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
Open accessAbstract
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.
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Variations of the M27-A2 methodology using different media, agar-based MIC methods, and measurements of minimum fungicidal concentrations appear to enhance detection of resistant isolates.
“Variations of the M27-A2 methodology using different media [6], agar-based MIC methods [12,35,36], and measurements of minimum fungicidal concentrations [11] appear to enhance detection of resistant isolates.”
From Guidelines for Treatment of Candidiasis (2004) · cites this paper as [12]
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- Authors
- Wanger, A., Mills, K., Nelson, P. W., & Rex, J. H.
- Affiliations
- Department of Pathology, University of Texas Medical School, Houston, USA.
- ORCID
- Rex, J H
- Venue
- Antimicrobial Agents and Chemotherapy
- Publisher
- American Society for Microbiology
- Published
- 1995-11
- Volume
- 39
- Issue
- 11
- Pages
- 2520-2522
- ISSN
- 0066-4804 (ISSN-L)
- 1098-6596
- PMC
- PMC162976
- OpenAlex
- W2142450445
- Cited by
- 202
- References
- 11
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 1 · 2023: 2 · 2022: 3 · 2021: 4 · 2020: 2 · 2019: 3 · 2018: 2 · 2017: 4 · 2016: 2 · 2015: 5 · 2014: 5 · 2013: 1 · 2012: 11
- FWCI
- 8.40
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- Antimicrobial Agents and Chemotherapy (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Clinical Biochemistry › Bacterial Identification and Susceptibility Testing
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Yeasts and Rust Fungi Studies
- Keywords
- E-test, antifungal susceptibility testing, Candida, amphotericin B resistance, fluconazole, broth macrodilution, minimum inhibitory concentration, measurement agreement
- MeSH terms
- Amphotericin B, Anti-Infective Agents, Antifungal Agents, Candida, Culture Media, Drug Resistance, Microbial, Microbial Sensitivity Tests, Quality Control, Fluconazole, Fluoroquinolones
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