ArticleAntimicrobial agents and chemotherapy2013
Interlaboratory variability of Caspofungin MICs for Candida spp. Using CLSI and EUCAST methods: should the clinical laboratory be testing this agent?
Article in Antimicrobial agents and chemotherapy, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 125 papers, 1 of them a synthesis that pooled it.
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125 citing papers in PubMed, 1 synthesis or guideline pooled it, 207 citations in OpenAlex.
- Pichia kudriavzevii (Candida krusei): A systematic review to inform the World Health Organisation priority list of fungal pathogens.Medical mycology · 2024Pooled it
- Low Caspofungin Exposure in Patients in Intensive Care Units.Antimicrobial agents and chemotherapy · 2017Trial
- Dual colored phenotypic switching and interaction-driven heterogeneity in clonal Candida auris clinical isolates.Infection · 2026Article
- Clinical Outcomes ofJournal of fungi (Basel, Switzerland) · 2026Article
- Evaluation of Sensititre YeastOne for antifungal susceptibility testing ofJournal of clinical microbiology · 2026Article
- Uncertainty undermines the validity of antimicrobial pharmacodynamics.Journal of pharmacokinetics and pharmacodynamics · 2026Article
- Comparative assessment of the broth microdilution and VITEK 2 systems for antifungal susceptibility testing of Candida auris (Candidozyma auris) Isolates.BMC microbiology · 2026Article
- Prevalence and molecular basis of resistance to echinocandins among clinical Candida glabrata isolates in Guangdong province, China.BMC microbiology · 2025Article
- Identification and antifungal susceptibility patterns of reference yeast strains to novel and conventional agents: a comparative study using CLSI, EUCAST and Sensititre YeastOne methods.JAC-antimicrobial resistance · 2025Article
- Anidulafungin is a useful surrogate marker for predictingJournal of clinical microbiology · 2025Article
- Comparative evaluation of antifungal susceptibility testing methods of invasive Candida species and detection of FKS genes mutations in caspofungin intermediate and resistant isolates.BMC infectious diseases · 2025Article
- Recent increase inAntimicrobial agents and chemotherapy · 2024Article
- Review
- In Vitro Activitiy of Rezafungin in Comparison with Anidulafungin and Caspofungin against Invasive Fungal Isolates (2017 to 2022) in China.Journal of fungi (Basel, Switzerland) · 2024Article
- Evaluation of the Vitek 2 system for antifungal susceptibility testing ofJournal of clinical microbiology · 2024Article
- In Vitro Killing Activities of Anidulafungin and Micafungin with and without Nikkomycin Z against FourPharmaceutics · 2023Article
- Inter-laboratory variability of caspofungin MICs forAccess microbiology · 2023Article
- Echinocandins Susceptibility Patterns of 2,787 Yeast Isolates: Importance of the Thresholds for the Detection of FKS Mutations.Antimicrobial agents and chemotherapy · 2022Article
- Comparison of Six Antifungal Susceptibilities of 11Microbiology spectrum · 2022Article
- Prevalence of Antifungal Resistance, Genetic Basis of Acquired Azole and Echinocandin Resistance, and Genotyping of Candida krusei Recovered from an International Collection.Antimicrobial agents and chemotherapy · 2022Article
65 more citing papers are in PubMed but not listed here.
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24 authors at 19 institutions in 13 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Although Clinical and Laboratory Standards Institute (CLSI) clinical breakpoints (CBPs) are available for interpreting echinocandin MICs for Candida spp., epidemiologic cutoff values (ECVs) based on collective MIC data from multiple laboratories have not been defined. While collating CLSI caspofungin MICs for 145 to 11,550 Candida isolates from 17 laboratories (Brazil, Canada, Europe, Mexico, Peru, and the United States), we observed an extraordinary amount of modal variability (wide ranges) among laboratories as well as truncated and bimodal MIC distributions. The species-specific modes across different laboratories ranged from 0.016 to 0.5 μg/ml for C. albicans and C. tropicalis, 0.031 to 0.5 μg/ml for C. glabrata, and 0.063 to 1 μg/ml for C. krusei. Variability was also similar among MIC distributions for C. dubliniensis and C. lusitaniae. The exceptions were C. parapsilosis and C. guilliermondii MIC distributions, where most modes were within one 2-fold dilution of each other. These findings were consistent with available data from the European Committee on Antimicrobial Susceptibility Testing (EUCAST) (403 to 2,556 MICs) for C. albicans, C. glabrata, C. krusei, and C. tropicalis. Although many factors (caspofungin powder source, stock solution solvent, powder storage time length and temperature, and MIC determination testing parameters) were examined as a potential cause of such unprecedented variability, a single specific cause was not identified. Therefore, it seems highly likely that the use of the CLSI species-specific caspofungin CBPs could lead to reporting an excessive number of wild-type (WT) isolates (e.g., C. glabrata and C. krusei) as either non-WT or resistant isolates. Until this problem is resolved, routine testing or reporting of CLSI caspofungin MICs for Candida is not recommended; micafungin or anidulafungin data could be used instead.
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