Affiliation:
1. Unidad de Bacteriologı́a Experimental-Centro de Investigación1 and
2. Servicio de Microbiologı́a,2Hospital Universitario La Fe, 46009 Valencia, and
3. ACIA Microbiologı́a, Barcelona,3 Spain
Abstract
ABSTRACT
The in vitro activity of fluconazole against 143
Candida
spp. obtained from the bloodstreams of 143 hospitalized patients from 1995 to 1997 was studied. Susceptibility tests were carried out by two macrodilution methods, the M27-A and a modified M27-A method (0.165 M, pH 7/morpholinepropanesulfonic acid-buffered RPMI 1640 medium supplemented with 20 g of
d
-dextrose per liter), and by the agar diffusion method (with 15-μg fluconazole [Neo-Sensitab] tablets). With 2 μg of fluconazole per ml, 96.92% of 65
C. albicans
isolates, 86.2% of 58
C. parapsilosis
isolates 7 of 8
C. tropicalis
isolates, and 1 of 6
C. glabrata
isolates were inhibited. Only one strain of
C. albicans
and one strain of
C. tropicalis
were resistant. The agreement between the two macrodilution methods was greater than 90% within ±2 log
2
dilutions for all strains except
C. glabrata
(83.3%) and
C. tropicalis
(87.5%). Generally, MICs were 1 log
2
dilution lower in glucose-supplemented RPMI 1640 medium. No correlation between zone sizes and MICs was found. All strains susceptible by the diffusion test were susceptible by the dilution method, but the converse was not necessarily true. Interestingly, inhibition zones were smaller for
C. albicans
, for which the geometric mean MIC was 0.29 μg/ml and the mean inhibition zone diameter was 25.7 mm, while for
C. parapsilosis
the geometric mean MIC was 0.96 μg/ml and the mean inhibition zone diameter was 31.52 mm. In conclusion, the two macrodilution methods give similar results. The modified M27-A method with 2% dextrose has the advantage of shortening the incubation time and simplifying the endpoint determination.
Publisher
American Society for Microbiology
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