Evidence map›Paper›PMID 35194639›Full record

ArticleThe Journal of antimicrobial chemotherapy2022

Spectrophotometric detection of azole-resistant Aspergillus fumigatus with the EUCAST broth microdilution method: is it time for automated MIC reading of EUCAST antifungal susceptibility testing of Aspergillus species?

Joseph Meletiadis, Ioanna Efstathiou, Hein A L van der Lee, Karen M T Astvad, Paul E Verweij, Maiken Cavling Arendrup

Open access · hybridAbstract read
In one paragraph

Article in The Journal of antimicrobial chemotherapy, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.4field-weighted citation impact, top 42% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 4 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 4 institutions in 3 countries.

Joseph MeletiadisClinical Microbiology Laboratory, Attikon University Hospital, Athens, Greece.ORCID 0000-0002-8869-1509
Ioanna EfstathiouClinical Microbiology Laboratory, Attikon University Hospital, Athens, Greece.
Hein A L van der LeeDepartment of Medical Microbiology, Radboud University Medical Centre, and Center of Expertise in Mycology Radboudumc/CWZ, Nijmegen, The Netherlands.
Karen M T AstvadUnit of Mycology, Statens Serum Institut, Copenhagen, Denmark.
Paul E VerweijDepartment of Medical Microbiology, Radboud University Medical Centre, and Center of Expertise in Mycology Radboudumc/CWZ, Nijmegen, The Netherlands.ORCID 0000-0002-8600-9860
Maiken Cavling ArendrupUnit of Mycology, Statens Serum Institut, Copenhagen, Denmark.ORCID 0000-0002-4747-0144
Radboud University Nijmegen · NLStatens Serum Institut · DKErasmus MC · NLUniversity General Hospital Attikon · GR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesCurrent reference susceptibility testing methods of Aspergillus require visual reading, which is subjective and necessitates experienced staff. We compared spectrophotometric and visual MIC reading of EUCAST E.Def 9.3.2 susceptibility testing of Aspergillus fumigatus for a large collection of isolates with different azole resistance mechanisms.

methodsA. fumigatus (n = 200) were examined, including 62 WT and 138 non-WT with the following alterations: TR34/L98H (n = 57), TR46/Y121F/T289A (n = 54) or single point mutations (n = 27). EUCAST E.Def 9.3.2 susceptibility testing was performed for amphotericin B, itraconazole, voriconazole, posaconazole and isavuconazole. MICs were determined after 48 h of incubation visually and spectrophotometrically, as the lowest concentration corresponding to a 1%, 3%, 5%, 10% or 15% OD increase above the background OD. The best spectrophotometric endpoint (SPE) was identified based on the highest essential agreement (EA; ±1 two-fold dilution) and categorical agreement (CA) and fewer very major errors (VMEs) and major errors (MEs).

resultsΤhe best SPEs were 5% and 10% for all drugs. The best agreement between visual and spectrophotometric MICs was found with the 10% growth endpoint, which resulted in identical median MICs with 90% of differences being ≤1 two-fold and higher EA (91%-100%) and CA (100%) and no VMEs and MEs compared with the 5% endpoint (77%-100%, 96%-98%, 0% and 0%-4%, respectively).

conclusionsSpectrophotometric MIC reading can be used for A. fumigatus susceptibility testing and for detecting azole resistance. A visual inspection of the plate should be performed to confirm equal inoculation, absence of well contamination and proper growth, and to identify potential uncommon phenotypes or subpopulations.

Indexed as

Aspergillus fumigatusAzolesAntifungal AgentsAspergillusDrug Resistance, FungalFungal ProteinsMicrobial Sensitivity TestsReadingAntifungal AgentsAzolesFungal Proteins

Identifiers

PMID35194639
PMCPMC9840474
OpenAlexW4210913602

What OpenQuestion holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.