Clinical Microbiology and Infection

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Clinical Microbiology and Infection 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 M.C. Arendrup, S. Arikan-Akdagli, F. Barchiesi, M. Castanheira, E. Chryssanthou, N. Friberg, J. Guinea, H. Järv, N. Klimko, O. Kurzai, K. Lagrou, C. Lass-Flörl, M. Mares, T. Matos, J. Meletiadis, C.B. Moore, J.W. Mouton, K. Muehlethaler, T.R. Rogers, C.T. Andersen, A. Velegraki J. Guinea, P.E. Verweij, J. Meletiadis, J.W. Mouton, F. Barchiesi, M.C. Arendrup M.C. Arendrup, S. Arikan-Akdagli, F. Barchiesi, M. Castanheira, E. Chryssanthou, N. Friberg, J. Guinea, H. Järv, N. Klimko, O. Kurzai, K. Lagrou, C. Lass-Flörl, M. Mares, T. Matos, J. Meletiadis, C.B. Moore, J.W. Mouton, K. Muehlethaler, T.R. Rogers, C.T. Andersen, A. Velegraki  Clinical Microbiology and Infection  DOI: 10.1016/j.cmi.2018.09.008 Copyright © 2018 European Society of Clinical Microbiology and Infectious Diseases Terms and Conditions

Fig. 1 Four-well agar plate with wells filled out with 1 mL of agar media-containing azoles (wells 1–3) or antifungal-free agar (well 4) used as growth control. ITC, itraconazole; VRC, voriconazole; POS, posaconazole. Clinical Microbiology and Infection DOI: (10.1016/j.cmi.2018.09.008) Copyright © 2018 European Society of Clinical Microbiology and Infectious Diseases Terms and Conditions

Fig. 2 Expected growth pattern for the A. fumigatus SSI-4524 QC strain harbouring the TR34/L98H alteration in the CYP51A gene and promoter. Each well of the plate contains the following azoles: well 1 (itraconazole 4 mg/L), well 2 (voriconazole 2 mg/L), well 3 (posaconazole 0.5 mg/L), and well 4 (no azoles, growth control). SSI = Statens Serum Institut, Copenhagen, Denmark. The QC strain is available from the EUCAST Development Laboratory (EDL) for fungi: http://www.eucast.org/organization/developmentlaboratories/. Clinical Microbiology and Infection DOI: (10.1016/j.cmi.2018.09.008) Copyright © 2018 European Society of Clinical Microbiology and Infectious Diseases Terms and Conditions

Fig. 3 Expected growth pattern for the A. fumigatus SSI-5586 QC strain harbouring a G54W substitution in the CYP51A gene. Each well of the plate contains the following azoles: well 1 (itraconazole 4 mg/L), well 2 (voriconazole 2 mg/L), well 3 (posaconazole 0.5 mg/L), and well 4 (no azoles, growth control). SSI, Statens Serum Institut, Copenhagen, Denmark. The QC strain is available from the EUCAST Development Laboratory (EDL) for fungi: http://www.eucast.org/organization/developmentlaboratories/. Clinical Microbiology and Infection DOI: (10.1016/j.cmi.2018.09.008) Copyright © 2018 European Society of Clinical Microbiology and Infectious Diseases Terms and Conditions