Evaluation of the Etest and disk diffusion methods for determining susceptibilities of 235 bloodstream isolates of Candida glabrata to fluconazole and voriconazole

M A Pfaller; D J Diekema; L Boyken; S A Messer; S Tendolkar; R J Hollis

doi:10.1128/JCM.41.5.1875-1880.2003

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Evaluation of the Etest and disk diffusion methods for determining susceptibilities of 235 bloodstream isolates of Candida glabrata to fluconazole and voriconazole

Journal article

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Evaluation of the Etest and disk diffusion methods for determining susceptibilities of 235 bloodstream isolates of Candida glabrata to fluconazole and voriconazole

M A Pfaller, D J Diekema, L Boyken, S A Messer, S Tendolkar and R J Hollis

Journal of clinical microbiology, Vol.41(5), pp.1875-1880

05/2003

DOI: 10.1128/JCM.41.5.1875-1880.2003

PMCID: PMC154736

PMID: 12734220

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Abstract

The performances of the Etest and the disk diffusion methods for testing of the susceptibilities of 235 Candida glabrata isolates to fluconazole and voriconazole were compared with that of the National Committee for Clinical Laboratory Standards (NCCLS) approved standard broth microdilution (BMD) method. The NCCLS method used RPMI 1640 broth medium, and MICs were read after incubation for 48 h at 35 degrees C. Etest MICs were determined with RPMI 1640 agar containing 2% glucose (RPG agar) and with Mueller-Hinton agar containing 2% glucose and 0.5 microg of methylene blue per ml (MBE agar) and were read after incubation for 48 h at 35 degrees C. Disk diffusion testing was performed with MBE agar, 25-microg fluconazole disks, and 1- microg voriconazole disks and by incubation at 35 degrees C for 24 h. Overall agreements between the Etest and the BMD MICs obtained with RPG and MBE agars were 91 and 96%, respectively, for fluconazole and 93 and 95%, respectively, for voriconazole. Categorical agreements between the agar-based methods and BMD were 52.3 to 64.7% with fluconazole and 94.8 to 97.4% with voriconazole. The vast majority of the discrepancies by the disk diffusion and Etest methods with fluconazole were minor errors. The agar-based methods performed well in identifying isolates with resistance to fluconazole and decreased susceptibility to voriconazole.

Antifungal Agents - pharmacology

Fluconazole - pharmacology

Humans

Agar

Pyrimidines - pharmacology

Candidiasis - microbiology

Fungemia - microbiology

Triazoles - pharmacology

Microbial Sensitivity Tests - standards

Culture Media

Candida glabrata - isolation & purification

Voriconazole

Microbial Sensitivity Tests - methods

Candida glabrata - drug effects

Quality Control

Details

Title: Subtitle: Evaluation of the Etest and disk diffusion methods for determining susceptibilities of 235 bloodstream isolates of Candida glabrata to fluconazole and voriconazole
Creators: M A Pfaller - Department of Pathology. Medicine, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, Iowa 52242, USA. michael-pfaller@uiowa.edu
D J Diekema
L Boyken
S A Messer
S Tendolkar
R J Hollis
Resource Type: Journal article
Publication Details: Journal of clinical microbiology, Vol.41(5), pp.1875-1880
DOI: 10.1128/JCM.41.5.1875-1880.2003
PMID: 12734220
PMCID: PMC154736
NLM abbreviation: J Clin Microbiol
ISSN: 0095-1137
eISSN: 1098-660X
Publisher: United States
Language: English
Date published: 05/2003
Academic Unit: Infectious Diseases; Epidemiology; Pathology; Internal Medicine
Record Identifier: 9983986263102771

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