Comparison of Etest and National Committee for Clinical Laboratory Standards broth macrodilution method for antifungal susceptibility testing: enhanced ability to detect amphotericin B-resistant Candida isolates

Author:

Wanger A1,Mills K1,Nelson P W1,Rex J H1

Affiliation:

1. Department of Pathology, University of Texas Medical School, Houston, USA.

Abstract

The National Committee for Clinical Laboratory Standards (NCCLS) proposed macrobroth reference method (M27P) for susceptibility testing of yeasts is technically difficult. We evaluated Etest, a simple agar-based MIC methodology, as a possible alternative. In studies of six yeast quality control strains, Etest yielded results identical to those obtained by the NCCLS reference method for both amphotericin B and fluconazole. In studies of 91 clinical Candida isolates, agreement +/- 2 dilutions between the two methods was 95% for fluconazole with phosphate-buffered RPMI 1640 agar and 96 to 97% for amphotericin B with either MOPS (morpholinepropanesulfonic acid)-buffered RPMI 1640 agar or antibiotic medium 3 agar. While the two methods had excellent general agreement, testing of a collection of amphotericin B-resistant isolates demonstrated that, unlike the NCCLS reference method, Etest readily identified the resistant isolates and could do so with a defined medium. Etest is equivalent to the NCCLS proposed method for susceptibility testing of yeasts and superior in its ability to detect amphotericin B resistance.

Publisher

American Society for Microbiology

Subject

Infectious Diseases,Pharmacology (medical),Pharmacology

Reference12 articles.

1. AB BIODISK. 1994. Etest technical guide 4b: antifungal susceptibility testing of yeasts. AB BIODISK Piscataway N.J.

2. Correlation between in vitro and in vivo activity of antifungal agents against Candida species;Anaissie E. J.;J. Infect. Dis.,1994

3. Comparison of Etest and National Committee for Clinical Laboratory Standards broth macrodilution method for azole antifungal susceptibility testing;Colombo A. L.;J. Clin. Microbiol.,1995

4. Etest for antifungal susceptibility testing of yeasts;Espinel-Ingroff A.;Diagn. Microbiol. Infect. Dis.,1994

5. Collaborative comparison of broth macrodilution and microdilution antifungal susceptibility tests;Espinel-Ingroff A.;J. Clin. Microbiol.,1992

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