Establishment of the epidemiological cut-off value for antifungal drugs against Cryptococcus neoformans in East China from 2017 to 2022
10.3760/cma.j.cn114452-20240214-00076
- VernacularTitle:2017—2022年华东地区新型隐球菌抗真菌药物流行病学折点的建立
- Author:
Lili WANG
1
;
Ziyi ZHOU
;
Ziwen WANG
;
Wenjie TIAN
;
Yan ZHANG
;
Lingbing ZENG
;
Wenjuan WU
Author Information
1. 舟山市妇女儿童医院检验科，舟山 316000
- Keywords:
Cryptococcus neoformans;
Antifungal agents;
Epidemiological cut-off value
- From:
Chinese Journal of Laboratory Medicine
2024;47(6):639-643
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To establish an epidemiological cut-off value (ECV) for antifungal drugs against Cryptococcus neoformans in East China through a multicenter in vitro drug susceptibility test. Methods:A retrospective collection of 479 clinical isolates of Cryptococcus neoformans was conducted by the East China Invasive Fungal Infection Group (ECIFIG) from January 1, 2017 to December 31, 2022. Mass spectrometry and gene sequencing were used for identification. A unified drug susceptibility testing system was established in the fungal laboratories across three sub centers in Shanghai, Jiangxi, and Jiangsu provinces. Drug susceptibility testings of Cryptococcus neoformans were independently completed in each center after passing consistency evaluation. Epidemiological breakpoints were established against fluconazole, voriconazole, amphotericin B, 5-fluorocytosine, isaconazole, posaconazole and itraconazole following the principles and procedures of the Clinical and Laboratory Standards Institute (CLSI) M57. Results:External consistency evaluation revealed that the minimum inhibitory concentration values ??for all drugs in each center did not differ by more than one dilution gradient. A new ECV type of Cryptococcus neoformans in East China was established, including fluconazole 16 mg/L, voriconazole 0.12 mg/L, amphotericin B 1 mg/L, 5-fluorocytosine 8 mg/L, isavuconazole 0.12 mg/L, posaconazole 0.5 mg/L, and itraconazole 0.5 mg/L. Conclusion:This study preliminarily revealed the drug susceptibility characteristics of clinical Cryptococcus neoformans in East China and established the ECVs for antifungal drugs against Cryptococcus neoformans in the region.
