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Mycology

Antifungal Susceptibility of 205 Candida spp. Isolated Primarily during Invasive Candidiasis and Comparison of the Vitek 2 System with the CLSI Broth Microdilution and Etest Methods

N. Bourgeois, L. Dehandschoewercker, S. Bertout, P.-J. Bousquet, P. Rispail, L. Lachaud
N. Bourgeois
Laboratoire de Parasitologie-Mycologie, Centre Hospitalier Universitaire de Nîmes, Faculté de Médecine de Montpellier—Nîmes, Université Montpellier I, Montpellier, France
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L. Dehandschoewercker
Laboratoire de Parasitologie-Mycologie, Centre Hospitalier Universitaire de Nîmes, Faculté de Médecine de Montpellier—Nîmes, Université Montpellier I, Montpellier, France
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S. Bertout
Laboratoire de Parasitologie et de Mycologie Médicale, UMR 145 (IRD-UM1) VIH-SIDA et Maladies Associées, Faculté de Pharmacie, Montpellier, France
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P.-J. Bousquet
BESPIM (Biostatistique, Epidémiologie Clinique, Santé Publique et Information Médicale), Centre Hospitalier Universitaire de Nîmes, Faculté de Médecine de Montpellier—Nîmes, Université Montpellier I, Montpellier, France
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P. Rispail
Laboratoire de Parasitologie-Mycologie, Centre Hospitalier Universitaire de Montpellier, Faculté de Médecine de Montpellier—Nîmes, Université Montpellier I, Montpellier, France
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L. Lachaud
Laboratoire de Parasitologie-Mycologie, Centre Hospitalier Universitaire de Nîmes, Faculté de Médecine de Montpellier—Nîmes, Université Montpellier I, Montpellier, France
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  • For correspondence: llachaud@gmail.com
DOI: 10.1128/JCM.01096-09
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Tables

  • TABLE 1.

    Fluconazole and voriconazole MIC50s and MIC90s obtained with VK2, CLSI (24 h and 48 h), and Etest (24 h and 48 h)

    Candida sp. (no. of isolates), azole, and method24 h48 hEAa (%)
    MIC rangeMIC50MIC90MIC rangeMIC50MIC90
    C. albicans (84)
        Fluconazole
            VK2≤1-≥64d≤1≤1
            CLSI<0.125-640.1250.5<0.125->640.5298.8
            Etest0.094-1280.250.380.094->2560.625289.3
        Voriconazole
            VK2≤0.12-0.5≤0.12≤0.12
            CLSI<0.03-10.030.125<0.03-20.030.125100
            Etest0.003-10.0080.0230.002-20.020.06498.8
    C. parapsilosis (22)
        Fluconazole
            VK2≤1≤1≤1
            CLSI<0.125-80.1250.5<0.125-80.250.595.4
            Etest0.064-0.50.3150.380.064-811.590.9
        Voriconazole
            VK2≤0.12≤0.12≤0.12
            CLSI<0.03-0.25<0.03<0.03<0.03-0.25<0.030.03100
            Etest0.004-0.0470.0120.0230.006-0.190.0320.064100
    C. tropicalis (17)
        Fluconazole
            VK2≤1-2≤12
            CLSI<0.125-20.250.50.125-20.52100
            Etest0.5-21.51.50.38-61.5364.7
        Voriconazole
            VK2≤0.12≤0.12≤0.12
            CLSI<0.03-0.060.030.060.03-0.250.060.125100
            Etest0.016-0.0940.0470.0940.012-0.250.0940.19100
    Other Candida spp. (5)c
        Fluconazole
            VK2≤1-2≤1≤1
            CLSI<0.125-0.50.1250.125<0.125-40.1250.125100
            Etest0.064-30.750.750.064-30.750.75100
        Voriconazole
            VK2≤0.12-≤0.12≤0.12≤0.12
            CLSI<0.03-<0.03<0.03<0.03<0.03-<0.03<0.003<0.003100
            Etest0.004-0.0940.0230.0230.004-0.0940.0230.023100
    C. glabrata (56)
        Fluconazole
            VK2≤1-≥64832
            CLSI<0.125-64280.125->6461694.6
            Etest0.094->2567160.094->256>256>25625
        Voriconazole
            VK2≤0.12-≥8≤0.122
            CLSI<0.03-80.1250.50.03-80.125289.3
            Etest0.016-80.1251.50.032->321.53232.1
    C. inconspicua (5), C. norvegensis (2)
        Fluconazole
            VK24-≥641616
            CLSI<0.125-16<0.125<0.1252-321616100
            Etest8-24101024->256>256>25685.7
        Voriconazole
            VK2≤0.12-0.25≤0.12≤0.12
            CLSI<0.03-0.5<0.03<0.030.03-0.50.250.25100
            Etest0.19-20.190.190.19-20.190.1985.7
    C. krusei (14)
        Fluconazole
            VK24-321632100/92.8b
            CLSI0.25-6416328-643264100b
            Etest32->256>256>256
        Voriconazole
            VK2≤0.12-0.25≤0.120.25
            CLSI0.03-0.50.250.50.25-10.5192.8
            Etest0.19-0.50.250.250.064-1.50.251.564.3
    • ↵a EA between VK2 and the two other methods at 48 h.

    • ↵b EA calculated with Vitek 2 expert software interpretive values.

    • ↵c C. lusitaniae (n = 2), C. guilliermondii (n = 1), C. kefyr (n = 1), and C. dubliniensis (n = 1).

    • ↵d MICs are in micrograms per milliliter.

  • TABLE 2.

    Fluconazole and voriconazole susceptibilities of 205 Candida sp. isolates, CAs, and errors between VK2 and CLSI/Etest methods at 24 and 48 h

    Species (no. of isolates), azole, and method% of isolates (24 h/48 h)a that were:% CA with VK2 (24 h/48 h)aNo. of VK2 errors (24 h/48 h)a
    SusceptibleSDDResistantVMEMEmE
    C. albicans (84)
        Fluconazole
            VK298.801.2
            CLSI98.801.2100000
            Etest98.801.2100000
        Voriconazole
            VK210000
            CLSI100/98.80/1.20100/98.8001
            Etest100/98.80/1.20100/98.8001
    C. parapsilosis (22), C. tropicalis (17), other spp. (5)b
        Fluconazole + voriconazole
            VK210000
            CLSI10000100000
            Etest10000100000
    C. glabrata (56)
        Fluconazole
            VK27516.18.9
            CLSI80.314.35.478.60111
            Etest71.5/12.516/23.212.5/64.377.3/23.21/231/012/20
        Voriconazole
            VK287.55.47.1
            CLSI89.3/85.77.2/10.73.5/3.689.3/87.5004/5
            Etest89.3/48.27.2/10.73.5/41.189.2/51.80/201/05/7
    C. inconspicua (5), C. norvegensis (2)
        Fluconazole
            VK242.8542.8514.3
            CLSI28.671.4071.4001/2
            Etest28.6/071.4/28.60/71.475/14.30/101/5
        Voriconazole
            VK210000
            CLSI10000100000
            Etest100/85.70/14.30100/85.7000/1
    C. krusei (14)
        Fluconazole
            VK2c00100
            CLSI35.7/7.157.1/64.37.1/28.67.1/28.605/18/9
            Etest07.192.992.9001
        Voriconazole
            VK210000
            CLSI10000100000
            Etest100/85.70/14.30100/85.7002
    • ↵a Interpretative results obtained at 48 h if different from results at 24 h for CLSI and Etest methods only.

    • ↵b Two strains of C. lusitaniae, one strain of C. guilliermondii, one strain of C. kefyr, and one strain of C. dubliniensis.

    • ↵c Interpretative values and errors based on Vitek 2 expert software expertise.

  • TABLE 3.

    Amphotericin B susceptibilities of the 205 Candida sp. isolates used in this study

    Species (no. of isolates) and method% of isolates (48 h) with MIC (mg/liter) of:24 h48 hEAa (%)
    ≤1>1MIC rangeMIC50MIC90MIC rangeMIC50MIC90
    C. albicans (84)
        VK2100≤0.25-1c0.51
        CLSI98.81.20.125-10.50.50.25-21198.8
        Etest1000.094-0.380.0940.190.016-0.50.1250.2529.8
    C. parapsilosis (22)
        VK2100≤0.25-10.50.5
        CLSI81.818.20.125-0.50.250.50.5-21286.4
        Etest1000.094-0.50.1250.250.064-10.380.7563.6
    C. tropicalis (17)
        VK2100≤0.25-0.50.50.5
        CLSI1000.5-10.2510.5-212100
        Etest1000.047-0.250.1250.190.032-0.750.250.570.6
    Other Candida spp. (5)b
        VK2100≤0.25-0.50.50.5
        CLSI1000.06-10.50.50.25-10.50.5100
        Etest1000.047-0.380.250.25100
    C. glabrata (56)
        VK294.65.4≤0.25-80.51
        CLSI89.310.70.125-20.510.25-21198.2
        Etest98.21.80.016-10.250.50.023->320.380.7573.2
    C. inconspicua (5), C. norvegensis (2)
        VK2100≤0.25-1≤0.25≤0.25
        CLSI1000.03-10.1250.1250.25-10.250.25100
        Etest1000.016-0.750.0640.064100
    C. krusei (14)
        VK292.97.10.5-20.51
        CLSI71.428.61-2120.25-212100
        Etest85.714.30.094-10.750.750.19-20.875278.6
    • ↵a EA between VK2 and the two other methods at 48 h.

    • ↵b C. lusitaniae (n = 2), C. guilliermondii (n = 1), C. kefyr (n = 1), and C. dubliniensis (n = 1).

    • ↵c MICs are in micrograms per milliliter.

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Antifungal Susceptibility of 205 Candida spp. Isolated Primarily during Invasive Candidiasis and Comparison of the Vitek 2 System with the CLSI Broth Microdilution and Etest Methods
N. Bourgeois, L. Dehandschoewercker, S. Bertout, P.-J. Bousquet, P. Rispail, L. Lachaud
Journal of Clinical Microbiology Jan 2010, 48 (1) 154-161; DOI: 10.1128/JCM.01096-09

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Antifungal Susceptibility of 205 Candida spp. Isolated Primarily during Invasive Candidiasis and Comparison of the Vitek 2 System with the CLSI Broth Microdilution and Etest Methods
N. Bourgeois, L. Dehandschoewercker, S. Bertout, P.-J. Bousquet, P. Rispail, L. Lachaud
Journal of Clinical Microbiology Jan 2010, 48 (1) 154-161; DOI: 10.1128/JCM.01096-09
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