Publications from the EUCAST AFST in journals

Recent publication: How to interpret MICs of amphotericin B, echinocandins

and flucytosine against Candida auris (Candidozyma auris) according to the newly

established EUCAST breakpoints. Maiken Cavling Arendrup et al. CMI 2025 (preprint)

Review 2024: Twenty Years in EUCAST Anti‑Fungal Susceptibility Testing: Progress &

Remaining Challenges. M Cavling Arendrup, J Guinea, J Meletiadis. https://rdcu.be/dNwq5

1. Technical notes on susceptibility testing of fungi

• EUCAST Definitive document E.Def 11.0 Antifungal susceptibility testing of microconidia-forming dermatophytes following the new reference EUCAST method exemplified by Trichophyton is available. The article is "open access" for a limited period of time (Download). 
• EUCAST DEFINITIVE DOCUMENT  E.DEF 9.1: Method for the determination of broth dilution minimum inhibitory concentrations of antifungal agents for conidia forming mould (Download)
• EUCAST technical note on the EUCAST definitive document EDef 7.2: method for the determination of broth dilution minimum inhibitory concentrations of antifungal agents for yeasts EDef 7.2 (EUCAST-AFST). (Download)
• EUCAST Definitive Document EDef 7.1: method for the determination of broth dilution MICs of antifungal agents for fermentative yeasts (Download)

2. Technical notes on antifungal breakpoints

Breakpoints for Candida

• Amphotericin B
• Voriconazole
• Posaconazole
• Micafungin, anidulafungin and fluconazole

Breakpoints for Aspergillus

• Amphotericin B, itraconazole, and posaconazole
• Voriconazole
• Isavuconazole and Amphotericin

3. Other publications

• Molecular mechanisms of acquired antifungal drug resistance in principal fungal pathogens and EUCAST guidance for their laboratory detection and clinical implications. Thomas R. Rogers, Paul E. Verweij, Mariana Castanheira, Eric Dannaoui, P. Lewis White and Maiken Cavling Arendrup on behalf of the Subcommittee on Antifungal Susceptibility Testing (AFST) of the ESCMID European Committee for Antimicrobial Susceptibility Testing (EUCAST). J Antimicrob Chemother https://doi.org/10.1093/jac/dkac161 
• Development and multicentre validation of an agar-based screening method for echinocandin susceptibility testing of Aspergillus species. Journal of Antimicrobial Chemotherapy, Volume 74, Issue 8, August 2019, Pages 2247–2254
• Comment on: Multicentre validation of a EUCAST method for the antifungal susceptibility testing of microconidiaforming dermatophytes. Maiken Cavling Arendrup, Karin Meinike Jørgensen, Jesus Guinea, Katrien Lagrou, Erja Chryssanthou, Marie-Pierre Hayette, Francesco Barchiesi, Cornelia Lass-Flörl, Petr Hamal Eric Dannaoui, Anuradha Chowdhary, Rasmus Krøger Hare and Joseph Meletiadis. J Antimicrob Chemother https://doi.org/10.1093/jac/dkac004
• How to interpret MICs of antifungal compounds according to the revised clinical breakpoints v. 10.0 European committee on antimicrobial susceptibility testing (EUCAST). Arendrup MC, Friberg N, Mares M, Kahlmeter G, Meletiadis J, Guinea J; Subcommittee on Antifungal Susceptibility Testing (AFST) of the ESCMID European Committee for Antimicrobial Susceptibility Testing (EUCAST). Clin Microbiol Infect. 2020 Nov;26(11):1464-1472. doi: 10.1016/j.cmi.2020.06.007. Epub 2020 Jun 17.PMID: 32562861 Review.
• How to: EUCAST recommendations on the screening procedure E.Def 10.1 for the detection of azole resistance in Aspergillus fumigatus isolates using four-well azole-containing agar plates. J. Guinea, P.E. Verweij, J. Meletiadis, J.W. Mouton, F. Barchiesi, M.C. Arendrup. https://www.clinicalmicrobiologyandinfection.com/article/S1198-743X 
• Multi-centre validation of 4-well azole agar plate as a screening method for detection of clinically relevant azole resistant Aspergillus fumigatus. Arendrup MC, Verweij PE, Mouton JW, Lagrou K, Meletiadis J. 2017. Volume 72, Issue 12, December 2017, Pages 3325–3333. https://academic.oup.com/jac/<wbr />article/72/12/3325/4339346  
• Comparison of DMSO and water as solvents for echinocandins susceptibility testing by EUCAST methodology. Alastruey-Izquierdo A, Gómez-López A, Arendrup MC, Lass-Florl C, Hope WW, Perlin DS, Rodriguez-Tudela JL, Cuenca-Estrella M. 2012. J Clin Microbiol. 50:2509-2012. http://jcm.asm.org/content/50/7/2509.long
• Caspofungin Etest susceptibility testing of Candida species: risk of misclassification of susceptible isolates of C. glabrata and C. krusei when adopting the revised CLSI caspofungin breakpoints. Arendrup MC, Pfaller MA; Danish Fungaemia Study Group. Antimicrob Agents Chemother. 2012 Jul;56(7):3965-8. http://aac.asm.org/content/56/7/3965.long
• Evaluation of Caspofungin Susceptibility Testing by the New VITEK(R) 2 AST-YS06 Yeast Card Using a Unique Collection of FKS Wild Type and Hot Spot Mutant Isolates Including the Five Most Common Candida Species. Astvad KM, Perlin DS, Johansen HK, Jensen RH, Arendrup MC. Antimicrob Agents Chemother. 2012 57(1):177-82 http://aac.asm.org/content/early/2012/10/16/AAC.01382-12.long
• Comparison of the VITEK 2 antifungal susceptibility system with the CLSI and the EUCAST broth microdilution reference methods and with the Sensititre Yeast-One and the Etest techniques for the detection in vitro of antifungal resistance in yeasts. Cuenca-Estrella M, Gomez-Lopez A, Alastruey-Izquierdo A, Bernal-Martinez L, Cuesta I, Buitrago MJ, Rodriguez-Tudela JL. J Clin Microbiol 2010, 48(5):1782. http://jcm.asm.org/content/48/5/1782.full.pdf+html
• Multicenter comparison of the ISO standard 20776-1 and the serial 2-fold dilution procedures to dilute hydrophilic and hydrophobic antifungal agents for susceptibility testing. Gomez-Lopez A, Arendrup MC, Lass-Floerl C, Rodriguez-Tudela JL, Cuenca-Estrella M. J Clin Microbiol 2010, 48(5):1918. http://jcm.asm.org/content/48/5/1918.full.pdf+html
• Echinocandin susceptibility testing of Candida species: comparison of EUCAST E.Def 7.1, CLSI M27-A3, Etest, disk diffusion, and agar dilution methods with RPMI and isosensitest media. Arendrup MC, Garcia-Effron G, Lass-Flörl C, Lopez AG, Rodriguez-Tudela JL, Cuenca-Estrella M, Perlin DS. Antimicrob Agents Chemother 2010; 54: 426-39.  http://aac.asm.org/content/54/1/426.full.pdf+html
• Evaluation by data mining techniques of fluconazole breakpoints established by the clinical and laboratory standards institute (CLSI) and comparison with those of the European Committee on Antimicrobial Susceptibility Testing (EUCAST). Cuesta I, Bielza C, Cuenca-Estrella M, Larrañaga P, Rodríguez-Tudela JL. Antimicrob Agents Chemother 2010; 54: 1541-6. http://aac.asm.org/content/54/4/1541.full.pdf+html
• EUCAST breakpoints for antifungals. Rodriguez-Tudela JL, Arendrup MC, Cuenca-Estrella M, Donnelly JP, Lass-Florl C. Drug News Perspect 2010; 23: 93-7. http://journals.prous.com/journals/servlet/xmlxsl/pk_journals.xml_summaryn_pr?p_JournalId=3&p_RefId=1400855
• Association of fluconazole pharmacodynamics with mortality in patients with candidemia. Arendrup MC, Cuenca-Estrella M, Donnelly JP, Lass-Flörl C, Rodriguez-Tudela JL. Antimicrob Agents Chemother 2009; 53: 2704-5. http://aac.asm.org/content/53/6/2704.full.pdf+html
• Data mining validation of fluconazole breakpoints established by the European Committee on Antimicrobial Susceptibility Testing. Cuesta I, Bielza C, Larrañaga P, Cuenca-Estrella M, Laguna F, Rodriguez-Pardo D, Almirante B, Pahissa A, Rodríguez-Tudela JL. Antimicrob Agents Chemother 2009; 53: 2949-54. http://aac.asm.org/content/53/7/2949.full.pdf+html
• Breakpoints for susceptibility testing should not divide wild-type distributions of important target species. Arendrup MC, Kahlmeter G, Rodriguez-Tudela JL, Donnelly JP. Antimicrob Agents Chemother 2009; 53:1628-9. http://aac.asm.org/content/53/4/1628.full.pdf+html
• Echinocandin susceptibility testing of Candida species: comparison of EUCAST E.Def 7.1, CLSI M27-A3, Etest, disk diffusion, and agar dilution methods with RPMI and Isosensitest media. Arendrup MC, Garcia-Effron G, Lass-Flörl C, Lopez AG, Rodriguez-Tudela JL, Cuenca-Estrella M, Perlin DS. Antimicrob Agents Chemother 2010;54(1):426-39. http://aac.asm.org/content/54/1/426.full.pdf+html
• Breakpoints for antifungal agents: an update from EUCAST focussing on echinocandins against Candida spp. and triazoles against Aspergillus spp. Arendrup MC, Cuenca-Estrella M, Lass-Flörl C, Hope WW. Drug Res Update 2013;16(6):81-95. http://www.sciencedirect.com/science/article/pii/S1368764614000028
• Interlaboratory variability of Caspofungin MICs for Candida spp. Using CLSI and EUCAST methods: should the clinical laboratory be testing this agent? Espinel-Ingroff A, Arendrup MC, Pfaller MA, Bonfietti LX, Bustamante B, Canton E, Chryssanthou E, Cuenca-Estrella M, Dannaoui E, Fothergill A, Fuller J,Gaustad P, Gonzalez GM, Guarro J, Lass-Flörl C, Lockhart SR, Meis JF, Moore CB, Ostrosky-Zeichner L, Pelaez T, Pukinskas SR, St-Germain G, Szeszs MW, Turnidge J. Antimicrob Agents Chemother 2013; 57(12): 5836-42. http://aac.asm.org/cgi/pmidlookup?view=long&pmid=24018263
• EUCAST testing of Isavuconazole susceptibility in Aspergillus: comparison of results for Inoculum standardization using Conidium counting versus optical density. Arendrup MC ,Howard S, Lass-Flörl C, Mouton JW, Meletiadis J, Cuenca-Estrella M. Antimicrob Agents Chemother 2014;58(11): 6432-6. http://aac.asm.org/content/58/11/6432.long
• J Antimicrob Chemother. 2017;72(12):3325-3333. Multicentre validation of 4-well azole agar plates as a screening method for detection of clinically relevant azole-resistant Aspergillus fumigatus. Arendrup MC, Verweij PE, Mouton JW, Meletiadis J. https://academic.oup.com/jac/article-abstract/72/12/3325/4339346?redirectedFrom=fulltext
• Clin Microbiol Infect. 2017;23(2):98-103. Spectrophotometric reading of EUCAST antifungal susceptibility testing of Aspergillus fumigatus. Meletiadis J, Leth Mortensen K, Verweij PE, Mouton JW, Arendrup MC. https://www.sciencedirect.com/science/article/pii/S1198743X16305067?via %3Dihub
• How to interpret MICs of antifungal compounds according to the revised clinical breakpoints v. 10.0 European committee onantimicrobial susceptibility testing (EUCAST). Arendrup et al. Clin Microbiol Infect. 2020; https://doi.org/10.1016/j.cmi.2020.06.007.  
• Molecular mechanisms of acquired antifungal drug resistance in principal fungal pathogens and EUCAST guidance for their laboratory detection and clinical implications. Rogers TR, Verweij PE, Castanheira M, Dannaoui E, White PL, Arendrup MC; Subcommittee on Antifungal Susceptibility Testing (AFST) of the ESCMID European Committee for Antimicrobial Susceptibility Testing (EUCAST). J Antimicrob Chemother. 2022 Jul 28;77(8):2053-2073.