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Mycology

Multicenter Comparative Evaluation of Six Commercial Systems and the National Committee for Clinical Laboratory Standards M27-A Broth Microdilution Method for Fluconazole Susceptibility Testing of Candida Species

G. Morace, G. Amato, F. Bistoni, G. Fadda, P. Marone, M. T. Montagna, S. Oliveri, L. Polonelli, R. Rigoli, I. Mancuso, S. La Face, L. Masucci, L. Romano, C. Napoli, D. Tatò, M. G. Buscema, C. M. C. Belli, M. M. Piccirillo, S. Conti, S. Covan, F. Fanti, C. Cavanna, F. D'Alò, L. Pitzurra
G. Morace
1Istituto di Microbiologia, Università degli Studi di Milano, Milan
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  • For correspondence: giulia.morace@unimi.it
G. Amato
2Laboratorio di Patologia Clinica, Azienda Ospedaliera di Rilievo Nazionale, Cardarelli, Naples
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F. Bistoni
3Dipartimento di Medicina Sperimentale e Scienze Biochimiche, Sezione di Microbiologia, Università degli Studi di Perugia, Perugia
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G. Fadda
4Istituto di Microbiologia, Università Cattolica del Sacro Cuore, Rome
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P. Marone
5Laboratorio di Batteriologia e Micologia, Istituto di Ricovero e Cura a Carattere Scientifico, San Matteo, Pavia
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M. T. Montagna
6Dipartimento di Medicina Interna e Medicina Pubblica, Sezione di Igiene, Università degli Studi di Bari, Bari
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S. Oliveri
7Dipartimento di Scienze Microbiologiche e Scienze Ginecologiche, Sezione di Microbiologia, Università degli Studi di Catania, Catania
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L. Polonelli
8Dipartimento di Patologia e Medicina di Laboratorio, Sezione di Microbiologia, Università degli Studi di Parma, Parma
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R. Rigoli
9Laboratorio di Microbiologia, Ospedale Ca' Foncello, Treviso
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I. Mancuso
10Pfizer Italia SpA, Rome, Italy
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S. La Face
10Pfizer Italia SpA, Rome, Italy
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L. Masucci
4Istituto di Microbiologia, Università Cattolica del Sacro Cuore, Rome
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L. Romano
4Istituto di Microbiologia, Università Cattolica del Sacro Cuore, Rome
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C. Napoli
6Dipartimento di Medicina Interna e Medicina Pubblica, Sezione di Igiene, Università degli Studi di Bari, Bari
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D. Tatò
6Dipartimento di Medicina Interna e Medicina Pubblica, Sezione di Igiene, Università degli Studi di Bari, Bari
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M. G. Buscema
7Dipartimento di Scienze Microbiologiche e Scienze Ginecologiche, Sezione di Microbiologia, Università degli Studi di Catania, Catania
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C. M. C. Belli
2Laboratorio di Patologia Clinica, Azienda Ospedaliera di Rilievo Nazionale, Cardarelli, Naples
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M. M. Piccirillo
2Laboratorio di Patologia Clinica, Azienda Ospedaliera di Rilievo Nazionale, Cardarelli, Naples
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S. Conti
8Dipartimento di Patologia e Medicina di Laboratorio, Sezione di Microbiologia, Università degli Studi di Parma, Parma
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S. Covan
8Dipartimento di Patologia e Medicina di Laboratorio, Sezione di Microbiologia, Università degli Studi di Parma, Parma
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F. Fanti
8Dipartimento di Patologia e Medicina di Laboratorio, Sezione di Microbiologia, Università degli Studi di Parma, Parma
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C. Cavanna
5Laboratorio di Batteriologia e Micologia, Istituto di Ricovero e Cura a Carattere Scientifico, San Matteo, Pavia
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F. D'Alò
3Dipartimento di Medicina Sperimentale e Scienze Biochimiche, Sezione di Microbiologia, Università degli Studi di Perugia, Perugia
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L. Pitzurra
3Dipartimento di Medicina Sperimentale e Scienze Biochimiche, Sezione di Microbiologia, Università degli Studi di Perugia, Perugia
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DOI: 10.1128/JCM.40.8.2953-2958.2002
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ABSTRACT

Fluconazole susceptibility among 800 clinical Candida isolates (60% C. albicans) and two control strains (C. krusei ATCC 6258 and C. parapsilosis ATCC 22019) was tested with the NCCLS M27-A method (gold standard) and six commercial products (Candifast, disk, Etest, Fungitest, Integral System Yeasts, and Sensititre YeastOne). Results were classified as susceptible, susceptible-dose dependent, or resistant using M27-A breakpoints or, for Fungitest, Integral System Yeasts, and Candifast, as susceptible, intermediate, or resistant, according to the manufacturers' instructions. Concordance with NCCLS M27-A results was analyzed with the χ2 test. Intra- and interlaboratory reproducibility was also evaluated. NCCLS M27-A (90.1%), Etest (93.1%), Sensititre YeastOne (93.1%), disk (96.7%), Fungitest (92.6%), Integral System Yeasts (40.6%), and Candifast (6.0%) classified the indicated percentages of C. albicans isolates as susceptible. Among non-C. albicans strains, the percentages of susceptible isolates were as follows: NCCLS M27-A, 74.0%; Etest, 83.8%; Sensititre YeastOne, 64.1%; disk, 60.6%; Fungitest, 76.6%; Integral System Yeasts, 28.3%; and Candifast, 27.4%. All methods except Candifast and Integral System Yeasts showed good agreement with NCCLS M27-A results for both C albicans and non-C. albicans isolates. Intralaboratory reproducibility was excellent for NCCLS M27-A, Etest, Sensititre YeastOne, disk, and Fungitest (88 to 91%). Similar results emerged from the interlaboratory reproducibility evaluation. Our findings indicate that some commercial methods can be useful for fluconazole susceptibility testing of clinical Candida isolates. Those characterized by a lack of medium standardization and/or objective interpretative criteria should be avoided. Particular caution is necessary when testing is being done for clinical and epidemiological purposes.

  • Copyright © 2002 American Society for Microbiology
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Multicenter Comparative Evaluation of Six Commercial Systems and the National Committee for Clinical Laboratory Standards M27-A Broth Microdilution Method for Fluconazole Susceptibility Testing of Candida Species
G. Morace, G. Amato, F. Bistoni, G. Fadda, P. Marone, M. T. Montagna, S. Oliveri, L. Polonelli, R. Rigoli, I. Mancuso, S. La Face, L. Masucci, L. Romano, C. Napoli, D. Tatò, M. G. Buscema, C. M. C. Belli, M. M. Piccirillo, S. Conti, S. Covan, F. Fanti, C. Cavanna, F. D'Alò, L. Pitzurra
Journal of Clinical Microbiology Aug 2002, 40 (8) 2953-2958; DOI: 10.1128/JCM.40.8.2953-2958.2002

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Multicenter Comparative Evaluation of Six Commercial Systems and the National Committee for Clinical Laboratory Standards M27-A Broth Microdilution Method for Fluconazole Susceptibility Testing of Candida Species
G. Morace, G. Amato, F. Bistoni, G. Fadda, P. Marone, M. T. Montagna, S. Oliveri, L. Polonelli, R. Rigoli, I. Mancuso, S. La Face, L. Masucci, L. Romano, C. Napoli, D. Tatò, M. G. Buscema, C. M. C. Belli, M. M. Piccirillo, S. Conti, S. Covan, F. Fanti, C. Cavanna, F. D'Alò, L. Pitzurra
Journal of Clinical Microbiology Aug 2002, 40 (8) 2953-2958; DOI: 10.1128/JCM.40.8.2953-2958.2002
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KEYWORDS

antifungal agents
Candida
fluconazole
Microbial Sensitivity Tests
Reagent Kits, Diagnostic

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