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Journal of Clinical Microbiology, March 2000, p. 971-976, Vol. 38, No. 3
0095-1137/00/$04.00+0
Copyright © 2000, American Society for Microbiology. All rights reserved.

Evaluation of a Capacitance Method for Direct Antifungal Susceptibility Testing of Yeasts in Positive Blood Cultures

Hsein Chang Chang,1 Jui Jung Chang,1 Ay Huey Huang,2 and Tsung Chain Chang3,*

Institute of Medical Engineering, National Cheng Kung University,1 Division of Clinical Microbiology, Department of Pathology, National Cheng Kung University Hospital,2 and Department of Medical Technology, College of Medicine, National Cheng Kung University,3 Tainan 701, Taiwan, Republic of China

Received 12 July 1999/Returned for modification 28 September 1999/Accepted 9 December 1999

The feasibility of using a capacitance method (CM) for direct antifungal susceptibility testing of yeasts in positive blood cultures was evaluated. The CM used the same test conditions as those recommended by the National Committee for Clinical Laboratory Standards. After direct inoculation of positive culture broths into module wells (Bactometer; bioMérieux, Inc., Hazelwood, Mo.), the end-point determination was made by monitoring the capacitance change in the culture broths with Bactometer. The MIC of amphotericin B was the lowest concentration at which yeast growth was completely inhibited, while the MICs of ketoconazole, flucytosine, and fluconazole were the concentrations at which a >= 80% reduction in capacitance change was observed. The MICs of the four drugs against each blood isolate obtained on subculture plates were also determined by the macrodilution method. For 51 positive blood cultures tested, the percent agreement (±2 log2 dilutions) between the CM and the macrodilution method were as follows: amphotericin B (98%), ketoconazole (92%), flucytosine (84%), and fluconazole (96%). The CM was further used for breakpoint susceptibility testing of fluconazole (8 and 64 µg/ml) and flucytosine (4 and 32 µg/ml) against yeasts in positive blood cultures. After testing of 74 specimens by the CM, flucytosine and fluconazole produced one (1.4%) major error and two (2.8%) minor errors, respectively. All yeasts that displayed resistance to flucytosine or fluconazole were detected within 24 h after direct inoculation of the positive broths into Bactometer. The CM may be useful for the rapid detection of antifungal resistance in positive blood cultures containing yeasts.

* Corresponding author. Mailing address: Department of Medical Technology, College of Medicine, National Cheng Kung University, 1 University Rd., Tainan 701, Taiwan, Republic of China. Phone: 886-6-2353535, ext. 5790. Fax: 886-6-2363956. E-mail: tsungcha{at}mail.ncku.edu.tw.

Journal of Clinical Microbiology, March 2000, p. 971-976, Vol. 38, No. 3
0095-1137/00/$04.00+0
Copyright © 2000, American Society for Microbiology. All rights reserved.


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