Why MIC matters? Microbiologists vs. clinicians
DOI:
https://doi.org/10.7175/rhc.v4i1S.863Keywords:
Fungal infections, Resistance, Sensitivity, Clinical cut-off, Epidemiological cut-offAbstract
Several mechanisms of resistance may interfere with the patients’ healing from a fungal infection. However, in premature children fungi are generally susceptible to antifungal agents, except in case of vertical transmission from the mother. In vitro sensitivity tests have been recently harmonized between American and European standards, after years of unhomogeneity: to date, the interpretation of epidemiological cut-off of wild-type population and clinical cut-off are common, and are often updated. Sensitivity tests are difficult to perform, but luckily new commercial tests approved
by FDA are available. Sometimes, knowing the intrinsic sensitivities and resistances of every fungal species and subspecies may be enough in the clinical practice, since few resistances are acquired.
References
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Pfaller MA. Antifungal drug resistance: mechanisms, epidemiology, and consequences for treatment. Am J Med 2012; 125(1 Suppl): S3-S13; http://dx.doi.org/10.1016/j.amjmed.2011.11.001
Pfaller MA, Andes D, Diekema DJ, et al; CLSI Subcommittee for Antifungal Susceptibility Testing. Wild-type MIC distributions, epidemiological cutoff values and species-specific clinical breakpoints for fluconazole and Candida: time for harmonization of CLSI and EUCAST broth microdilution methods. Drug Resist Updat 2010; 13: 180-95; http://dx.doi.org/10.1016/j.drup.2010.09.002
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