Table 2.
Susceptibility of 131 Candida spp. to antifungal drugs and distributions of MIC (µg/ml) by CLSI broth microdilution method.
| Organism | AF | Breakpoints | S | SDD | I | R | ECVa | WT | N-WT | MIC50a | MIC90a | MIC rangea |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| C. albicans | AmpB | S ≤ 1, R ≥ 1 | 93.1% | – | – | 6.9% | 4 | 96% | 4% | 0.250 | 0. 50 | 0.032–8 |
| CSF | S ≤ 0.25, I = 0.5, R ≥ 1 | 97.1% | – | 1.96% | 1% | 0.25 | 97% | 3% | 0.032 | 0.064 | 0.032–1 | |
| VCZ | S ≤ 0.12, I = 0.25, − 0.5 R ≥ 1 | 100% | – | – | – | 0.032 | 98% | 2% | 0.032 | 0.032 | 0.032–0.125 | |
| FCZ | S ≤ 2, SDD = 4, R ≥ 8 | 100% | – | – | – | 0.25 | 98% | 2% | 0.032 | 0.125 | 0.032–4 | |
| ITC | S ≤ 0.12, SDD = 0.25, − 0.5 R ≥ 1 | 100% | – | – | – | 0.064 | 98% | 2% | 0.032 | 0.032 | 0.032–0.064 | |
| C. glabrata | AmpB | S ≤ 1, R ≥ 1 | 100% | – | – | – | 0.25 | 75% | 25% | 0.250 | 0.5 | 0.25–0.5 |
| CSF | S ≤ 0.12, I = 0.25, R ≥ 0.5 | 75% | – | 25% | – | 0.125 | 75% | 25% | 0.125 | 0.25 | 0.064–0.25 | |
| VCZ | ECV = 0.5, WT: MIC ≤ ECV & non-WT: MIC > ECV | 0.032 | 100% | – | 0.032 | 0.032 | 0.032 | |||||
| FCZ | SDD ≤ 32, R ≥ 64 | – | 100% | – | – | 0.25 | 75% | 25% | 0.25 | 1 | 0.125–1 | |
| ITC | S ≤ 0.12, SDD = 0.25, − 0.5 R ≥ 1 | 100% | – | – | – | 0.064 | 75% | 25% | 0.064 | 0.125 | 0.064–0.125 | |
| C. krusei | AmpB | S ≤ 1, R ≥ 1 | 100% | – | – | – | 0.5 | 85.7% | 28.6% | 0.5 | 1 | 0.25–1 |
| CSF | S ≤ 0.25, I = 0.5, R ≥ 1 | 14.3% | – | 57.1% | 28.6% | 0.5 | 71.4% | 14.3% | 0.5 | 1 | 0.25–1 | |
| VCZ | S ≤ 0.5, I = 1, R ≥ 2 | 100% | – | – | – | 0.125 | 85.7% | 28.6% | 0.125 | 0.25 | 0.064–0.25 | |
| FCZ | C. krusei is considered resistant to FCZ, irrespective of the MIC | – | – | – | – | – | – | |||||
| ITC | S ≤ 0.12, SDD = 0.25, − 0.5 R ≥ 1 | 85.7% | 14.3% | – | – | 0.125 | 85.7% | 28.6% | 0.125 | 0.25 | 0.125–0.25 | |
| C. tropicalis | AmpB | S ≤ 1, R ≥ 1 | 100% | – | – | – | 0.25 | 66.7% | 33.3% | 0.25 | 0.5 | 0.25–0.5 |
| CSF | S ≤ 2 | 100% | – | – | – | 0.064 | 66.7% | 33.3% | 0.064 | 1 | 0.032–1 | |
| VCZ | S ≤ 0.12, I = 0.25, − 0.5 R ≥ 1 | 100% | – | – | – | 0.032 | 100% | – | 0.032 | 0.032 | 0.032 | |
| FCZ | S ≤ 8, R ≥ 64 | 100% | – | – | – | 0.032 | 66.7% | 33.3% | 0.032 | 0.125 | 0.032–0.25 | |
| ITC | S ≤ 0.12, SDD = 0.25, − 0.5 R ≥ 1 | 100% | – | – | – | 0.032 | 100% | – | 0.032 | 0.032 | 0.032 | |
| C. parapsilosis | AmpB | S ≤ 1, R ≥ 1 | 100% | – | – | – | 0.25 | 80% | 20% | 0.25 | 0.5 | 0.032–0.5 |
| CSF | S ≤ 2, I = 4, R ≥ 8 | 100% | – | – | – | 0.5 | 80% | 20% | 0.064 | 0.125 | 0.032–0.125 | |
| VCZ | S ≤ 0.12, I = 0.25, − 0.5 R ≥ 1 | 80% | – | 20% | – | 0.032 | 80% | 20% | 0.032 | 0.5 | 0.032–0.5 | |
| FCZ | S ≤ 2, SDD = 4, R ≥ 8 | 80% | – | – | 20% | 0.064 | 80% | 20% | 0.064 | 16 | 0.032–16 | |
| ITC | S ≤ 0.12, SDD = 0.25, − 0.5 R ≥ 1 | 80% | 20% | – | – | 0.032 | 80% | 20% | 0.032 | 0.25 | 0.032–0.25 | |
Based on recommended CLSI 24-h minimum inhibitory concentration limits.
AmpB Amphotericin B, CSF Caspofungin, VCZ Voriconazole, FCZ Fluconazole, ITC Itraconazole, AF antifungal, SDD susceptible dose-dependent, S sensitive, I intermediate, R resistant, ECV Epidemiological Cutoff Value; ECVs capture ≥ 97.5% of the statistically modelled population, WT Wild-type, NWT non-wild-type, MIC50 Minimum Inhibitory Concentration required to inhibit the growth of 50% of organisms, MIC90 Minimum Inhibitory Concentration required to inhibit the growth of 90% of fungal species.
a(µg/ml).