ESCMID Online Lecture Library. by author

Size: px
Start display at page:

Download "ESCMID Online Lecture Library. by author"

Transcription

1 Eric DANNAOUI ESCMID Postgraduate Education Course June 2013, Sibiu Antifungal susceptibility testing and detection of resistance: principles and practices Unité de Parasitologie-Mycologie, Laboratoire de microbiologie, HEGP Université Paris 5

2 What is a resistance How to detect resistance When to detect resistance The way to define resistance: ECOFFs and CBs Revision of CBs Reference methods: EUCAST, CLSI Commercialized methods (e.g. Etest) Other methods Recommendations in the clinical laboratory

3 «Clinical resistance» depends on many factors Patient Immune status Site of infection Foreign materials Non compliance Clinical failure Antifungal Fungistatic nature Dosage Pharmacokinetics Drug-drug interactions Fungus Microbiological resistance Biofilm production Inoculum size «Clinical resistance» is different from microbiological resistance

4 From MICs to Clinical Breakpoints : three steps MIC ECOFF MIC determination: technical issues (EUCAST, CLSI) CB Determination of clinical breakpoints (CBs) Determination of WT population for each species (ECOFFs/ECVs) S I R

5 Determination and analysis of MIC distributions

6 EUCAST definitions of wild-type MIC distribution and epidemiological cut-off Values (ECOFFs) Wild Type (WT) A micro-organism is defined as wild type (WT) for a species by the absence of acquired and mutational resistance mechanisms to the drug in question A micro-organism is categorized as wild type (WT) for a species by applying the appropriate cutoff value in a defined phenotypic test system Wild type micro-organisms may or may not respond clinically to antimicrobial treatment The wild type is presented as WT<z mg/l and non-wild type as NWT >z mg/l

7 EUCAST wild-type (WT) MIC distribution and epidemiological cut-off Values (ECOFFs) 1. Set-up of MIC distribution Specific for a given species Must integrate all MIC values of the distribution (lowest and highest values not truncated) 2. Methods for ECOFFs determination Simple estimation by visual inspection Statistical analysis (important when overlap between WT and non-wt populations) Turnidge et al. Clin Microbiol Infect 2006; 12: Turnidge et al. CMR 2007; 20:

8 EUCAST wild-type MIC distribution and epidemiological cut-off Values (ECOFFs) % of isolates C. albicans/ fluconazole MIC (mg/l) Epidemiological cut-off: WT 1 mg/l 3756 observations (12 data sources) ECOFF

9 EUCAST wild-type MIC distribution and epidemiological cut-off Values (ECOFFs) % of isolates C. glabrata/ fluconazole Epidemiological cut-off: WT 32 mg/l 898 observations (12 data sources) MIC (mg/l) 4 8 ECOFF

10 ECOFFs main characteristics Can be determined for all species No change over time Useful for epidemiological surveillance Sensitive for detection of resistance Non WT may or may not respond clinically Useful when CBs not determined

11 CLSI wild-type MIC distribution and epidemiological cutoff Values (ECVs) ITZ VRZ ECV ECV ECV PSZ A. fumigatus / azoles Adapted from Espinel-Ingroff et al., JCM 2010, 48, 3251

12 Interpretation of MICs Definition of Clinical Breakpoints (CBs)

13 EUCAST definitions of clinical breakpoints Clinical resistance and clinical breakpoints Clinically Resistant (R) A micro-organism is defined as resistant by a level of antimicrobial activity associated with a high likelihood of therapeutic failure A micro-organism is categorized as resistant (R) by applying the appropriate breakpoint in a defined phenotypic test system This breakpoint may be altered with legitimate changes in circumstances Clinical breakpoints are presented as S<x mg/l; I>x, <y mg/l; R>y mg/l

14 % of isolates EUCAST wild-type MIC distribution and epidemiological cut-off Values (ECOFFs) Determination of CBs C. albicans/ fluconazole WT Epidemiological cut-off: WT 1 mg/l 3756 observations (12 data sources) 0.5 ECOFF 1 Clinical failure? MIC (mg/l) Clinical failure? 16 Clinical failure? Genotypically detectable resistance Phenotypically detectable resistance 32 Clinical failure? Adapted from G. Kahlmeter

15 Strategy for CBs determination: Complex problem Should integrate many parameters Historical data ATF pharmacokinetics MIC distributions Molecular mechanisms of resistance Animal models Clinical data

16 EUCAST Procedure for Harmonising and Defining Breakpoints Relevant factors in setting breakpoints for new antimicrobials and assessment of data: Dosing, formulations (oral, iv), indications and practices, target organisms MIC distributions and ECOFFs determined Dose-effect relationships in vitro studies, animal studies and humans (PK/PD data) evaluated National CBs compared and discussed Clinical data relating outcome to MIC-values Modelling processes, Monte Carlo simulation Consensus breakpoints are sought CBs tested against target species MIC distributions. CBs should not divide the WT distributions No CBs if species a poor target for the drug ( - ) or insufficient evidence that the species is a good target for the drug (IE)

17 Clinical Breakpoints (CBs) main characteristics Useful to predict therapeutic efficacy Not determined for all species No obvious relationships between CBs and ECOFFs May change (revised by committees) over time

18 CLSI wild-type MIC distribution and epidemiological cutoff Values (ECVs) Determination of CBs % of isolates C. albicans/ fluconazole ECV 1 2 MIC (mg/l) Epidemiological cut-off: WT 1 mg/l 7851 observations (12 data sources) S I R S I R New CLSI CBs Old CLSI CBs

19 Candida glabrata Antifungals: MIC - CBs Revision of CLSI Clinical Breakpoints Antifungal Susceptible SDD/Interm Resistant Echinocandins 2 ND ND WT Mutant Garcia-Effron et al. AAC 2009;53 :3690

20 Antifungals: MIC - CBs Definition of CBs for Candida spp. (µg/ml) Revision of CLSI Clinical Breakpoints 1-6 Antifungal Susceptible SDD/Interm Resistant Echinocandins 2 ND ND Species Caspo Mica Anidula C. albicans C. tropicalis C. krusei S I R For C. glabrata: S 0.12, I 0,25, R ³ 0.5 for caspo and anidula and S 0.06, I 0,125, R ³ 0.25 for micafungin 1. CLSI M27-A3, Pfaller et al. JCM 2006;44 : Pfaller et al. JCM 2008;46 : Pfaller et al. ICAAC 2010, M Pfaller et al. Drug resist Updat 2011,14, CLSI M27-S4, 2013

21 ECOFFs and CBs take-home messages ECOFFs and CBs: two different parameters ECOFFs: microbiological resistance CBs: clinical failure No relationships between these 2 parameters ECOFFs stable, CBs may be revised

22 How to detect resistance in practice

23 Parameter CLSI (M27-A3) Format Microdilution Microdilution EUCAST (E.Def 7.2) Culture medium RPMI + MOPS, ph 7.0 RPMI + MOPS + 2% glucose, ph 7.0 Final inoculum 0.5 à 2.5 x10 3 CFU /ml 0.5 to 2.5x10 5 CFU /ml Incubation 48h (24h echino, +/- AMB, FCZ) 24h Reading Visual Spectrophotometric MIC endpoint Candida spp. Technique standardization Azoles, 5FC, echino 50% inhibition 50% inhibition AMB 100% inhibition 90% inhibition To note: trends towards harmonization

24 Antifungal Microdilution broth techniques: CLSI, EUCAST 5FC FCZ ITZ VRZ PSZ TER AMB CAS Concentration (mg/l) MIC MIC MIC MIC MIC MIC MIC Les techniques in vitro 5FC : > 128 µg/ml FCZ : 4 µg/ml ITZ : 0.12 µg/ml VRZ : 0.06 µg/ml PSZ : 0.06 µg/ml TER : 0.25 µg/ml AMB : 0.5 µg/ml CAS : 0.12 µg/ml

25 Etest method Commercialized Standardized Easy to perform Adapted to routine testing in clinical lab Sometime better than ref technique (AMB et Candida) Alternative methods But Expensive May be difficult to read Sometime less effective than ref technique (5FC and Crypto)

26 Etest method Exponential gradient of antifungal Inoculum preparation Alternative methods Inoculation Incubation reading

27 Acquired resistance to echinocandins in Candida spp. Isolate Caspofungin MIC (µg/ml) EUCAST Etest S R Baixench, M. T., et al J Antimicrob Chemother 59: Dannaoui, E., et al Emerg Infect Dis 18:86-90.

28 Screening of azole-resistance in Aspergillus spp. Azole-containing agar Drug-free ITZ VRZ S R Isolate EUCAST MIC (µg/ml) ITZ VRZ >8 4 Choukri et al. Unpublished

29 When to perform AFST for resistance detection in practice?

30 Candida spp. infections On a routine basis When to detect resistance Identification to species level for deep site Routine testing of FCZ and echino against C. glabrata (deep site) Routine testing of other species possibly helpful but susceptibility usually predictable by species Use CBPs or ECVs to interpret results as appropriate Consider cross-resistance between fluconazole and all other azoles to be complete for C. glabrata Adapted from Pfaller et al. J. Clin. Microbiol. 2012, 50(9):2846

31 Candida spp. infections Mucosal candidiasis Determination of azole susceptibility not routinely necessary Susceptibility testing of azoles may be useful for patients unresponsive to therapy Invasive disease with clinical failure of initial therapy When to detect resistance Consider susceptibility testing as an adjunct AMB, 5FC, FCZ, VRZ, and an echinocandin Consultation with an experienced microbiologist recommended Adapted from Pfaller et al. J. Clin. Microbiol. 2012, 50(9):2846

32 Candida spp. infections When to detect resistance Infection with species with high rates of intrinsic or acquired resistance Susceptibility testing not necessary when intrinsic resistance is known C. lusitaniae and amphotericin B C. krusei and fluconazole, flucytosine C. guilliermondii and echinocandins With high rates of acquired resistance, monitor closely for signs of failure and perform susceptibility testing C. glabrata and fluconazole, AMB, and echinocandins C. krusei and AMB C. guilliermondii and AMB C. rugosa and AMB, fluconazole, and echinocandins Adapted from Pfaller et al. J. Clin. Microbiol. 2012, 50(9):2846

33 Candida spp. infections When to detect resistance New treatment options (e.g., echinocandins, voriconazole, posaconazole) or unusual species Susceptibility testing warranted if prior exposure to echinocandins or fluconazole Susceptibility testing may be helpful when patient is not responding to what should be effective therapy Patients who respond to therapy despite being infected with an organism later found to be resistant Best approach not clear Take into account severity of infection, patient immune status, consequences of recurrent infection, etc. Consider alternative therapy for infections with isolates that appear to be highly resistant to initial therapy Adapted from Pfaller et al. J. Clin. Microbiol. 2012, 50(9):2846

34 Aspergillus spp. infections Identification to the species level Routine testing of triazoles against Aspergillus spp. : ITZ, VRZ, PSZ Other mold infections When to detect resistance On a case-by-case basis After discussion between clinician and microbiologist

35 Thank you!

36

Empfindlichkeitstestung bei Pilzen Neuigkeiten? Bericht aus einem EUCAST AFST (yeasts and moulds) Netzwerk-Laboratorium

Empfindlichkeitstestung bei Pilzen Neuigkeiten? Bericht aus einem EUCAST AFST (yeasts and moulds) Netzwerk-Laboratorium Empfindlichkeitstestung bei Pilzen Neuigkeiten? Bericht aus einem EUCAST AFST (yeasts and moulds) Netzwerk-Laboratorium EUCAST reloaded 6.0 Follow-up Workshop 23.03.2017 Cornelia Lass-Flörl Division of

More information

testing for the daily routine?

testing for the daily routine? What is the role of in vitro antifungal susceptibility testing for the daily routine? ESCMID, Rome 2010 Cornelia Lass-Flörl Medical University Innsbruck Faculty disclosure Invited speaker: Pfizer, Gilead,

More information

ANTIFUNGAL SUSCEPTIBILITY TESTING

ANTIFUNGAL SUSCEPTIBILITY TESTING MYCOLOGY QAP UPDATE ANTIFUNGAL SUSCEPTIBILITY TESTING Sarah Kidd: National Mycology Reference Centre, SA Pathology Deb Walker, Elizabeth Haremza, Arthur Morris: RCPAQAP sarah.kidd@sa.gov.au @thefunguskidd

More information

Case. Case. Case. Case. Reference lab AST. Nelesh Govender, NICD 2013/03/08. Candida species: Antifungal susceptibility testing in 2013

Case. Case. Case. Case. Reference lab AST. Nelesh Govender, NICD 2013/03/08. Candida species: Antifungal susceptibility testing in 2013 Nelesh Govender, NICD 13/3/8 se ndida species: Antifungal susceptibility testing in 13 Nelesh Govender National Institute for Communicable Diseases and University of the Witwatersrand, Johannesburg Elderly

More information

Cut-off Values and Species-Specific Breakpoints 12/19/2016

Cut-off Values and Species-Specific Breakpoints 12/19/2016 Welcome to Mayo Medical Laboratories Hot Topics. These presentations provide short discussion of current topics and may be helpful to you in your practice. 1 Laboratories and Professor of Laboratory Medicine

More information

Voriconazole and Aspergillus spp. Rationale for the EUCAST clinical breakpoints, version May 2012

Voriconazole and Aspergillus spp. Rationale for the EUCAST clinical breakpoints, version May 2012 Voriconazole and Aspergillus spp. Rationale for the EUCAST clinical breakpoints, version 1.0 20 May 2012 Foreword EUCAST The European Committee on Antimicrobial Susceptibility Testing (EUCAST) is organised

More information

Dr. Rukumani Devi Velayuthan Mycology Unit Co-ordinator PPUM

Dr. Rukumani Devi Velayuthan Mycology Unit Co-ordinator PPUM Antifungal sensitivity testing using VITEK 2 Dr. Rukumani Devi Velayuthan Mycology Unit Co-ordinator PPUM VITEK 2 Systems The VITEK 2 System is intended for the automated identification and susceptibility

More information

Susceptibility testing in Aspergillus species complex

Susceptibility testing in Aspergillus species complex REVIEW 10.1111/1469-0691.12514 Susceptibility testing in Aspergillus species complex C. Lass-Fl orl Division of Hygiene and Medical Microbiology, Innsbruck Medical University, Innsbruck, Austria Abstract

More information

Antifungal PK/PD Made Simple. David Andes, MD University of Wisconsin

Antifungal PK/PD Made Simple. David Andes, MD University of Wisconsin Antifungal PK/PD Made Simple David Andes, MD University of Wisconsin PK/PD Concept Serum Drug Concentration Peak:MIC AUC:MIC Ratio Time Above MIC MIC Time Hypothesis and Concept There is an optimal drug

More information

Chapter 2 Antifungal Susceptibility Testing: Clinical Laboratory and Standards Institute (CLSI) Methods

Chapter 2 Antifungal Susceptibility Testing: Clinical Laboratory and Standards Institute (CLSI) Methods Chapter 2 Antifungal Susceptibility Testing: Clinical Laboratory and Standards Institute (CLSI) Methods Annette W. Fothergill Abstract Antifungal susceptibility testing has become an important tool for

More information

Antifungal Suceptibility Testing : Guidelines to Practical approach. Dr Deepti Rawat

Antifungal Suceptibility Testing : Guidelines to Practical approach. Dr Deepti Rawat Antifungal Suceptibility Testing : Guidelines to Practical approach Dr Deepti Rawat Introduction Increase incidence of fungal infections Increase in immunosuppressive states Increasing evidence of invasive

More information

ACCEPTED. Yanjun Li 1. M. Hong Nguyen 2,3,4. Harmut Derendorf 1. Shaoji Cheng 2. *Cornelius J. Clancy 2,3

ACCEPTED. Yanjun Li 1. M. Hong Nguyen 2,3,4. Harmut Derendorf 1. Shaoji Cheng 2. *Cornelius J. Clancy 2,3 AAC Accepts, published online ahead of print on 21 May 2007 Antimicrob. Agents Chemother. doi:10.1128/aac.00308-07 Copyright 2007, American Society for Microbiology and/or the Listed Authors/Institutions.

More information

for Antifungal Susceptibility Testing of Yeast Isolates

for Antifungal Susceptibility Testing of Yeast Isolates JOURNAL OF CLINICAL MICROBIOLOGY, Aug. 1994, p. 1992-1996 0095-1137/94/$00+0 Copyright C 1994, American Society for Microbiology Vol., No. 8 Evaluation of a Novel Colorimetric Broth Microdilution Method

More information

for Antifungal Susceptibility Testing of Yeast Isolates

for Antifungal Susceptibility Testing of Yeast Isolates JOURNAL OF CLINICAL MICROBIOLOGY, Aug. 1994, p. 1992-1996 0095-1137/94/$00+0 Copyright C 1994, American Society for Microbiology Vol., No. 8 Evaluation of a Novel Colorimetric Broth Microdilution Method

More information

for Antifungal Susceptibility Testing of Yeast Isolates

for Antifungal Susceptibility Testing of Yeast Isolates JOURNAL OF CLINICAL MICROBIOLOGY, Aug. 1994, p. 1992-1996 0095-1137/94/$00+0 Copyright C 1994, American Society for Microbiology Vol., No. 8 Evaluation of a Novel Colorimetric Broth Microdilution Method

More information

Antifungal Resistance: Focus on Candida species

Antifungal Resistance: Focus on Candida species Antifungal Resistance: Focus on Candida species Peter G. Pappas, MD, FACP Professor of Medicine and Director, MSG Division of Infectious Diseases University of Alabama at Birmingham Birmingham, AL, USA

More information

Approximately 20% of the responding CLSI membership whose hospitals had greater than 200 beds was performing antifungal testing.

Approximately 20% of the responding CLSI membership whose hospitals had greater than 200 beds was performing antifungal testing. Vol. 28 No. 14 Replaces M27-A2 Vol. 22 No. 15 Reference Method for Broth Dilution Antifungal Susceptibility Testing of Yeasts; Approved Standard Third Edition This document addresses the selection and

More information

on September 27, 2018 by guest

on September 27, 2018 by guest AAC Accepts, published online ahead of print on 26 August 2013 Antimicrob. Agents Chemother. doi:10.1128/aac.01032-13 Copyright 2013, American Society for Microbiology. All Rights Reserved. Comparison

More information

Candida biofilm. José Garnacho Montero Hospital Universitario Virgen del Rocío Sevilla. Spain

Candida biofilm. José Garnacho Montero Hospital Universitario Virgen del Rocío Sevilla. Spain Candida biofilm José Garnacho Montero Hospital Universitario Virgen del Rocío Sevilla. Spain Introduction Candidemia is frequently associated with the biofilm growth of Candida organisms on medical devices

More information

Standardization of Antifungal Susceptibility Variables for a Semiautomated Methodology

Standardization of Antifungal Susceptibility Variables for a Semiautomated Methodology JOURNAL OF CLINICAL MICROBIOLOGY, July 2001, p. 2513 2517 Vol. 39, No. 7 0095-1137/01/$04.00 0 DOI: 10.1128/JCM.39.7.2513 2517.2001 Copyright 2001, American Society for Microbiology. All Rights Reserved.

More information

EUCAST DEFINITIVE DOCUMENT

EUCAST DEFINITIVE DOCUMENT EUCAST DEFINITIVE DOCUMENT 10.1111/j.1469-0691.2007.01935.x EUCAST Definitive Document EDef 7.1: method for the determination of broth dilution MICs of antifungal agents for fermentative yeasts Subcommittee

More information

Received 5 June 2009/Returned for modification 31 July 2009/Accepted 23 October 2009

Received 5 June 2009/Returned for modification 31 July 2009/Accepted 23 October 2009 JOURNAL OF CLINICAL MICROBIOLOGY, Jan. 2010, p. 154 161 Vol. 48, No. 1 0095-1137/10/$12.00 doi:10.1128/jcm.01096-09 Copyright 2010, American Society for Microbiology. All Rights Reserved. Antifungal Susceptibility

More information

Influence of Glucose Supplementation and Inoculum Size on Growth Kinetics and Antifungal Susceptibility Testing of Candida spp.

Influence of Glucose Supplementation and Inoculum Size on Growth Kinetics and Antifungal Susceptibility Testing of Candida spp. JOURNAL OF CLINICAL MICROBIOLOGY, Feb. 2001, p. 525 532 Vol. 39, No. 2 0095-1137/01/$04.00 0 DOI: 10.1128/JCM.39.2.525 532.2001 Copyright 2001, American Society for Microbiology. All Rights Reserved. Influence

More information

New Hope For Serious Infections

New Hope For Serious Infections New Hope For Serious Infections Forward-Looking Statements Statements contained in this press release regarding matters that are not historical facts are "forward-looking statements" within the meaning

More information

Identification of Candida inconspicua clinical isolates and testing of fluconazole, amphotericin B, flucytosine and caspofungin susceptibility

Identification of Candida inconspicua clinical isolates and testing of fluconazole, amphotericin B, flucytosine and caspofungin susceptibility Identification of Candida inconspicua clinical isolates and testing of fluconazole, amphotericin B, flucytosine and caspofungin susceptibility Ph.D. theses László Majoros Department of Medical Microbiology,

More information

Influence of Test Conditions on Antifungal Time-Kill Curve Results: Proposal for Standardized Methods

Influence of Test Conditions on Antifungal Time-Kill Curve Results: Proposal for Standardized Methods ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, May 1998, p. 1207 1212 Vol. 42, No. 5 0066-4804/98/$04.00 0 Copyright 1998, American Society for Microbiology Influence of Test Conditions on Antifungal Time-Kill

More information

Hours: Comparison of the Rapid Susceptibility Assay with the Clinical and Laboratory. Standards Institute s Microbroth Dilution Assay AFFILIATION

Hours: Comparison of the Rapid Susceptibility Assay with the Clinical and Laboratory. Standards Institute s Microbroth Dilution Assay AFFILIATION JCM Accepts, published online ahead of print on 21 October 2009 J. Clin. Microbiol. doi:10.1128/jcm.01306-09 Copyright 2009, American Society for Microbiology and/or the Listed Authors/Institutions. All

More information

Received 14 November 2010/Returned for modification 27 December 2010/Accepted 13 March 2011

Received 14 November 2010/Returned for modification 27 December 2010/Accepted 13 March 2011 ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, June 2011, p. 3031 3035 Vol. 55, No. 6 0066-4804/11/$12.00 doi:10.1128/aac.01569-10 Copyright 2011, American Society for Microbiology. All Rights Reserved. In Vitro

More information

SHORT THESIS FOR DEGREE OF DOCTOR OF PHILOSOPHY (Ph.D.)

SHORT THESIS FOR DEGREE OF DOCTOR OF PHILOSOPHY (Ph.D.) SHORT THESIS FOR DEGREE OF DOCTOR OF PHILOSOPHY (Ph.D.) The paradoxical growth of Candida albicans, C. dubliniensis, C. krusei and C. tropicalis strains in the presence of high concentration caspofungin

More information

Cencountered problem in hospitalised

Cencountered problem in hospitalised Utility of Chrom Medium for Antifungal Susceptibility Testing of Candida Species Against Fluconazole and Voriconazole in Resource Constrained Settings Shashir Wanjare, Rupali Suryawanshi, Arati Bhadade,

More information

Disk diffusion test and E-test with enriched Mueller-Hinton agar for determining susceptibility of Candida species to voriconazole and fluconazole

Disk diffusion test and E-test with enriched Mueller-Hinton agar for determining susceptibility of Candida species to voriconazole and fluconazole J Microbiol Immunol Infect. 2009;42:148-153 Disk diffusion test and E-test with enriched Mueller-Hinton agar for determining susceptibility of Candida species to voriconazole and fluconazole Sai-Cheong

More information

Received 5 September 2006/Returned for modification 17 October 2006/Accepted 21 December 2006

Received 5 September 2006/Returned for modification 17 October 2006/Accepted 21 December 2006 JOURNAL OF CLINICAL MICROBIOLOGY, Mar. 2007, p. 698 706 Vol. 45, No. 3 0095-1137/07/$08.00 0 doi:10.1128/jcm.01840-06 Copyright 2007, American Society for Microbiology. All Rights Reserved. Comparative

More information

Received 2 August 1995/Returned for modification 10 October 1995/Accepted 18 January 1996

Received 2 August 1995/Returned for modification 10 October 1995/Accepted 18 January 1996 JOURNAL OF CLINICAL MICROBIOLOGY, Apr. 1996, p. 842 847 Vol. 34, No. 4 0095-1137/96/$04.00 0 Copyright 1996, American Society for Microbiology Fluconazole and Amphotericin B Antifungal Susceptibility Testing

More information

Johan W Mouton Canisius-Wilhelmina Hospital Nijmegen, The Netherlands

Johan W Mouton Canisius-Wilhelmina Hospital Nijmegen, The Netherlands Can pk/pd replace clinical trials? Johan W Mouton Canisius-Wilhelmina Hospital Nijmegen, The Netherlands The Traditional Approach Phase Participants Research questions Number Characteristics I 10-50 Usually

More information

Setting Clinical Breakpoints/ECOFFS

Setting Clinical Breakpoints/ECOFFS 23 rd August 2016 Setting Clinical Breakpoints/ECOFFS Robin A Howe Antimicrobial use in Primary Care An E. coli is grown from blood cultures Cefuroxime MIC 2mg/L Zone around CXM 30ug disc 27mm Is it sensitive?

More information

Comparison of four reading methods of broth microdilution based on the Clinical and Laboratory Standards Institute M27-A3 method for Candida spp.

Comparison of four reading methods of broth microdilution based on the Clinical and Laboratory Standards Institute M27-A3 method for Candida spp. Oct. 2012 THE JAPANESE JOURNAL OF ANTIBIOTICS 65 5 335 45 Comparison of four reading methods of broth microdilution based on the Clinical and Laboratory Standards Institute M27-A3 method for Candida spp.

More information

Candida species remain the most common cause of invasive fungal infections, with. crossm

Candida species remain the most common cause of invasive fungal infections, with. crossm PHARMACOLOGY crossm SCY-078 Is Fungicidal against Candida Species in Time-Kill Studies Bernard Scorneaux, a David Angulo, a Katyna Borroto-Esoda, a Mahmoud Ghannoum, b Michael Peel, a Stephen Wring a Scynexis,

More information

ACCEPTED. Species-Specific Differences in the Susceptibility of Biofilms Formed by. University Medical School, Gwangju, Korea

ACCEPTED. Species-Specific Differences in the Susceptibility of Biofilms Formed by. University Medical School, Gwangju, Korea AAC Accepts, published online ahead of print on February 00 Antimicrob. Agents Chemother. doi:./aac.01-0 Copyright 00, American Society for Microbiology and/or the Listed Authors/Institutions. All Rights

More information

Preliminary Evaluation of a Semisolid Agar Antifungal Susceptibility Test for Yeasts and Molds

Preliminary Evaluation of a Semisolid Agar Antifungal Susceptibility Test for Yeasts and Molds JOURNAL OF CLINICAL MICROBIOLOGY, Feb. 2000, p. 537 541 Vol. 38, No. 2 0095-1137/00/$04.00 0 Copyright 2000, American Society for Microbiology. All Rights Reserved. Preliminary Evaluation of a Semisolid

More information

Differentiated Antifungal Potentially Meeting A Clear Medical Need: Initiating BUY/$14 TP

Differentiated Antifungal Potentially Meeting A Clear Medical Need: Initiating BUY/$14 TP SCYNEXIS, Inc November 17, 2016 BUY (SCYX, $3.53) Differentiated Antifungal Potentially Meeting A Clear Medical Need: Initiating BUY/$14 TP Jonathan Aschoff, Ph.D. 212.417.8277 jaschoff@opnresearch.com

More information

Montagna et al. BMC Microbiology (2015) 15:106 DOI /s

Montagna et al. BMC Microbiology (2015) 15:106 DOI /s Montagna et al. BMC Microbiology (2015) 15:106 DOI 10.1186/s12866-015-0442-4 RESEARCH ARTICLE Open Access Susceptibility to echinocandins of Candida spp. strains isolated in Italy assessed by European

More information

by author How to effectively report laboratory findings to clinicians (Breakpoints and Interpretation)

by author How to effectively report laboratory findings to clinicians (Breakpoints and Interpretation) How to effectively report laboratory findings to clinicians (Breakpoints and Interpretation) A Vatopoulos National School of Public Health & Central Public Health Laboratory KEELPNO Antibiotic Activity

More information

Comparison between Disk Diffusion and Microdilution Methods for Determining Susceptibility of Clinical Fungal Isolates to Caspofungin

Comparison between Disk Diffusion and Microdilution Methods for Determining Susceptibility of Clinical Fungal Isolates to Caspofungin JOURNAL OF CLINICAL MICROBIOLOGY, Nov. 2007, p. 3529 3533 Vol. 45, No. 11 0095-1137/07/$08.00 0 doi:10.1128/jcm.00826-07 Copyright 2007, American Society for Microbiology. All Rights Reserved. Comparison

More information

Correlation of MIC with Outcome for Candida Species Tested against Voriconazole: Analysis and Proposal for Interpretive Breakpoints

Correlation of MIC with Outcome for Candida Species Tested against Voriconazole: Analysis and Proposal for Interpretive Breakpoints JOURNAL OF CLINICAL MICROBIOLOGY, Mar. 2006, p. 819 826 Vol. 44, No. 3 0095-1137/06/$08.00 0 doi:10.1128/jcm.44.3.819 826.2006 Copyright 2006, American Society for Microbiology. All Rights Reserved. Correlation

More information

Phenotypic characterization of Candida isolates obtained from non respiratory clinical specimens from superspeciality tertiary care center in Mumbai

Phenotypic characterization of Candida isolates obtained from non respiratory clinical specimens from superspeciality tertiary care center in Mumbai Original article: Phenotypic characterization of Candida isolates obtained from non respiratory clinical specimens from superspeciality tertiary care center in Mumbai Dr. Dhruv K. Mamtora, Dr Sanjith Saseedharan,

More information

Effects of Temperature on Anti-Candida Activities of Antifungal Antibiotics

Effects of Temperature on Anti-Candida Activities of Antifungal Antibiotics ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, Apr. 1993, p. 685-691 Vol. 37, No. 4 66-484/93/4685-7$2./ Copyright 1993, American Society for Microbiology Effects of Temperature on Anti-Candida Activities of Antifungal

More information

New Hope For Serious Infections

New Hope For Serious Infections New Hope For Serious Infections Forward-Looking Statements These slides and the accompanying oral presentation (the Presentation ) contain forward-looking statements within the meaning of the Private Securities

More information

Antifungal Susceptibility testing: New trends. Abstract: Amina Mostafa Abdel Aal, Mohamed M. Taha*, Noha El-Mashad and Walaa El-Shabrawy

Antifungal Susceptibility testing: New trends. Abstract: Amina Mostafa Abdel Aal, Mohamed M. Taha*, Noha El-Mashad and Walaa El-Shabrawy Antifungal Susceptibility testing: New trends Amina Mostafa Abdel Aal, Mohamed M. Taha*, ha El-Mashad and Walaa El-Shabrawy Egyptian Dermatology Online Journal 3 (1): 1, June, 2007 Departments of: Clinical

More information

ECCMID SCY-078 Scientific Data Presentation Conference Call

ECCMID SCY-078 Scientific Data Presentation Conference Call A New Path for Antifungal Treatments ECCMID SCY-078 Scientific Data Presentation Conference Call April 25, 2017 4:05pm ET Forward-Looking Statements Certain statements regarding SCYNEXIS, Inc. (the Company

More information

In Vivo Pharmacokinetics and Pharmacodynamics of APX001 against. Candida spp. in a Neutropenic Disseminated Candidiasis Mouse Model

In Vivo Pharmacokinetics and Pharmacodynamics of APX001 against. Candida spp. in a Neutropenic Disseminated Candidiasis Mouse Model AAC Accepted Manuscript Posted Online 29 January 2018 Antimicrob. Agents Chemother. doi:10.1128/aac.02542-17 Copyright 2018 American Society for Microbiology. All Rights Reserved. 1 2 In Vivo Pharmacokinetics

More information

Terapia delle Infezioni Fungine. Claudio Viscoli Malattie Infettive Università di Genova e IRCCS an Martino-IST

Terapia delle Infezioni Fungine. Claudio Viscoli Malattie Infettive Università di Genova e IRCCS an Martino-IST Terapia delle Infezioni Fungine Claudio Viscoli Malattie Infettive Università di Genova e IRCCS an Martino-IST Invasive candidiasis IDSA guidelines 2016 Treatment for candidemia in non-neutropenic patients

More information

FLUCONAZOLE SUSCEPTIBILITY TESTING OF CANDIDA SPECIES BY DISC DIFFUSION AND AGAR DILUTION METHOD

FLUCONAZOLE SUSCEPTIBILITY TESTING OF CANDIDA SPECIES BY DISC DIFFUSION AND AGAR DILUTION METHOD FLUCONAZOLE SUSCEPTIBILITY TESTING OF CANDIDA SPECIES BY DISC DIFFUSION AND AGAR DILUTION METHOD Supriya Tankhiwale, Sunita Gajbhiye, Rajaram Powar 1. Associate Professor, Department of Microbiology, Government

More information

ACCEPTED. In vitro interactions of micafungin with amphotericin B against. clinical isolates of Candida spp.

ACCEPTED. In vitro interactions of micafungin with amphotericin B against. clinical isolates of Candida spp. AAC Accepts, published online ahead of print on January 00 Antimicrob. Agents Chemother. doi:./aac.0-0 Copyright 00, American Society for Microbiology and/or the Listed Authors/Institutions. All Rights

More information

Method for the determination of broth dilution minimum Inhibitory concentrations of antifungal agents for yeasts

Method for the determination of broth dilution minimum Inhibitory concentrations of antifungal agents for yeasts EUCAST DEFINITIVE DOCUMENT E.DEF 7.3 Method for the determination of broth dilution minimum Inhibitory concentrations of antifungal agents for yeasts M. C. Arendrup 1, J Guinea 2, M. Cuenca-Estrella 3,

More information

SIOPI MARIA, M.Sc. Clinical Chemistry

SIOPI MARIA, M.Sc. Clinical Chemistry Personal information Date of birth: 20/09/1984 Place of birth: Athens, Greece Work address: Clinical Microbiology Laboratory, Attikon University General Hospital, 1 Rimini Str., Haidari, Athens 124 62,

More information

Alle Echinocandine sind gleich?

Alle Echinocandine sind gleich? Alle Echinocandine sind gleich? Giftiger Donnerstag Hospital Velden, 1.06.2017 Cornelia Lass-Flörl Division of Hygiene and Medical Microbiology Innsbruck Medical University Indications Caspofungin - Candicas

More information

In vitro Antifungal Activity of Isavuconazole and Comparators Against Rare Yeast Pathogens

In vitro Antifungal Activity of Isavuconazole and Comparators Against Rare Yeast Pathogens AAC Accepts, published online ahead of print on 21 June 2010 Antimicrob. Agents Chemother. doi:10.1128/aac.00685-10 Copyright 2010, American Society for Microbiology and/or the Listed Authors/Institutions.

More information

Le resistenze agli antifungini: le conferme microbiologiche. Anna Prigitano Università degli Studi Milano

Le resistenze agli antifungini: le conferme microbiologiche. Anna Prigitano Università degli Studi Milano Le resistenze agli antifungini: le conferme microbiologiche Anna Prigitano Università degli Studi Milano Microbiological resistance Genotypic resistance presence of a particular resistance mechanism mutation

More information

Adopting EUCAST breakpoints in countries currently on CLSI breakpoints

Adopting EUCAST breakpoints in countries currently on CLSI breakpoints 19th ECCMID 1 Adopting EUCAST breakpoints in countries currently on CLSI breakpoints and some personal thinking Paul M. Tulkens Representative of ISC to EUCAST Unité de pharmacologie cellulaire et moléculaire

More information

Direct detec)on of resistance: candins vs. azoles

Direct detec)on of resistance: candins vs. azoles Direct detec)on of resistance: candins vs. azoles David S. Perlin, PhD Execu)ve Director and Professor Public Health Research Ins)tute New Jersey Medical School- UMDNJ 11-14 October 2013 6th Trends in

More information

Isolation and Characterization of Clinical Triazole Resistance Aspergillus fumigatus in Iran

Isolation and Characterization of Clinical Triazole Resistance Aspergillus fumigatus in Iran Iran J Public Health, Vol. 47, No.7, Jul 2018, pp.994-1000 Original Article Isolation and Characterization of Clinical Triazole Resistance in Iran Faezezeh MOHAMMADI 1, *Seyed Jamal HASHEMI 2,3, Seyed

More information

In Vitro and In Vivo Activities of Syn2836, Syn2869, Syn2903, and Syn2921: New Series of Triazole Antifungal Agents

In Vitro and In Vivo Activities of Syn2836, Syn2869, Syn2903, and Syn2921: New Series of Triazole Antifungal Agents ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, Sept. 2001, p. 2420 2426 Vol. 45, No. 9 0066-4804/01/$04.00 0 DOI: 10.1128/AAC.45.9.2420 2426.2001 Copyright 2001, American Society for Microbiology. All Rights Reserved.

More information

EVOLUTION OF DRUG RESISTANCE IN CANDIDA ALBICANS

EVOLUTION OF DRUG RESISTANCE IN CANDIDA ALBICANS Annu. Rev. Microbiol. 2002. 56:139 65 doi: 10.1146/annurev.micro.56.012302.160907 Copyright c 2002 by Annual Reviews. All rights reserved First published online as a Review in Advance on May 16, 2002 EVOLUTION

More information

Multicenter Evaluation of Four Methods of Yeast Inoculum Preparation

Multicenter Evaluation of Four Methods of Yeast Inoculum Preparation JOURNAL OF CLINICAL MICROBIOLOGY, Aug. 1988, p. 1437-1441 0095-1137/88/081437-05$02.00/0 Copyright C 1988, American Society for Microbiology Vol. 26, No. 8 Multicenter Evaluation of Four Methods of Yeast

More information

MICROBIOLOGY AND INVASIVE FUNGAL INFECTION. Javier Pemán, MD, PhD. Mycology Unit, Hospital Univ. La Fe Valencia (Spain)

MICROBIOLOGY AND INVASIVE FUNGAL INFECTION. Javier Pemán, MD, PhD. Mycology Unit, Hospital Univ. La Fe Valencia (Spain) MICROBIOLOGY Mycology Unit, Hospital Univ. La Fe Valencia (Spain) AND INVASIVE FUNGAL INFECTION Javier Pemán, MD, PhD What tools we can offer to optimize antifungal treatment? From lab Bench to Bedside:

More information

Comparison of the ATB Fungus 2 with the AFST-EUCAST for in vitro susceptibility testing of Candida spp.

Comparison of the ATB Fungus 2 with the AFST-EUCAST for in vitro susceptibility testing of Candida spp. Artículo de investigación e innovación Revista de la Universidad Industrial de Santander. Salud Vol.46 No.1 Enero - Abril de 2014 Comparison of the ATB Fungus 2 with the AFST-EUCAST for in vitro susceptibility

More information

Int.J.Curr.Microbiol.App.Sci (2018) 7(8):

Int.J.Curr.Microbiol.App.Sci (2018) 7(8): International Journal of Current Microbiology and Applied Sciences ISSN: 2319-7706 Volume 7 Number 08 (2018) Journal homepage: http://www.ijcmas.com Original Research Article https://doi.org/10.20546/ijcmas.2018.708.276

More information

JAC A comparative evaluation of Etest and broth microdilution methods for fluconazole and itraconazole susceptibility testing of Candida spp.

JAC A comparative evaluation of Etest and broth microdilution methods for fluconazole and itraconazole susceptibility testing of Candida spp. Journal of Antimicrobial Chemotherapy (1999) 43, 477 481 JAC A comparative evaluation of Etest and broth microdilution methods for fluconazole and itraconazole susceptibility testing of Candida spp. Estrella

More information

In vitro Activity of Caspofungin against Planktonic and Sessile Candida sp. Cells

In vitro Activity of Caspofungin against Planktonic and Sessile Candida sp. Cells Polish Journal of Microbiology 2006, Vol. 55, No 2, 133 137 In vitro Activity of Caspofungin against Planktonic and Sessile Candida sp. Cells ANNA SEREFKO, BEATA CHUDZIK and ANNA MALM Department of Pharmaceutical

More information

Well diffusion for antifungal susceptibility testing

Well diffusion for antifungal susceptibility testing International Journal of Infectious Diseases (2004) 8, 39 45 Well diffusion for antifungal susceptibility testing S. Magaldi a, S. Mata-Essayag a, *, C. Hartung de Capriles a, C. Perez a, M.T. Colella

More information

Standard Operating Procedure

Standard Operating Procedure Date of issue: 23 January 2018 Page 1 of 11 Standard Operating Procedure EUCAST SOP 3.2 23 January 2018 Date of issue: 23 January 2018 Page 2 of 11 SOP Number (number.version): 3.2 Date of issue: 23 January

More information

Comparative evaluation of the Vitek 2 yeast susceptibility test and CLSI. broth microdilution reference method for antifungal susceptibility testing

Comparative evaluation of the Vitek 2 yeast susceptibility test and CLSI. broth microdilution reference method for antifungal susceptibility testing JCM Accepts, published online ahead of print on 14 July 2010 J. Clin. Microbiol. doi:10.1128/jcm.00952-10 Copyright 2010, American Society for Microbiology and/or the Listed Authors/Institutions. All Rights

More information

Alle Echinocandine sind gleich?

Alle Echinocandine sind gleich? Alle Echinocandine sind gleich? Giftiger Donnerstag Hospital Innsbruck, 14.09.2017 Cornelia Lass-Flörl Division of Hygiene and Medical Microbiology Innsbruck Medical University Indications Caspofungin

More information

Novel Fluorescent Broth Microdilution Method for Fluconazole Susceptibility Testing of Candida albicans

Novel Fluorescent Broth Microdilution Method for Fluconazole Susceptibility Testing of Candida albicans JOURNAL OF CLINICAL MICROBIOLOGY, July 2001, p. 2708 2712 Vol. 39, No. 7 0095-1137/01/$04.00 0 DOI: 10.1128/JCM.39.7.2708 2712.2001 Copyright 2001, American Society for Microbiology. All Rights Reserved.

More information

Resistance Patterns and Clinical Significance of Candida Colonization and Infection in Combat- Related Injured Patients From Iraq and Afghanistan

Resistance Patterns and Clinical Significance of Candida Colonization and Infection in Combat- Related Injured Patients From Iraq and Afghanistan MAJOR ARTICLE Resistance Patterns and Clinical Significance of Candida Colonization and Infection in Combat- Related Injured Patients From Iraq and Afghanistan Dana M. Blyth, 1 Katrin Mende, 1,2,3 Amy

More information

Rapid identification of Candida glabrata in Candida bloodstream infections

Rapid identification of Candida glabrata in Candida bloodstream infections Journal of Medical Microbiology (2007), 56, 1639 1643 DOI 10.1099/jmm.0.47406-0 Rapid identification of Candida glabrata in Candida bloodstream infections Nicholas Foster, Charlotte Symes, Richard Barton

More information

Top five papers in mycology: the lab perspective

Top five papers in mycology: the lab perspective Top five papers in mycology: the lab perspective MARIE-PIERRE HAYETTE D E PA RT M E N T O F C L I N I C A L M I C RO B I O LOGY-CNR M YC O S E S U N I V E RS I T Y H O S P I TA L O F L I È G E - C I R

More information

Mycology Diagnostics

Mycology Diagnostics Mycology Diagnostics Catriona Halliday Clinical Mycology Reference Laboratory, NSW Health Pathology - CIDMLS, Westmead Hospital www.wslhd.health.nsw.gov.au/cidm-ph Diagnosis of IFD IFDs associated with

More information

Pharmacodynamic Target Evaluation of a Novel Oral Glucan Synthase Inhibitor, SCY-078 (MK-3118), using an In Vivo Murine Invasive Candidiasis Model

Pharmacodynamic Target Evaluation of a Novel Oral Glucan Synthase Inhibitor, SCY-078 (MK-3118), using an In Vivo Murine Invasive Candidiasis Model AAC Accepts, published online ahead of print on 15 December 2014 Antimicrob. Agents Chemother. doi:10.1128/aac.04445-14 Copyright 2014, American Society for Microbiology. All Rights Reserved. 1 2 Pharmacodynamic

More information

Use of Fluorescent Probes To Determine MICs of Amphotericin B and Caspofungin against Candida spp. and Aspergillus spp.

Use of Fluorescent Probes To Determine MICs of Amphotericin B and Caspofungin against Candida spp. and Aspergillus spp. JOURNAL OF CLINICAL MICROBIOLOGY, Aug. 2005, p. 3788 3792 Vol. 43, No. 8 0095-1137/05/$08.00 0 doi:10.1128/jcm.43.8.3788 3792.2005 Copyright 2005, American Society for Microbiology. All Rights Reserved.

More information

Investigational New Drug - Groundwork for in vitro antimicrobial susceptibility testing

Investigational New Drug - Groundwork for in vitro antimicrobial susceptibility testing Investigational New Drug - Groundwork for in vitro antimicrobial susceptibility testing Erika Matuschek, Ph D Lead Scientist/Operational Manager EUCAST Development Laboratory (EDL) Växjö, Sweden ASM/ESCMID

More information

In vitro activity of fluconazole and voriconazole against clinical isolates of Candida spp. by E-test method

In vitro activity of fluconazole and voriconazole against clinical isolates of Candida spp. by E-test method Tropical Biomedicine 27(2): 200 207 (2010) In vitro activity of fluconazole and voriconazole against clinical isolates of Candida spp. by E-test method Madhavan, P. 1, Jamal, F. 1*, Chong, P.P. 2 and Ng,

More information

Gentian Violet Exhibits Activity against Biofilms formed by Oral Candida isolates Obtained from HIV-infected Patients

Gentian Violet Exhibits Activity against Biofilms formed by Oral Candida isolates Obtained from HIV-infected Patients AAC Accepts, published online ahead of print on 28 March 2011 Antimicrob. Agents Chemother. doi:10.1128/aac.01601-10 Copyright 2011, American Society for Microbiology and/or the Listed Authors/Institutions.

More information

Susceptibility testing of sequential isolates of Aspergillus fumigatus recovered from treated patients

Susceptibility testing of sequential isolates of Aspergillus fumigatus recovered from treated patients Journal of Medical Microbiology (2004), 53, 129 134 DOI 10.1099/jmm.0.05326-0 Susceptibility testing of sequential isolates of Aspergillus fumigatus recovered from treated patients Eric Dannaoui, 1 Joseph

More information

Utility of the Germ Tube Test for the Identification of Candida albicans Directly from Positive Blood Culture Bottles. ACCEPTED

Utility of the Germ Tube Test for the Identification of Candida albicans Directly from Positive Blood Culture Bottles. ACCEPTED JCM Accepts, published online ahead of print on August 00 J. Clin. Microbiol. doi:./jcm.01-0 Copyright 00, American Society for Microbiology and/or the Listed Authors/Institutions. All Rights Reserved.

More information

Method for the determination of broth dilution minimum inhibitory concentrations of antifungal agents for conidia forming moulds

Method for the determination of broth dilution minimum inhibitory concentrations of antifungal agents for conidia forming moulds EUCAST DEFINITIVE DOCUMENT EDef 9.2 Method for the determination of broth dilution minimum inhibitory concentrations of antifungal agents for conidia forming moulds M. C. Arendrup 1, M. Cuenca-Estrella

More information

Received 4 May 2011/Returned for modification 20 July 2011/Accepted 23 July 2011

Received 4 May 2011/Returned for modification 20 July 2011/Accepted 23 July 2011 ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, Oct. 2011, p. 4880 4887 Vol. 55, No. 10 0066-4804/11/$12.00 doi:10.1128/aac.00621-11 Copyright 2011, American Society for Microbiology. All Rights Reserved. Pharmacodynamics

More information

Diversity and antifungal susceptibility of Norwegian Candida glabrata clinical isolates

Diversity and antifungal susceptibility of Norwegian Candida glabrata clinical isolates ournal of ral icrobiology æ ORIGINAL ARTICLE Diversity and antifungal susceptibility of Norwegian Candida glabrata clinical isolates Kari-Mette Andersen 1,2 *, Anne Karin Kristoffersen 2, André Ingebretsen

More information

Vulvovaginal Candidiasis due to non albicans Candida: its species distribution and antifungal susceptibility profile

Vulvovaginal Candidiasis due to non albicans Candida: its species distribution and antifungal susceptibility profile ISSN: 2319-7706 Volume 2 Number 12 (2013) pp. 323-328 http://www.ijcmas.com Original Research Article Vulvovaginal Candidiasis due to non albicans Candida: its species distribution and antifungal susceptibility

More information

Tentative epidemiological cutoff values for fluconazole, itraconazole, posaconazole and voriconazole for six Candida species determined by the

Tentative epidemiological cutoff values for fluconazole, itraconazole, posaconazole and voriconazole for six Candida species determined by the JCM Accepts, published online ahead of print on 12 June 2013 J. Clin. Microbiol. doi:10.1128/jcm.01230-13 Copyright 2013, American Society for Microbiology. All Rights Reserved. 1 2 3 4 5 6 7 8 9 10 11

More information

CORPORATE PRESENTATION

CORPORATE PRESENTATION A New Path for Antifungal Treatments Overview of SCY-078 -- First Representative of a Novel Oral/IV Triterpenoid Antifungal Family CORPORATE PRESENTATION September 2017 Forward-Looking Statements Certain

More information

Caspofungin in Combination with Amphotericin B against Candida parapsilosis

Caspofungin in Combination with Amphotericin B against Candida parapsilosis ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, Mar. 2007, p. 941 945 Vol. 51, No. 3 0066-4804/07/$08.00 0 doi:10.1128/aac.00880-06 Copyright 2007, American Society for Microbiology. All Rights Reserved. Caspofungin

More information

Possible mechanisms of the antifungal activity of fluconazole in combination with terbinafine against Candida albicans

Possible mechanisms of the antifungal activity of fluconazole in combination with terbinafine against Candida albicans http://informahealthcare.com/phb ISS 388-29 print/iss 744-56 online Editor-in-Chief: John M. Pezzuto Pharm Biol, Early Online: 5! 24 Informa Healthcare USA, Inc. DOI:.39/38829.24.988 ORIGIAL PAPER Possible

More information

Effect of uvastatin and pravastatin, HMG-CoA reductase inhibitors, on uconazole activity against Candida albicans

Effect of uvastatin and pravastatin, HMG-CoA reductase inhibitors, on uconazole activity against Candida albicans J. Med. Microbiol. Ð Vol. 51 2002), 105±109 # 2002 Society for General Microbiology ISSN 0022-2615 MYCOLOGY Effect of uvastatin and pravastatin, HMG-CoA reductase inhibitors, on uconazole activity against

More information

Can whole genome sequencing replace AST?

Can whole genome sequencing replace AST? Can whole genome sequencing replace AST? Matthew J Ellington Antimicrobial Resistance & Healthcare Associated Infections (AMRHAI) Reference Unit Crown copyright EUCAST Subcommittee on the role of whole

More information

VARIABILITY. Clinical Impact of the Blood Levels of Azoles OUTLINE BACKGROUND

VARIABILITY. Clinical Impact of the Blood Levels of Azoles OUTLINE BACKGROUND Clinical Impact of the Blood Levels of Azoles O. Marchetti, MD Infectious Disease Service, Department of Medicine Centre Hospitalier Universitaire Vaudois and University of Lausanne Switzerland Symposium

More information

trials of aspergillosis Karl V. Clemons, Ph.D. CIMR, SCVMC, & Stanford Univ.

trials of aspergillosis Karl V. Clemons, Ph.D. CIMR, SCVMC, & Stanford Univ. Animal models in preclinical trials of aspergillosis K l V Cl Ph D Karl V. Clemons, Ph.D. CIMR, SCVMC, & Stanford Univ. Why Perform Animal Models of Aspergillosis? Studies on therapy Monotherapy & Combination

More information

Comparison of Three Methods for Testing Azole Susceptibilities of Candida albicans Strains Isolated Sequentially from Oral Cavities of AIDS Patients

Comparison of Three Methods for Testing Azole Susceptibilities of Candida albicans Strains Isolated Sequentially from Oral Cavities of AIDS Patients JOURNAL OF CLINICAL MICROBIOLOGY, June 1998, p. 1578 1583 Vol. 36, No. 6 0095-1137/98/$04.00 0 Copyright 1998, American Society for Microbiology Comparison of Three Methods for Testing Azole Susceptibilities

More information

APX001 is effective against echinocandin and multidrug resistant Candida isolates

APX001 is effective against echinocandin and multidrug resistant Candida isolates APX001 is effective against echinocandin and multidrug resistant Candida isolates David S. Perlin Executive Director and Professor Public Health Research Institute New Jersey Medical School, Rutgers University

More information

EUCAST DISCUSSION DOCUMENT E.Dis 7.1 JUNE 2002

EUCAST DISCUSSION DOCUMENT E.Dis 7.1 JUNE 2002 EUCAST DISCUSSION DOCUMENT E.Dis 7.1 JUNE 2002 Method for the determination of minimum inhibitoryconcentration (MIC) bybroth dilution of fermentative yeasts Subcommittee on Antifungal Susceptibility Testing

More information