICs for Cryptococcus isolates, 1 C. albicans isolate, 4 C. glabrata isolates, 1 C. parapsilosis isolate, 2 R. mucilaginosa isolates, and 13 S. cerevisiae isolates were read after ≥48 h of incubation due to poor fungal growth on RPMI agar plates.
Percentages of MICs that fell within ±2 log2 of the MICs obtained by the gold standard procedure.
CLSI considered the gold standard.
ETsd considered the gold standard.
Including C. dubliniensis (n = 2), K. marxianus (n = 1), and P. guilliermondii (n = 3).
Mixed fungemia corresponded to four episodes caused by two different species: C. albicans plus C. parapsilosis (n = 2) and C. albicans plus C. glabrata (n = 2). A bottle containing C. albicans and C. parapsilosis was excluded due to bacterial overgrowth (coagulase-negative Staphylococcus).
Due to the absence of growth of Cryptococcus strains, MICs of fluconazole by CLSI M27-A3 after 24 h of incubation were not obtained.
Including S. cerevisiae (n = 15), D. capitatus (n = 9), T. mucoides (n = 3), R. mucilaginosa (n = 2), T. inkin (n = 1), and A. adeninivorans (n = 1).