TABLE 2.
In vitro susceptibilities of the 706 Aspergillus spp. isolates against five antifungal agents and proposed ECVs for Aspergillus fumigatus and Aspergillus flavus obtained using CLSI M38-A3 broth microdilution method.
| Species (N) | Antifungal agents |
No. of isolates |
MIC/MEC (μg/ml)d | CLSI ECVe (μg/ml) | WT (%) | Non-WT | Calculated ECVf (μg/ml) | WTg | |||||||||||||||||
|
MIC/MEC (μg/ml) |
|||||||||||||||||||||||||
| 0.008 | 0.015 | 0.03 | 0.06 | 0.125 | 0.25 | 0.5 | 1 | 2 | 4 | 8 | 16 | 32 | 50 | 90 | Range | ||||||||||
| Aspergillus fumigatus (445) | ITC | 2 | 3 | 10 | 61 | 119 | 234 | 16 | 1 | 1 | 0.03–16 | 1 | 96.4 | 16 (3.6%) | 1 | 96.4% | |||||||||
| VRC | 15 | 101 | 232 | 88 | 4 | 2 | 3 | 0.5 | 1 | 0.125–16 | 1 | 98.0 | 9 (2.0%) | 1 | 98.0% | ||||||||||
| POS | 1 | 27 | 69 | 220 | 77 | 39 | 5 | 1 | 6 | 0.125 | 0.5 | 0.015–16 | 0.5 | 97.3 | 12 (2.7%) | 0.5 | 97.3% | ||||||||
| CAS | 13 | 28 | 89 | 126 | 76 | 71 | 42 | 0.06 | 0.25 | 0.008–0.5 | 0.5 | 100 | 0 | 0.5 | 100% | ||||||||||
| AMB | 4 | 5 | 18 | 180 | 238 | 2 | 2 | 0.125–2 | 2 | 100 | 0 | 2 | 100% | ||||||||||||
| Aspergillus flavus (166) | ITC | 1 | 2 | 3 | 6 | 45 | 40 | 59 | 9 | 1 | 0.5 | 1 | 0.015–4 | 1 | 94.0 | 10 (6.0%) | 2 | 99.4% | |||||||
| VRC | 1 | 7 | 39 | 75 | 39 | 3 | 1 | 1 | 0.5 | 1 | 0.03–16 | 2 | 98.8 | 2 (1.2%) | 2 | 98.8% | |||||||||
| POSa | 1 | 2 | 2 | 8 | 38 | 8 | 0.25 | 0.5 | 0.015–0.5 | 0.5 | 100 | 0 | ND | ND | |||||||||||
| CAS | 36 | 20 | 17 | 31 | 32 | 22 | 7 | 1 | 0.06 | 0.25 | 0.008–4 | 0.5 | 99.4 | 1 (0.6%) | 0.5 | 99.4% | |||||||||
| AMB | 1 | 2 | 7 | 51 | 76 | 23 | 3 | 1 | 2 | 4 | 0.125–32 | 4 | 97.6 | 4 (2.4%) | 4 | 97.6% | |||||||||
| Aspergillus terreus (48) | ITC | 2 | 3 | 7 | 5 | 6 | 1 | 19 | 4 | 1 | 0.5 | 2 | 0.008–8 | 2 | 97.9 | 1 (2.1%) | ND | ND | |||||||
| VRC | 1 | 10 | 24 | 8 | 4 | 1 | 0.25 | 1 | 0.06–2 | 2 | 100 | 0 | ND | ND | |||||||||||
| POSb | 5 | 3 | 6 | 3 | 3 | 0.06 | 0.25 | 0.015–0.25 | 1 | 100 | 0 | ND | ND | ||||||||||||
| CAS | 12 | 3 | 8 | 11 | 11 | 3 | 0.06 | 0.125 | 0.008–0.25 | 0.25 | 100 | 0 | ND | ND | |||||||||||
| AMB | 1 | 1 | 4 | 24 | 15 | 3 | 2 | 8 | 0.25–8 | 4 | 93.7 | 3 (6.3%) | ND | ND | |||||||||||
| Aspergillus niger (35) | ITC | 1 | 1 | 13 | 13 | 3 | 4 | 1 | 4 | 0.125–4 | 4 | 100 | 0 | ND | ND | ||||||||||
| VRC | 2 | 7 | 16 | 10 | 0.5 | 1 | 0.125–1 | 2 | 100 | 0 | ND | ND | |||||||||||||
| POSc | 1 | 4 | 6 | 7 | 0.25 | 0.25 | 0.03–0.5 | 2 | 100 | 0 | ND | ND | |||||||||||||
| CAS | 11 | 5 | 4 | 3 | 6 | 5 | 1 | 0.03 | 0.25 | 0.008–1 | 0.25 | 97.1 | 1 (2.9%) | ND | ND | ||||||||||
| AMB | 1 | 2 | 11 | 17 | 3 | 2 | 2 | 0.25–8 | 2 | 91.4 | 3 (8.6%) | ND | ND | ||||||||||||
| Aspergillus nidulans (8) | ITC | 1 | 2 | 5 | ND | ND | 0.06–0.25 | 1 | 100 | 0 | ND | ND | |||||||||||||
| VRC | 2 | 4 | 1 | 1 | ND | ND | 0.06–0.5 | 2 | 100 | 0 | ND | ND | |||||||||||||
| POS | 1 | 1 | 5 | 1 | ND | ND | 0.03–0.25 | 1 | 100 | 0 | ND | ND | |||||||||||||
| CAS | 2 | 5 | 1 | ND | ND | 0.008–2 | 0.5 | 87.5 | 1 (12.5%) | ND | ND | ||||||||||||||
| AMB | 4 | 3 | 2 | ND | ND | 1–4 | 4 | 100 | 0 | ND | ND | ||||||||||||||
| Aspergillus sydowii (1) | ITC | 1 | ND | ND | ND | 2 | 100 | 0 | ND | ND | |||||||||||||||
| VRC | 1 | ND | ND | ND | 2 | 100 | 0 | ND | ND | ||||||||||||||||
| POS | 1 | ND | ND | ND | 1 | 100 | 0 | ND | ND | ||||||||||||||||
| CAS | 1 | ND | ND | ND | 0.25 | 100 | 0 | ND | ND | ||||||||||||||||
| AMB | 1 | ND | ND | ND | 2 | 100 | 0 | ND | ND | ||||||||||||||||
| Aspergillus penicillioides (1) | ITC | 1 | ND | ND | ND | ND | 100 | 0 | ND | ND | |||||||||||||||
| VRC | 1 | ND | ND | ND | ND | 100 | 0 | ND | ND | ||||||||||||||||
| POS | 1 | ND | ND | ND | ND | 100 | 0 | ND | ND | ||||||||||||||||
| CAS | 1 | ND | ND | ND | ND | 100 | 0 | ND | ND | ||||||||||||||||
| AMB | 1 | ND | ND | ND | ND | 100 | 0 | ND | ND | ||||||||||||||||
| Aspergillus tamarii (1) | ITC | 1 | ND | ND | ND | 1 | 100 | 0 | ND | ND | |||||||||||||||
| VRC | 1 | ND | ND | ND | 2 | 100 | 0 | ND | ND | ||||||||||||||||
| POS | 1 | ND | ND | ND | 0.5 | 100 | 0 | ND | ND | ||||||||||||||||
| CAS | 1 | ND | ND | ND | 0.5 | 100 | 0 | ND | ND | ||||||||||||||||
| AMB | 1 | ND | ND | ND | 4 | 100 | 0 | ND | ND | ||||||||||||||||
| Aspergillus undagawae (1) | ITC | 1 | ND | ND | ND | 1 | 100 | 0 | ND | ND | |||||||||||||||
| VRC | 1 | ND | ND | ND | 1 | 100 | 0 | ND | ND | ||||||||||||||||
| POS | 1 | ND | ND | ND | 0.5 | 100 | 0 | ND | ND | ||||||||||||||||
| CAS | 1 | ND | ND | ND | 0.5 | 100 | 0 | ND | ND | ||||||||||||||||
| AMB | 1 | ND | ND | ND | 2 | 100 | 0 | ND | ND | ||||||||||||||||
MIC50/90 was the MIC inhibiting the growth of 50 and 90% of the isolates, respectively.
ITC, itraconazole; VRC, voriconazole; POS, posaconazole; AMB, amphotericin B; CAS, caspofungin; MIC, minimum inhibitory concentration; MEC, minimum effective concentration; ECVs, epidemiological cutoff values; non-WT, non-wild type; ND, not determined.
aThe susceptibilities of 59 A. flavus isolates were tested using the CLSI broth microdilution method.
bThe susceptibilities of 20 A. terreus isolates were tested using the CLSI broth microdilution method.
cThe susceptibilities of 18 A. niger isolates were tested using the CLSI broth microdilution method.
dMIC50/90 values were calculated for species with ≥10 isolates.
eThe CLSI ECVs were recommended by CLSI M59 document.
fThe calculated ECVs captured ≥97.5% of the statistically modeled population.
gThe percentage of MICs less than the calculated ECVs.