Spectrophotometric azole and amphotericin B MIC readings against Aspergillus fumigatus sensu lato using the EUCAST 9.3.2 methodology. Are ≥ 90% and ≥ 95% fungal growth inhibition endpoints equally suitable?

We recently reported high essential (97.1%) and categorical (99.6%) agreements between azole and amphotericin B MICs against Aspergillus fumigatus sensu lato obtained by visual and spectrophotometric readings using a ≥ 95% fungal growth endpoint and following the EUCAST methodology (doi: 10.1128/AAC.01693-20). Here, we compared the aforementioned MICs against spectrophotometric MIC readings with a ≥ 90% inhibition endpoint. Spectrophotometric readings using either ≥ 90% or ≥ 95% fungal growth inhibition resulted in high categorical (>99.9%) agreements with visual MIC readings against A. fumigatus sensu stricto. In contrast, agreements with visual MICs against cryptic species were higher with a ≥ 95% fungal growth inhibition endpoint. LAY SUMMARY Spectrophotometrically obtained MIC readings using either ≥ 90% or ≥ 95% fungal growth inhibition endpoints and following the EUCAST methodology are suitable against A. fumigatus sensu stricto. However, the ≥ 95% fungal growth inhibition endpoint is preferred against cryptic species.