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

Antimicrob Agents Chemother. 1995 Nov;39(11):2520-2. doi: 10.1128/AAC.39.11.2520.

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.

Publication types

  • Comparative Study

MeSH terms

  • Amphotericin B / pharmacology*
  • Anti-Infective Agents / pharmacology
  • Antifungal Agents / pharmacology*
  • Candida / drug effects*
  • Culture Media
  • Drug Resistance, Microbial
  • Fluconazole / pharmacology
  • Fluoroquinolones
  • Microbial Sensitivity Tests / methods*
  • Microbial Sensitivity Tests / standards
  • Quality Control

Substances

  • Anti-Infective Agents
  • Antifungal Agents
  • Culture Media
  • Fluoroquinolones
  • Amphotericin B
  • Fluconazole