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Journal of Clinical Microbiology, June 2000, p. 2334-2338, Vol. 38, No. 6
Mycotic Diseases Branch, Division of
Bacterial and Mycotic Diseases, National Center for Infectious
Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
Received 2 February 2000/Returned for modification 14 March
2000/Accepted 4 April 2000
We evaluated a new microtiter assay for antifungal susceptibility
testing based on a colorimetric reaction to monitor fungal substrate
utilization. This new method (rapid susceptibility assay [RSA])
provides quantitative endpoint readings in less than 8 h compared
with visual determination of MIC by the National Committee for Clinical
Laboratory Standards (NCCLS) broth microdilution method, which requires
a minimum of 48 h of incubation. In this study, we tested clinical
isolates from each of the following species: Candida
albicans (20 isolates), C. glabrata (20 isolates), C. krusei (19 isolates), C. tropicalis (19 isolates), and C. parapsilosis (28 isolates). RSA and NCCLS
broth dilution methods were used to determine the MICs of amphotericin
B, fluconazole, itraconazole, and 5-flucytosine for all 106 isolates.
RPMI 1640 medium buffered with morpholinopropanesulfonic acid was used
for both methods; however, glucose and inoculum concentrations in the
RSA were modified. RSA MICs were determined as the lowest drug
concentration that prevented glucose consumption by the organism after
6 h of incubation. MICs obtained from the RSA were compared with
those obtained from the NCCLS M-27A method read at 24 and 48 h.
MIC pairs were considered in agreement when the difference between the
pairs was within 2 twofold dilutions. For the 106 isolates tested,
amphotericin B and 5-flucytosine demonstrated the highest agreement in
MICs between the two methods (100 and 98%, respectively), whereas
fluconazole and itraconazole produced less favorable MIC agreement
(63.2 and 61.3%, respectively). The azole MIC differences between the
two methods were significantly reduced when lower inocula were used with a prolonged incubation time. This preliminary comparison suggests
that this rapid procedure may be a reliable tool for the in vitro
determination of MICs of amphotericin B and 5-flucytosine and warrants
further evaluation.
0095-1137/00/$04.00+0
Comparison of a New Colorimetric Assay with the
NCCLS Broth Microdilution Method (M-27A) for Antifungal Drug
MIC Determination
*
Corresponding author. Mailing address: Mycotic Diseases
Branch, Centers for Disease Control and Prevention, 1600 Clifton Rd., N.E., Mailstop G-11, Atlanta, GA 30333. Phone: (404) 639-0894. Fax:
(404) 639-3546. E-mail: rhl9{at}cdc.gov.
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