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    Posaconazole MIC Distributions for Aspergillus fumigatus Species Complex by Four Methods: Impact of cyp51A Mutations on Estimation of Epidemiological Cutoff Values
    (Amer Soc Microbiology, 2018) Espinel-Ingroff, A.; Turnidge, J.; Alastruey-Izquierdo, A.; Dannaoui, E.; Garcia-Effron, G.; Guinea, J.; Kidd, S.; Pelaez, T.; Sanguinetti, M.; Meletiadis, J.; Botterel, F.; Bustamante, B.; Chen, Y. -C.; Chakrabarti, A.; Chowdhary, A.; Chryssanthou, E.; Cordoba, S.; Gonzalez, G. M.; Guarro, J.; Johnson, E. M.; Kus, J. V.; Lass-Floerl, C.; Linares-Sicilia, M. J.; Martin-Mazuelos, E.; Negri, Clara Ezequiel [UNIFESP]; Pfaller, M. A.; Tortorano, A. M.
    Estimating epidemiological cutoff endpoints (ECVs/ECOFFS) may be hindered by the overlap of MICs for mutant and nonmutant strains (strains harboring or not harboring mutations, respectively). Posaconazole MIC distributions for the Aspergillus fumigatus species complex were collected from 26 laboratories (in Australia, Canada, Europe, India, South and North America, and Taiwan) and published studies. Distributions that fulfilled CLSI criteria were pooled and ECVs were estimated. The sensitivity of three ECV analytical techniques (the ECOFFinder, normalized resistance interpretation [NRI], derivatization methods) to the inclusion of MICs for mutants was examined for three susceptibility testing methods (the CLSI, EUCAST, and Etest methods). The totals of posaconazole MICs for nonmutant isolates (isolates with no known cyp51A mutations) and mutant A. fumigatus isolates were as follows: by the CLSI method, 2,223 and 274, respectively