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Journal of Clinical Microbiology, June 2002, p. 2101-2107, Vol. 40, No. 6
0095-1137/02/$04.00+0     DOI: 10.1128/JCM.40.6.2101-2107.2002
Copyright © 2002, American Society for Microbiology. All Rights Reserved.

E-Test Method for Testing Susceptibilities of Aspergillus spp. to the New Triazoles Voriconazole and Posaconazole and to Established Antifungal Agents: Comparison with NCCLS Broth Microdilution Method

Ana Espinel-Ingroff1,2* and A. Rezusta1,2

Division of Infectious Diseases, Medical College of Virginia Campus of Virginia Commonwealth University, Richmond, Virginia 23298-0049,1 Facultad Huesca, Zaragoza, Spain2

Received 1 February 2002/ Returned for modification 12 March 2002/ Accepted 24 March 2002

NCCLS document M38-P describes standard parameters for testing the fungistatic activities (MICs) of established agents against filamentous fungi (molds). This study evaluated the in vitro susceptibilities of 15 Aspergillus flavus isolates, 62 A. fumigatus isolates, and 10 isolates each of A. niger, A. nidulans, and A. terreus to voriconazole, posaconazole, itraconazole, and amphotericin B by the E-test and NCCLS M38-P microdilution methods. The agreement (within 3 dilutions) between methods for voriconazole was independent of the E-test incubation time (93.3 to 100% for four of five species at both incubation times). In contrast, with amphotericin B, itraconazole, and posaconazole, E-test results were more dependent on the incubation time for certain species. For A. fumigatus, posaconazole E-test MICs had better concordance with reference values after 48 h (95.2%) than after 24 h (90%), while the highest agreement for itraconazole MICs was after 24 h (90.3 versus 74.2%) of incubation. Better agreement between the methods was also obtained with 24-h E-test amphotericin B MICs for A. flavus (73.3 versus 26.7%) and A. fumigatus (96.7 versus 64.5%). E-test MICs of the four agents had the lowest percentages of agreement with reference values for A. nidulans (60 to 80%). For isolates for which high MICs were obtained for the four agents by the reference method, high MICs were also obtained by E-test at both 24 and 48 h. The utility of in vitro results of either the E-test or the NCCLS broth microdilution (M38-P) method for Aspergillus spp. needs to be established in clinical trials.

* Corresponding author. Mailing address: Medical Mycology Research Laboratory, Medical College of Virginia/VCU, P.O. Box 980049, 1101 E. Marshall St., Sanger Hall, Room 7049, Richmond, VA 23298-0049. Phone: (804) 828-9711. Fax: (804) 828-3097. E-mail: avingrof{at}hsc.vcu.edu.

Journal of Clinical Microbiology, June 2002, p. 2101-2107, Vol. 40, No. 6
0095-1137/02/$04.00+0     DOI: 10.1128/JCM.40.6.2101-2107.2002
Copyright © 2002, American Society for Microbiology. All Rights Reserved.



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