CLSI Break Points
Clinical breakpoints (CBPs) and Epidemiological Cut-Off (ECV) values based on MICs or MECs for Candida and Aspergillus species as endorsed by CLSI.3,4 Note that some genotype-specific CLSI ECVs are now available for Cryptococcus species, but require molecular typing for valid use. 4
Current as at September 2021
Abbreviations: ANID, anidulafungin, MICA, micafungin; CASP, caspofungin; VORI, voriconazole; FLUZ, fluconazole; ITRA, itraconazole; POSA, posaconazole; AMB, amphotericin B. * interpretive criteria for echinocandins against Aspergillusspp. are relevant to an MEC endpoint.
|
Species |
Species-specific interpretive categories for CLSI 2-fold broth microdilution MICs (mg/L) |
|||||
S | I | SDD | R | WT | NWT | ||
ANID | C. albicans | ≤0.25 | 0.5 | ≥1 | |||
C. auris | ≤2 | ≥4 | |||||
C. dubliniensis | 0.12 | 0.25 | |||||
C. glabrata | ≤0.12 | 0.25 | ≥0.5 | ||||
C. guilliermondii | ≤2 | 4 | ≥8 | ||||
C. krusei | ≤0.25 | 0.5 | ≥1 | ||||
C. lusitaniae | 1 | 2 | |||||
C. parapsilosis | ≤2 | 4 | ≥8 | ||||
C. tropicalis | ≤0.25 | 0.5 | ≥1 | ||||
CASP | C. albicans | ≤0.25 | 0.5 | ≥1 | |||
C.auris | ≤1 | ≤2 | |||||
C. glabrata | ≤0.12 | 0.25 | ≥0.5 | ||||
C. guilliermondii | ≤2 | 4 | ≥8 | ||||
C. krusei | ≤0.25 | 0.5 | ≥1 | ||||
C. parapsilosis | ≤2 | 4 | ≥8 | ||||
C. tropicalis | ≤0.25 | 0.5 | ≥1 | ||||
A. flavus * | 0.5 | 1 | |||||
A. fumigatus * | 0.5 | 1 | |||||
A. niger * | 0.25 | 0.5 | |||||
A. terreus * | 0.25 | 0.5 | |||||
MICA | C. albicans | ≤0.25 | 0.5 | ≥1 | |||
C. auris | ≤2 | ≤4 | |||||
C. dubliniensis | 0.12 | 0.25 | |||||
C. glabrata | ≤0.06 | 0.12 | ≥0.25 | ||||
C. guilliermondii | ≤2 | 4 | ≥8 | ||||
C. krusei | ≤0.25 | 0.5 | ≥1 | ||||
C. lusitaniae | 0.5 | 1 | |||||
C. parapsilosis | ≤2 | 4 | ≥8 | ||||
C. tropicalis | ≤0.12 | 0.5 | ≥1 | ||||
VORI | C. albicans | ≤0.12 | 0.25-0.5 | ≥1 | |||
C. glabrata | 0.25 | 0.5 | |||||
C. krusei | ≤0.5 | 1 | ≥2 | ||||
C. parapsilosis | ≤0.12 | 0.25-0.5 | ≥1 | ||||
C. tropicalis | ≤0.12 | 0.25-0.5 | ≥1 | ||||
A. flavus | 2 | 4 | |||||
A. fumigatus | ≤0.5 | 1 | ≥2 | 1 | 2 | ||
A. niger | 2 | 4 | |||||
A. terreus | 2 | 4 | |||||
FLUZ | C. albicans | ≤2 | 4 | ≥8 | |||
C. dubliniensis | 0.5 | 1 | |||||
C. glabrata | < 32 | ≥64 | |||||
C. guilliermondii | 8 | 16 | |||||
C. lusitaniae | 1 | 2 | |||||
C. parapsilosis | ≤2 | 4 | ≥8 | ||||
C. tropicalis | ≤2 | 4 | ≥8 | ||||
POSA | C. albicans | 0.06 | 0.12 | ||||
C. glabrata | 1 | 2 | |||||
C. guilliermondii | 0.5 | 1 | |||||
C. krusei | 0.5 | 1 | |||||
C. lusitaniae | 0.06 | 0.12 | |||||
C. parapsilosis | 0.25 | 0.5 | |||||
C. tropicalis | 0.12 | 0.25 | |||||
A. flavus | 0.5 | 1 | |||||
A. niger | 2 | 4 | |||||
A. terreus | 1 | 2 | |||||
ITRA | C. glabrata | 4 | 8 | ||||
C. krusei | 1 | 2 | |||||
C. lusitania | 1 | 2 | |||||
C. tropicalis | 0.5 | 1 | |||||
A. flavus | 1 | 2 | |||||
A. fumigatus | 1 | 2 | |||||
A. niger | 4 | 8 | |||||
A. terreus | 2 | 4 | |||||
AMB | C. albicans | 2 | 4 | ||||
C. auris | ≤1 | ≥2 | |||||
C. glabrata | 2 | 4 | |||||
C. krusei | 2 | 4 | |||||
C. parapsilosis | 2 | 4 | |||||
C. tropicalis | 2 | 4 | |||||
A. flavus | 4 | 8 | |||||
A. fumigatus | 2 | 4 | |||||
A. niger | 2 | 4 | |||||
A. terreus | 4 | 8 | |||||
A. versicolor | 2 | 4 |
Abbreviations: ANID, anidulafungin, MICA, micafungin; CASP, caspofungin; VORI, voriconazole; FLUZ, fluconazole; ITRA, itraconazole; POSA, posaconazole; AMB, amphotericin B. * interpretive criteria for echinocandins against Aspergillusspp. are relevant to an MEC endpoint.