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1 Key words: yeast, Etest(R), microdilution method, MIC
2
3 Table 1 MICs of quality control strains The data shown are the range of MIC performed in triplicate
4 Table 2 Renge of MICs, MIC50s and MIC90s for 81 species of yeast
5 Table 3 Comparison of E test MICs with FP panel MICs
6
7 Table 4 Test of significance to MICs by FP panel and E test *: <0.05 significant **: <0.01 significant
8
9 6) Kitchen VS, Savage M, Harris FRW: Candida albicans resistance in AIDS. J Infect 1991; 22: ) Smith D, Boag F, Midgley F, Gazzard B: Fluconazole resistant Candida in AIDS. J Infect 10) AB BIODISK Etest technical guide No. 4: Antifungal susceptibility testing of yeasts. AB BIODISK, Solna, Sweden. 11) National Committee for Clinical Laboratory Stan- dards: Perfomance standards for antimicrobial disk susceptibility tests sixthedition; Approved sylvania, ) National Committee for Clinical Laboratory Standards: standard. NCCLS Document M2-A5. Wayne, Pen- 2) Anaissie E: Opportunistic mycoses in the immunocompromised Reference method for broth dilution anti- host : Experience at a cancer center and review. C Infect Dis 1992; 14 (Suppl. fungal susceptibility testing of yeasts; Standard M27-A Approved 1): S ) Eldere JV, Joosten L, Verhaeghe A, Surmont I: Fluconazole and amphotericin B antifungal susceptibility testing by national committee for clini- cal laboratory standards broth macrodilution 4) Fox R, Neal KR, Leen CLS, Ellis ME, Mandal method compared with Etest and semiautomated BK: Fluconazole resistant Candida in AIDS. J Infect 1991; 22: broth microdilution test. J Clin Microbiol Apr 1996; ) Colombo AL, Barchiesi F, McGough DA, Fother- gill AW, Rinaldi MG : Evaluation of the Etest system versus a microtitre broth method for antifungal susceptibility testing of yeasts against fluconaole and itraconazole. J Antimicro Chemother 1995; 36: ) Colombo AL, Barchiesi F, McGough DA, Rinaldi 1991; 23: MG: Comparison of Etest and National Committee for Clinical Laboratory Standards broth macrodilution method for azole antifungal susceptibility testing. J Clin Microbiol 1995; 33: ) Pfaller MA, Messer SA, Karlsson A, Bolmstrom A: Evaluation of the Etest method for determining fluconazole susceptibilities of 402 clinical yeast isolates by using three different agar media. J Clin Microbiol 1998;
10 Evaluation of a New Method for Antifungal Drugs Susceptibility Testing to Yeasts Shinobu ISHIGAKI1), Sayoko KAWAKAMI1), Yasuo ONO1)2)&Yukihisa MIYAZAWA1) Department of Central Laboratory, 2)Department of Microbiology and Immunology, Teikyo School of Medicine We compared the Etest(R) with a broth microdilution method (FP panel(r)), performed according to the National Committee for modified Clinical Laboratory Standards (NCCLS) document M27-P guidelines, for determining the MICs of 81 clinical isolates of yeasts (7 Candida albicans, 8 Candida glabrata, 10 Candida parapsilosis, 6 Pichia anomala, 10 Candida tropicalis, 4 Candida guilliermondii, 4 Candida krusei, 6 Trichosporon cutaneum, 5 Candida ciferrii, 3 Candida famata, 4 Candida norvegensis, 2 Rhodotorula rubra, 3 Candida lusitaniae, 2 Candida curvata, 1 Candida inconspicua, 1 Candida intermedia, 1 Candida colliculosa, 1 Cryptococcus spp, 1 Tricosporon capitatum, 1 Pichia ohmeri, 1 Saccharomyces cerevisiae). The Etest(R) results for 6 ATCC standard strains correlated well with reference MICs except those of flucytosine (5-FC) for C. krusei, which tended to be 1 to 2 log2 dilution higher than the MIC range determined by NCCLS guidelines. However, the best agreement between the results for clinical isolates was seen with 5-FC (100% agreement [Within }2 log2 dilutions] between the results of the two methods). There was a 91.4% agreement between the results of the two methods with amphotericin B (Etest(R) MICs tended to be 1 to 2 log2 dilution lower than those of the FP panel). The Etest(R) results with litraconazole for clinical isolates except C. tropicalis were similar to MICs of the FP panel(r) (Etest(R) for C. tropicalis showed 1 to 2 log2 dilution lower than FP panel(r)). Also, the Etest(R) results with fluconazole for clinical isolates except C. tropicalis were similar of 1 log2 dilution higher than MICs of the FP panel(r) (Etest(R) for C. tropicalis showed more than 2 log2 dilution lower thas FP panel(r)). These results showed a good level of overall agreement between the Etest(R) method and the broth microdilution test (FP panel(r)). Since the Etest(R) is a less laborintensive and much simpler method, it appears to be a useful procedure for testing the susceptibility of yeasts to antifungal agents.
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