Isham genotyping resistance workshop

ISHAM Genotyping Resistance in Fungi Workshop
Convenors David W. Denning (david.denning@manchester.ac.uk) William W. Hope Objectives 1. To develop an agreed nomenclature for mutations and other structural genetic alterations in Candida spp., Aspergillus spp. and Pneumocystis jiroveci that confer antifungal resistance 2. To document all genotypic resistance mutations in these 3 species 3. To agree for each genus what dataset is sufficient to ‘call’ a genotypic resistance 4. To publish a supplement describing the output of this workshop 5. To communicate the agreed findings to the CLSI and EUCAST AFST to aid future decision-making in antifungal susceptibility testing methodology discussions and breakpoint decision-making Participants and roles David Denning, Manchester - chairperson William Hope, Manchester – primary drafter of consensus document + flucytosine Dominique Sanglard, Lausanne - azole and fungicide resistance in Candida and Ted White, Seattle – azole resistance in Candida Steve Kelly, Swansea – azole resistance David Perlin, Newark – azole and echinocandin resistance in Candida and Aspergillus and terbinafine resistance in Aspergillus Emilia Mellado, Madrid – azole resistance in Aspergillus Philip Hauser, Lausanne – sulphamethoxazole and atavaquone resistance in Pneumocystis Pentti Huovinen, Turku - sulphamethoxazole resistance in Pneumocystis Peter Iliades, Victoria - sulpha resistance in Pneumocystis Frank Odds, Aberdeen – antifungal resistance in Candida generally and CLSI committee Gunnar Kahlmeter, Stockholm – EUCAST chairman, nomenclature Derek Brown, Cambridge – EUCAST secretary, nomenclature Juan-Luis Rodriguez-Tudela, Madrid, EUCAST AFST chairman, susceptibility testing in Peter Donnelly, Nijmegen – EUCAST AFST secretary, nomenclature and drafting Workers in the relevant laboratories, other members of the EUCAST AFST and CLSI antifungal committee and other members of ISHAM will be invited to come at their own expense and without specific contributions, other than contributing to discussion. Outline agenda Objectives and introductions Current nomenclature in bacteria and viruses for genotypic resistance ‘Gold standard’ for resistance [In vitro, in vivo model, clinical data] Azole resistance in Aspergillus (the in vitro/in vivo correlation, poor clincial data Flucytosine resistance in Candida (the in vivo/in vitro mismatch, no clinical data Echinocandin resistance in Candida (the partial in vitro, biochemical and in vivo, limited Cotrimazole in Pneumocystis (the clinical data and biochemical example) Atavaquone in Pneumocystis (the limited clinical data example) Terbinafine in Aspergillus (the in vitro only example) Selection of nomenclature ‘Approved’ and ‘provisional’ genotypic resistance markers Monitoring and data centralisation Publication and consultation Duration 1.5 days Location Education and Research Centre, Wythenshawe Hospital, Manchester (10 minutes by car

Source: http://www.isham.org/pdf/Working-Genotyping-Resistance-WEB.pdf