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Journal of Clinical Microbiology
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Mycology

Multicenter Evaluation of a New Disk Agar Diffusion Method for Susceptibility Testing of Filamentous Fungi with Voriconazole, Posaconazole, Itraconazole, Amphotericin B, and Caspofungin

A. Espinel-Ingroff, B. Arthington-Skaggs, N. Iqbal, D. Ellis, M. A. Pfaller, S. Messer, M. Rinaldi, A. Fothergill, D. L. Gibbs, A. Wang
A. Espinel-Ingroff
1Virginia Commonwealth University Medical Center, Richmond, Virginia
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  • For correspondence: avingrof@vcu.edu
B. Arthington-Skaggs
2Centers for Disease Control, Atlanta, Georgia
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N. Iqbal
2Centers for Disease Control, Atlanta, Georgia
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D. Ellis
3Women's and Children's Hospital, North Adelaide, South Australia, Australia
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M. A. Pfaller
4University of Iowa, Iowa City, Iowa
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S. Messer
4University of Iowa, Iowa City, Iowa
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M. Rinaldi
5University of Texas, San Antonio, Texas
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A. Fothergill
5University of Texas, San Antonio, Texas
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D. L. Gibbs
6Giles Scientific Inc., Santa Barbara, California
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A. Wang
6Giles Scientific Inc., Santa Barbara, California
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DOI: 10.1128/JCM.00134-07
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ABSTRACT

The purpose of this study was to correlate inhibition zone diameters, in millimeters (agar diffusion disk method), with the broth dilution MICs or minimum effective concentrations (MECs) (CLSI M38-A method) of five antifungal agents to identify optimal testing guidelines for disk mold testing. The following disk diffusion testing parameters were evaluated for 555 isolates of the molds Absidia corymbifera, Aspergillus sp. (five species), Alternaria sp., Bipolaris spicifera, Fusarium sp. (three species), Mucor sp. (two species), Paecilomyces lilacinus, Rhizopus sp. (two species), and Scedosporium sp. (two species): (i) two media (supplemented Mueller-Hinton agar [2% dextrose and 0.5 μg/ml methylene blue] and plain Mueller-Hinton [MH] agar), (ii) three incubation times (16 to 24, 48, and 72 h), and (iii) seven disks (amphotericin B and itraconazole 10-μg disks, voriconazole 1- and 10-μg disks, two sources of caspofungin 5-μg disks [BBL and Oxoid], and posaconazole 5-μg disks). MH agar supported better growth of all of the species tested (24 to 48 h). The reproducibility of zone diameters and their correlation with either MICs or MECs (caspofungin) were superior on MH agar (91 to 100% versus 82 to 100%; R, 0.71 to 0.93 versus 0.53 to 0.96 for four of the five agents). Based on these results, the optimal testing conditions for mold disk diffusion testing were (i) plain MH agar; (ii) incubation times of 16 to 24 h (zygomycetes), 24 h (Aspergillus fumigatus, A. flavus, and A. niger), and 48 h (other species); and (iii) the posaconazole 5-μg disk, voriconazole 1-μg disk, itraconazole 10-μg disk (for all except zygomycetes), BBL caspofungin 5-μg disk, and amphotericin B 10-μg (zygomycetes only).

  • Copyright © 2007 American Society for Microbiology
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Multicenter Evaluation of a New Disk Agar Diffusion Method for Susceptibility Testing of Filamentous Fungi with Voriconazole, Posaconazole, Itraconazole, Amphotericin B, and Caspofungin
A. Espinel-Ingroff, B. Arthington-Skaggs, N. Iqbal, D. Ellis, M. A. Pfaller, S. Messer, M. Rinaldi, A. Fothergill, D. L. Gibbs, A. Wang
Journal of Clinical Microbiology Jun 2007, 45 (6) 1811-1820; DOI: 10.1128/JCM.00134-07

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Multicenter Evaluation of a New Disk Agar Diffusion Method for Susceptibility Testing of Filamentous Fungi with Voriconazole, Posaconazole, Itraconazole, Amphotericin B, and Caspofungin
A. Espinel-Ingroff, B. Arthington-Skaggs, N. Iqbal, D. Ellis, M. A. Pfaller, S. Messer, M. Rinaldi, A. Fothergill, D. L. Gibbs, A. Wang
Journal of Clinical Microbiology Jun 2007, 45 (6) 1811-1820; DOI: 10.1128/JCM.00134-07
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KEYWORDS

antifungal agents
Disk Diffusion Antimicrobial Tests
fungi

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