Establishment of epidemiological cutoff values for yeast-phase Talaromyces marneffei against six antifungal agents: a multicenter study in China
14 affiliations
- 1Department of Dermatology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
- 2Guangxi Scientific and Technological Innovation Cooperation Base of Mycosis Prevention and Control, Nanning, China
- 3Department of Dermatology and Venerology, Peking University First Hospital, Beijing, China
- 4Department of Dermatology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
- 5Department of Medical Mycology, Institute of Dermatology and Hospital for Skin Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Nanjing, China
- 6Department of Dermatology and Venereology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
- 7National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
- 8The First Affiliated Hospital of Guilin Medical University, Guilin, China
- 9The Fourth People’s Hospital of Nanning, Nanning, China
- 10Fangchenggang Wanqing Institute of Mycosis Prevention and Control, Fangchenggang, China
- 11Dermatology Hospital of Southern Medical University, Guangzhou, China
- 12Department of Laboratory Medicine, The First Affiliated Hospital of Xiamen University, Xiamen, Fujian, China
- 13Centre for Infectious Diseases Research, Diagnostics and Laboratory Surveillance, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
- 14Department of Medical Microbiology and Radboudumc - CWZ Centre of Expertise for Mycology, Radboud University Medical Centre, Nijmegen, the Netherlands
Abstract
This study aimed to establish epidemiological cutoff values (ECVs) for amphotericin B, fluconazole, itraconazole, voriconazole, posaconazole, and isavuconazole against Talaromyces marneffei (T. marneffei) using the CLSI broth microdilution method. Antifungal susceptibility testing of 207 T. marneffei isolates was performed independently at five laboratories across China according to CLSI M27-A4 guidelines. Minimum inhibitory concentration (MIC) distributions were analyzed using ECOFFinder software (version 2.1), and ECVs were set at the upper MIC limit encompassing 97.5% of the modeled wild-type (WT) population. ECVs were determined as follows: amphotericin B (AMB) 8 µg/mL, voriconazole (VRC) 0.03 µg/mL, itraconazole (ITC) 0.125 µg/mL, posaconazole (POS) 0.06 µg/mL, isavuconazole (ISA) 0.125 µg/mL, and fluconazole (FLC) 8 µg/mL. MIC distributions for all six agents conformed well to the fitted models (normal or log-normal), supporting the validity of ECV determination. No non-WT isolates were detected for amphotericin B, whereas non-WT rates for azoles were 15.5% (voriconazole), 8.45% (itraconazole), 6.37% (posaconazole), 3.0% (fluconazole), and 1.02% (isavuconazole). Among voriconazole non-WT isolates, all were from patients with prior voriconazole exposure. This study provides the first standardized ECVs for T. marneffei against six key antifungal agents. The data establish a reference framework for antifungal susceptibility testing and resistance surveillance and highlight the need for continued monitoring of azole susceptibility in this pathogen.
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BibTeX
@article{pan2026establishment,
title = {{Establishment of epidemiological cutoff values for yeast-phase Talaromyces marneffei against six antifungal agents: a multicenter study in China}},
author = {Kai-su Pan and Ying-gai Song and Sha Lu and Xiao-fang Li and Huai-qiu Huang and Jie Gong and Ruo-yu Li and Hai-lin Zheng and Miao-rong Zhan and Shu Zhang and Xin-yu Zhou and Yuan-yuan Geng and Si-wen Jiang and Sheng-xiu Fang and Yanqing Zheng and Dong-yan Zheng and Weixuan Wu and Li-yan Xi and He-ping Xu and Paul E. Verweij and Cun-wei Cao},
journal = {Antimicrobial Agents and Chemotherapy},
year = {2026},
month = aug,
doi = {10.1128/aac.00650-26},
url = {https://doi.org/10.1128/aac.00650-26},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Establishment of epidemiological cutoff values for yeast-phase Talaromyces marneffei against six antifungal agents: a multicenter study in China
AU - Kai-su Pan
AU - Ying-gai Song
AU - Sha Lu
AU - Xiao-fang Li
AU - Huai-qiu Huang
AU - Jie Gong
AU - Ruo-yu Li
AU - Hai-lin Zheng
AU - Miao-rong Zhan
AU - Shu Zhang
AU - Xin-yu Zhou
AU - Yuan-yuan Geng
AU - Si-wen Jiang
AU - Sheng-xiu Fang
AU - Yanqing Zheng
AU - Dong-yan Zheng
AU - Weixuan Wu
AU - Li-yan Xi
AU - He-ping Xu
AU - Paul E. Verweij
AU - Cun-wei Cao
PY - 2026
DA - 2026/08/05
JO - Antimicrobial Agents and Chemotherapy
DO - 10.1128/aac.00650-26
UR - https://doi.org/10.1128/aac.00650-26
AB - This study aimed to establish epidemiological cutoff values (ECVs) for amphotericin B, fluconazole, itraconazole, voriconazole, posaconazole, and isavuconazole against Talaromyces marneffei (T. marneffei) using the CLSI broth microdilution method. Antifungal susceptibility testing of 207 T. marneffei isolates was performed independently at five laboratories across China according to CLSI M27-A4 guidelines. Minimum inhibitory concentration (MIC) distributions were analyzed using ECOFFinder software (version 2.1), and ECVs were set at the upper MIC limit encompassing 97.5% of the modeled wild-type (WT) population. ECVs were determined as follows: amphotericin B (AMB) 8 µg/mL, voriconazole (VRC) 0.03 µg/mL, itraconazole (ITC) 0.125 µg/mL, posaconazole (POS) 0.06 µg/mL, isavuconazole (ISA) 0.125 µg/mL, and fluconazole (FLC) 8 µg/mL. MIC distributions for all six agents conformed well to the fitted models (normal or log-normal), supporting the validity of ECV determination. No non-WT isolates were detected for amphotericin B, whereas non-WT rates for azoles were 15.5% (voriconazole), 8.45% (itraconazole), 6.37% (posaconazole), 3.0% (fluconazole), and 1.02% (isavuconazole). Among voriconazole non-WT isolates, all were from patients with prior voriconazole exposure. This study provides the first standardized ECVs for T. marneffei against six key antifungal agents. The data establish a reference framework for antifungal susceptibility testing and resistance surveillance and highlight the need for continued monitoring of azole susceptibility in this pathogen.
SN - 0066-4804
SN - 1098-6596
ER -