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https://www.arca.fiocruz.br/handle/icict/36386
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2020-04-11
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- INI - Artigos de Periódicos [3028]
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CRYPTOCOCCUS NEOFORMANS-CRYPTOCOCCUS GATTII SPECIES COMPLEX: AN INTERNATIONAL STUDY OF WILD-TYPE SUSCEPTIBILITY ENDPOINT DISTRIBUTIONS AND EPIDEMIOLOGICAL CUTOFF VALUES FOR AMPHOTERICIN B AND FLUCYTOSINE
Author
Affilliation
VCU Medical Center. Richmond, VA, USA.
University of Delhi. Vallabhbhai Patel Chest Institute. Delhi, India.
Instituto de Salud Carlos III. Centro Nacional de Microbiología. Servicio de Micología. Pozuelo, Spain.
University of Texas. Health Science Center. San Antonio, TX, USA.
University of Alberta. Edmonton, AB, Canada.
Canisius Wilhelmina Hospital. Department of Medical Microbiology and Infectious Diseases. Nijmegen, The Netherlands.
National Institute for Communicable Diseases. Division of the National Health Laboratory Service. Johannesburg, South Africa.
Universitat Rovira i Virgili. Facultat de Medicina. Instituto de Investigación Sanitaria Pere Virgili. Reus, Spain.
The HPA Mycology Reference Laboratory. Kingsdown, Bristol, UK.
The Innsbruck Medical University. Innsbruck, Austria.
Centers for Disease Control and Prevention. Atlanta, GA, USA.
Adolfo Lutz Institute Public Health Reference Center. Rio Claro, SP, Brazil.
Canisius Wilhelmina Hospital. Department of Medical Microbiology and Infectious Diseases. Nijmegen, The Netherlands / Radboud University Medical Centre. Nijmegen, The Netherlands.
Adolfo Lutz Institute Public Health Reference Center. Rio Claro, SP, Brazil.
University of Texas. Health Science Center. Houston, TX, USA.
Universidad Complutense. Facultad de Medicina. Madrid, Spain / Hospital General Universitario Gregorio Marañón, Madrid, Spain.
University of Iowa. Iowa City, IA, USA.
Duke University Medical Center. Durham, NC, USA.
Fundação Oswaldo Cruz. Instituto de Pesquisa Clinica Evandro Chagas. Rio de Janeiro, RJ, Brasil.
Women’s and Children’s Hospital. Adelaide, Australia.
Women’s and Children’s Hospital. Adelaide, Australia / University of Adelaide. Adelaide, Australia.
University of Delhi. Vallabhbhai Patel Chest Institute. Delhi, India.
Instituto de Salud Carlos III. Centro Nacional de Microbiología. Servicio de Micología. Pozuelo, Spain.
University of Texas. Health Science Center. San Antonio, TX, USA.
University of Alberta. Edmonton, AB, Canada.
Canisius Wilhelmina Hospital. Department of Medical Microbiology and Infectious Diseases. Nijmegen, The Netherlands.
National Institute for Communicable Diseases. Division of the National Health Laboratory Service. Johannesburg, South Africa.
Universitat Rovira i Virgili. Facultat de Medicina. Instituto de Investigación Sanitaria Pere Virgili. Reus, Spain.
The HPA Mycology Reference Laboratory. Kingsdown, Bristol, UK.
The Innsbruck Medical University. Innsbruck, Austria.
Centers for Disease Control and Prevention. Atlanta, GA, USA.
Adolfo Lutz Institute Public Health Reference Center. Rio Claro, SP, Brazil.
Canisius Wilhelmina Hospital. Department of Medical Microbiology and Infectious Diseases. Nijmegen, The Netherlands / Radboud University Medical Centre. Nijmegen, The Netherlands.
Adolfo Lutz Institute Public Health Reference Center. Rio Claro, SP, Brazil.
University of Texas. Health Science Center. Houston, TX, USA.
Universidad Complutense. Facultad de Medicina. Madrid, Spain / Hospital General Universitario Gregorio Marañón, Madrid, Spain.
University of Iowa. Iowa City, IA, USA.
Duke University Medical Center. Durham, NC, USA.
Fundação Oswaldo Cruz. Instituto de Pesquisa Clinica Evandro Chagas. Rio de Janeiro, RJ, Brasil.
Women’s and Children’s Hospital. Adelaide, Australia.
Women’s and Children’s Hospital. Adelaide, Australia / University of Adelaide. Adelaide, Australia.
Abstract
Clinical breakpoints (CBPs) are not available for the Cryptococcus neoformans-Cryptococcus gattii species complex. MIC distributions were constructed for the wild type (WT) to establish epidemiologic cutoff values (ECVs) for C. neoformans and C. gattii versus amphotericin B and flucytosine. A total of 3,590 amphotericin B and 3,045 flucytosine CLSI MICs for C. neoformans (including 1,002 VNI isolates and 8 to 39 VNII, VNIII, and VNIV isolates) and 985 and 853 MICs for C. gattii, respectively (including 42 to 259 VGI, VGII, VGIII, and VGIV isolates), were gathered in 9 to 16 (amphotericin B) and 8 to 13 (flucytosine) laboratories (Europe, United States, Australia, Brazil, Canada, India, and South Africa) and aggregated for the analyses. Additionally, 442
amphotericin B and 313 flucytosine MICs measured by using CLSI-YNB medium instead of CLSI-RPMI medium and 237 Etest amphotericin B MICs for C. neoformans were evaluated. CLSI-RPMI ECVs for distributions originating in >3 laboratories (with the percentages of isolates for which MICs were less than or equal to ECVs given in parentheses) were as follows: for amphotericin B, 0.5 g/ml for C. neoformans VNI (97.2%) and C. gattii VGI and VGIIa (99.2 and 97.5%, respectively) and 1 g/ml for C. neoformans (98.5%) and C. gattii nontyped (100%) and VGII (99.2%) isolates; for flucytosine, 4 g/ml for C. gattii nontyped (96.4%) and VGI (95.7%) isolates, 8 g/ml for VNI (96.6%) isolates, and 16 g/ml for C. neoformans nontyped (98.6%) and C. gattii VGII (97.1%) isolates. Other molecular types had apparent variations in MIC distributions, but the number of laboratories contributing data was too low to allow us to ascertain that the differences were due to factors other than assay variation. ECVs may aid in the detection of isolates with acquired resistance mechanisms.
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