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Journal of Clinical Microbiology, January 2001, p. 339-342, Vol. 39, No. 1
0095-1137/01/$04.00+0   DOI: 10.1128/JCM.39.1.339-342.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.

Improved Detection of Amphotericin B-Resistant Isolates of Candida lusitaniae by Etest

Florence Peyron,1 Anne Favel,1,* Annie Michel-Nguyen,2 Magali Gilly,1 Patrick Regli,1 and Anne Bolmström3

Laboratoire de Botanique, Cryptogamie et Biologie Cellulaire, Faculté de Pharmacie, 13005 Marseille,1 and Laboratoire de Microbiologie, CHU Nord, and Hôpital St. Joseph, 13000 Marseille,2 France, and AB BIODISK, Solna, Sweden3

Received 31 July 2000/Returned for modification 15 August 2000/Accepted 17 October 2000

Both intrinsic and acquired resistance to amphotericin B have been documented for Candida lusitaniae. Amphotericin B remains the drug of choice for many critical fungal infections, and the detection of resistance is essential to monitor treatment effectively. The limitations of the National Committee for Clinical Laboratory Standards (NCCLS) reference methodology for detection of amphotericin B resistance are well documented, and several alternative methods have been proposed. Etest assays with RPMI and antibiotic medium 3 (AM3) agar were compared to the NCCLS M27-A broth macrodilution method using AM3 for amphotericin B resistance testing with 49 clinical isolates of C. lusitaniae. The panel included nine isolates with known or presumed resistance to amphotericin B on the basis of in vivo and/or in vitro data. The distribution of amphotericin B MICs by Etest with RPMI ranged from 0.032 to 16 µg/ml and was bimodal. All of the putatively resistant isolates were inhibited by amphotericin B at >= 0.38 µg/ml and could be categorized as resistant using this breakpoint. Etest with AM3 yielded a broader amphotericin B MIC range (0.047 to 32 µg/ml), and there were six putatively resistant isolates for which MICs were >1 µg/ml. The separation of putatively susceptible and resistant isolates was less obvious. Broth macrodilution with AM3 generated a unimodal distribution of MICs (ranging from 0.032 to 2 µg/ml) and failed to discriminate most of the putatively resistant isolates at both 24 and 48 h. Etest using RPMI and, to a lesser extent, using AM3 provided better discrimination between amphotericin B-resistant and -susceptible isolates of C. lusitaniae.

* Corresponding author. Mailing address: Laboratoire de Botanique, Cryptogamie et Biologie Cellulaire, Faculté de Pharmacie, 27 Blvd. J. Moulin, 13005 Marseille Cedex 5, France. Phone: 33-4-91-83-56-37. Fax: 33-4-91-80-26-12. E-mail: Reglip{at}pharmacie.univ-mrs.fr.

Journal of Clinical Microbiology, January 2001, p. 339-342, Vol. 39, No. 1
0095-1137/01/$04.00+0   DOI: 10.1128/JCM.39.1.339-342.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.


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