Affiliation:
1. Division of Infectious Diseases, Medical College of Virginia of Virginia Commonwealth University, Richmond, Virginia 23298-0049
Abstract
ABSTRACT
The National Committee for Clinical Laboratory Standards (NCCLS) M38-P method describes standard parameters for testing the fungistatic antifungal activities (MICs) of established agents against filamentous fungi (molds). The present study evaluated the in vitro fungistatic activities of itraconazole and amphotericin B by the E-test and the NCCLS M38-P microdilution method against 186 common and emerging pathogenic molds (123 isolates of
Aspergillus
spp. [five species], 16 isolates of
Fusarium
spp. [two species], 4
Paecilomyces lilacinus
isolates, 5
Rhizopus arrhizus
isolates, 15
Scedosporium
spp., 18 dematiaceous fungi, and 5
Trichoderma longibrachiatum
isolates). The agreement between the methods for amphotericin B MICs ranged from 70% for
Fusarium solani
to ≥90% for most of the other species after the first reading; agreement was dependent on both the incubation time and the species being evaluated. Major discrepancies between the amphotericin B MICs determined by the E-test and the NCCLS M38-P method were demonstrated for three of the five species of
Aspergillus
tested and the two species of
Fusarium
tested. This discrepancy was more marked after 48 h of incubation; the geometric mean MICs determined by the E-test increased between 24 and 48 h from between 1.39 and 3.3 μg/ml to between 5.2 and >8 μg/ml for
Aspergillus flavus, Aspergillus fumigatus
, and
Aspergillus nidulans
. The agreement between the itraconazole MICs determined by the E-test and the NCCLS M38-P method ranged from 83.3% for
A. nidulans
to ≥90% for all the other species tested; the overall agreement was higher (92.7%) than that for amphotericin B (87.9%). The agreement was less dependent on the incubation time. Clinical trials need to be conducted to establish the role of the results of either the E-test or the NCCLS M38-P method in vitro for molds with the two agents as predictors of clinical outcome.
Publisher
American Society for Microbiology
Cited by
212 articles.
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