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Journal of Clinical Microbiology, October 1998, p. 2874-2876, Vol. 36, No. 10
0095-1137/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.

Fluconazole Susceptibility Testing of Cryptococcus neoformans: Comparison of Two Broth Microdilution Methods and Clinical Correlates among Isolates from Ugandan AIDS Patients

C. J. Jessup,1 M. A. Pfaller,2 S. A. Messer,2 J. Zhang,2 M. Tumberland,3 E. K. Mbidde,4 and M. A. Ghannoum1,*

Mycology Reference Laboratory, Center for Medical Mycology, Department of Dermatology, Case Western Reserve University and University Hospitals of Cleveland, Cleveland, Ohio,1 Department of Pathology, University of Iowa College of Medicine, Iowa City, Iowa,2 Infectious Diseases Division, University of California San Francisco, San Francisco, California,3 and Uganda Cancer Institute, Kampala, Uganda4

Received 16 March 1998/Returned for modification 14 April 1998/Accepted 10 July 1998

We compared the yeast nitrogen base (YNB) broth microdilution method with the National Committee for Clinical Laboratory Standards (NCCLS) M27-A microdilution reference method for measuring the in vitro susceptibility of Cryptococcus neoformans isolates to fluconazole. A total of 149 isolates of C. neoformans var. neoformans from Ugandan AIDS patients was tested by both methods. An overall agreement of 88% between the two microdilution methods was observed. All isolates grew well in both RPMI 1640 and YNB media, and MICs could be read after 48 h of incubation by both methods. The range of fluconazole MICs obtained with the YNB method was broader than that obtained with the NCCLS method. The extended range of MICs provided by the YNB method may be of clinical value, as it appears that the clinical outcome may be better among patients infected with strains inhibited by lower concentrations of fluconazole as determined by the YNB method. The YNB method appears to be a viable option for testing C. neoformans against fluconazole.

* Corresponding author. Mailing address: Center for Medical Mycology, Mycology Reference Laboratory, University Hospitals of Cleveland, 11100 Euclid Ave., Cleveland, OH 44106-5028. Phone: (216) 844-8580. Fax: (216) 844-1076. E-mail: mag3{at}po.cwru.edu.

Journal of Clinical Microbiology, October 1998, p. 2874-2876, Vol. 36, No. 10
0095-1137/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.


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