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Identification and antifungal susceptibility patterns of reference yeast strains to novel and conventional agents: a comparative study using CLSI, EUCAST and Sensititre YeastOne methods

Summary

Researchers compared three different laboratory methods for testing how well antifungal drugs work against common yeast infections. They tested 22 different yeast strains including Candida species using CLSI, EUCAST, and Sensititre YeastOne methods. The methods showed strong agreement overall, but some newer antifungal drugs like ibrexafungerp showed more variation between methods. The findings suggest these methods are reliable for guiding treatment decisions, but further standardization is needed for newer drugs.

Background

Antifungal susceptibility testing (AFST) is crucial for managing fungal infections and guiding appropriate therapy. Reference yeast strains serve as globally recognized benchmarks for laboratory testing. Discrepancies between MIC values and clinical outcomes can arise due to variations in testing methods across different AFST approaches.

Objective

To identify and determine the MICs of 13 antifungal drugs, including novel agents ibrexafungerp, manogepix and rezafungin, against 22 laboratory reference strains from 14 different Candida species using EUCAST, CLSI and Sensititre YeastOne methods. The study aimed to evaluate concordance between these three testing methodologies.

Results

Complete identification agreement was achieved between molecular and proteomics methods. Manogepix showed the lowest geometric mean MIC (0.01 mg/L), followed by isavuconazole (0.05) and rezafungin (0.03-0.07). Overall essential agreement between EUCAST and CLSI was 95%, with values of 91% for EUCAST vs SYO and 89% for CLSI vs SYO. Ibrexafungerp showed the lowest agreement at 82% between EUCAST and CLSI.

Conclusion

High essential agreement observed reinforces reliability of EUCAST, CLSI and SYO methods for guiding antifungal therapy. However, differences in essential agreement, particularly for ibrexafungerp and 5-flucytosine, highlight the importance of continued evaluation and harmonization of methodologies. Consistent standardization is essential to prevent misclassification of susceptibility profiles that could impact clinical outcomes.
  • Published in:JAC Antimicrobial Resistance,
  • Study Type:Comparative Study,
  • Source: PMID: 40110552, DOI: 10.1093/jacamr/dlaf040
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