Establishment and Use of Epidemiological Cutoff Values for Molds and Yeasts by Use of the Clinical and Laboratory Standards Institute M57 Standard

J Clin Microbiol. 2017 May;55(5):1262-1268. doi: 10.1128/JCM.02416-16. Epub 2017 Feb 15.

Abstract

Breakpoints are used to predict whether an antifungal agent will be clinically effective against a particular fungal isolate. They are based on a combination of MIC values, pharmacokinetic/pharmacodynamic values, and clinical outcome data. For many fungus-antifungal combinations, these data might never be available. For these combinations, epidemiological cutoff values (ECVs) provide a methodology for categorizing isolates as either wild type (WT) or non-WT. In this review, we define ECVs, explain how they are generated using the CLSI methodology in standard M57, and describe how they can be used in clinical practice.

Keywords: ECV; breakpoint; epidemiological cutoff value.

Publication types

  • Review

MeSH terms

  • Antifungal Agents / pharmacology*
  • Candida glabrata / drug effects*
  • Candidiasis / drug therapy*
  • Candidiasis / epidemiology
  • Cryptococcosis / drug therapy*
  • Cryptococcosis / epidemiology
  • Cryptococcus neoformans / drug effects*
  • Drug Resistance, Fungal / physiology*
  • Humans
  • Microbial Sensitivity Tests / methods
  • Treatment Outcome

Substances

  • Antifungal Agents