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Mycology

Quality Control Limits for Broth Microdilution Susceptibility Tests of Ten Antifungal Agents

A. L. Barry, M. A. Pfaller, S. D. Brown, A. Espinel-Ingroff, M. A. Ghannoum, C. Knapp, R. P. Rennie, J. H. Rex, M. G. Rinaldi
A. L. Barry
The Clinical Microbiology Institute, Wilsonville, Oregon;
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M. A. Pfaller
University of Iowa College of Medicine, Iowa City, Iowa;
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S. D. Brown
The Clinical Microbiology Institute, Wilsonville, Oregon;
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A. Espinel-Ingroff
Medical College of Virginia Commonwealth University, Richmond, Virginia;
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M. A. Ghannoum
University Center Reference Laboratory for Medical Mycology, Cleveland, Ohio;
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C. Knapp
Trek Diagnostic Systems, Inc., Westlake, Ohio;
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R. P. Rennie
National Center for Mycology, Edmonton, Alberta, Canada; and
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J. H. Rex
University of Texas Health Sciences Center, Houston, and
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M. G. Rinaldi
University of Texas Health Sciences Center, San Antonio, Texas
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DOI: 10.1128/JCM.38.9.3457-3459.2000
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Tables

  • Table 1.

    Distribution of MICs reported by eight participating facilities each testing two control strains on 10 separate days

    Antifungal agent and control strainaIncubation time (h)No. of times the following MICs (μg/ml) were reported (n = 240)b:
    ≤0.0160.030.060.120.250.51.02.04.08.0163264128
    Amphotericin B
     C. parapsilosis247[11201093]
    4820[1881238]
     C. krusei24[214197]
    48[1020228]
    Flucytosine
     C. parapsilosis24[43c15243]11
    484c[1218934]1
     C. krusei2415[3611979]
    481[741623]
    Fluconazoled
     C. parapsilosis2412[4559115]
    48121[4211941]
     C. krusei24[595764]
    48[4108980]
    Voriconazole
     C. parapsilosis24[9861414]
    48[21113833]
     C. krusei244[17761394]
    48[01101255]
    Ketoconazole
     C. parapsilosis246[710610813]
    482[231148217]2
     C. krusei24110[32741230]
    48[2514370]1
    Itraconazole
     C. parapsilosis2454[3412966]1
    485[2814957]1
     C. krusei2419[23681363]
    48[2317046]
    Caspofungin (MK0991)
     C. parapsilosis24611[2915944]
    4815[11143672]92c
     C. krusei243[22981161]
    484[2216448]2
    Ravuconazole (BMS 207147)
     C. parapsilosis24[9931217]10
    483[81149222]1
     C. krusei24610[17729639]
    48[831525]
    Posaconazole (SCH 56592)
     C. parapsilosis247[3611977]1
    4811[1516161]1
     C. krusei24[125110770]
    481[3931403]
    LY 303366
     C. parapsilosis24432[43111770]
    481[31831232]
     C. krusei241[81307523]21
    4812[591084414]102
    • ↵a C. parapsilosis ATCC 22019 and C. krusei ATCC 6258.

    • ↵b Proposed QC limits are indicated by brackets.

    • ↵c MICs outside the range of flucytosine or caspofungin that were actually tested.

    • ↵d Data from one laboratory were excluded because MICs of the control drug, amphotericin B, were outside of the proposed limits; another laboratory reported only 48-h readings. A third laboratory experienced growth failures with two lots of broth, especially after 24 h. Consequently, the total number of evaluable fluconazole MICs was less than the 240 expected test results.

  • Table 2.

    Proposed MIC ranges of various antifungal agents for two quality control strains of Candida spp. when tested by the NCCLS microdilution procedure

    Antifungal agentMIC (μg/ml) ranges for microdilution tests with:
    C. parapsilosisATCC 22019 at:C. krusei ATCC 6258 at:
    24 h48 h24 h48 h
    Amphotericin B0.25–2.00.5–4.00.5–2.01.0–4.0
    Flucytocine0.06–0.250.12–0.54.0–168.0–32
    Fluconazole0.5–4.01.0–4.08.0–6416–128
    Voriconazole0.016–0.120.03–0.250.06–0.50.12–1.0
    Ketoconazole0.03–0.250.06–0.50.12–1.00.25–1.0
    Itraconazole0.12–0.50.12–0.50.12–1.00.25–1.0
    Caspofungin (MK0991)0.25–1.00.5–4.00.12–1.00.25–1.0
    Ravuconazole (BMS 207147)0.016–0.120.03–0.250.06–0.50.25–1.0
    Posaconazole (SCH 56592)0.06–0.250.06–0.250.06–0.50.12–1.0
    LY3033661.0–8.01.0–8.00.03–0.250.06–0.5
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Quality Control Limits for Broth Microdilution Susceptibility Tests of Ten Antifungal Agents
A. L. Barry, M. A. Pfaller, S. D. Brown, A. Espinel-Ingroff, M. A. Ghannoum, C. Knapp, R. P. Rennie, J. H. Rex, M. G. Rinaldi
Journal of Clinical Microbiology Sep 2000, 38 (9) 3457-3459; DOI: 10.1128/JCM.38.9.3457-3459.2000

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Quality Control Limits for Broth Microdilution Susceptibility Tests of Ten Antifungal Agents
A. L. Barry, M. A. Pfaller, S. D. Brown, A. Espinel-Ingroff, M. A. Ghannoum, C. Knapp, R. P. Rennie, J. H. Rex, M. G. Rinaldi
Journal of Clinical Microbiology Sep 2000, 38 (9) 3457-3459; DOI: 10.1128/JCM.38.9.3457-3459.2000
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KEYWORDS

antifungal agents
Candida
laboratories
Microbial Sensitivity Tests

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