Relationship between the Antifungal Susceptibility Profile and the Production of Virulence-Related Hydrolytic Enzymes in Brazilian Clinical Strains of Candida glabrata

Table 1

In vitro antifungal susceptibility profile in 91 Brazilian clinical strains of Candida glabrata.

Antifungals	MIC (μg/mL)			CLSI interpretation; Number of strains (%)
	Range	MIC50/MIC90	GM	S	SDD or I	R
Amphotericin B^1	0.06–8	0.5/2	0.61	82 (90.1)	—	9 (9.9)
Fluconazole^2	0.5–≥64	16/64	11.23	—	77 (84.6)	14 (15.4)
Itraconazole^1	0.016–4	0.25/0.5	0.22	31 (34.1)	55 (60.4)	5 (5.5)
Micafungin^2	0.016–1	0.06/0.25	0.08	51 (56.0)	26 (28.6)	14 (15.4)
5-Flucytosine^1	0.12	0.12/0.12	0.12	91 (100.0)	—	—

MIC: minimal inhibitory concentration; CLSI: clinical and laboratory standards institute; GM: geometric mean; S: susceptible; SDD: susceptible-dose dependent; I: intermediary; R: resistant. ¹Breakpoints established by M27-S3 protocol [20]. In sum, strains with amphotericin B MIC > 1 μg/mL are likely to be resistant to this drug; itraconazole MIC ≤ 0.125 μg/mL are likely to be susceptible, 0.25 ≤ MIC ≤ 0.5 μg/mL are likely to be intermediary, and MIC ≥ 1 μg/mL are likely to be resistant to this drug; 5-flucytosine MIC ≤ 4 μg/mL are likely to be susceptible, 8 ≤ MIC ≤ 16 μg/mL are likely to be intermediary, and MIC ≥ 32 μg/mL are likely to be resistant to this drug. ²Breakpoints established by M27-S4 protocol [21]. In sum, C. glabrata strains with fluconazole MIC ≤ 32 μg/mL are likely to be susceptible-dose dependent and MIC ≥ 64 μg/mL are likely to be resistant to this drug; C. glabrata strains with micafungin MIC ≤ 0.06 μg/mL are likely to be susceptible, MIC = 0.12 μg/mL are likely to be intermediary, and MIC ≥ 0.25 μg/mL are likely to be resistant to this drug.