scholarly journals Comparative Evaluation of Micronaut-AM and CLSI broth micro-dilution method for antifungal susceptibility testing of Aspergillus species against four commonly used antifungals

2019 ◽  
Author(s):  
Ali Nuh ◽  
Newara Ramadan ◽  
Silke Schelenz ◽  
Darius Armstrong-James

AbstractThe aim of this study was to evaluate a colorimetric method, Micronaut-AM, for determining susceptibility testing of anidulafungin, amphotericin, voriconazole and itraconazole by comparing the Minimum Inhibitory (Effective) Concentrations (MICs/MECs) obtained by this method to those generated by the reference Clinical Laboratory Standard Investigation (CLSI) method. 78 clinical isolates of Aspergillus species, nine of them azole-resistant, were tested against above antifungals. A fumigatus ATCC 204305 was used as a reference strain and test was performed in accordance with slightly modified yeast susceptibility testing instruction of the manufacture; conidia suspension inoculum and alamarBlue concentration were optimised. These same isolates were referred to Bristol Mycology reference laboratory and tested by CLSI method. The MICs and MECs generated by the two methods were compared using concordance analysis.Micronaut-AM (MN) showed significant concordance (P< 0.0001) with CLSI method and overall agreement was high (≥ 90%). In addition, Micronaut-AM produced echinocandin MECs results within 18-24h incubation time and reliably detected azole resistant isolates. Essential agreement (within 2 log2 dilution of median) between MN and CLSI reference laboratory method was 99 % for anidulafungin, 100 % for amphotericin; 90% for voriconazole and 87 % for itraconazole. Categorical agreement for anidulafungin, amphotericin B, voriconazole and itraconazole were 100%, 96%, 97% and 99% respectively.Micronaut-AM showed very good agreement with the reference broth micro-dilution method results for all antifungal agents tested and was able to detect azole resistance. This colorimetric method is very promising and appears to be a suitable alternative susceptibility testing method to labour intensive broth microdilution method for Aspergillus species.

2020 ◽  
Vol 58 (8) ◽  
pp. 1085-1090
Author(s):  
Ali Nuh ◽  
Newara Ramadan ◽  
Silke Schelenz ◽  
Darius Armstrong-James

Abstract The aim of this study was to evaluate a colorimetric method, MIRONAUT-AM, for determining susceptibility testing of anidulafungin, amphotericin, voriconazole, and itraconazole by comparing the minimum inhibitory (effective) concentrations (MICs/MECs) obtained by this method to those generated by the reference Clinical Laboratory Standard Institute (CLSI) broth microdilution method. In sum, 78 clinical isolates of Aspergillus species, nine of them non-wild type (non-WT) with itraconazole MIC ranging from 2 mg/l to &gt;16 mg/l, were tested against above antifungals. A. fumigatus ATCC 204305 was used as a reference strain, and test was performed in accordance with slightly modified yeast susceptibility testing instruction of the manufacture; conidia suspension inoculum and alamarBlue concentration were optimized. These same isolates were referred to Bristol Mycology reference laboratory and tested by CLSI method. The MICs and MECs generated by the two methods were compared using concordance analysis. MIRONAUT-AM showed significant concordance (P &lt; .0001) with CLSI method, and overall agreement was high (≥90%). In addition, MIRONAUT-AM produced echinocandin MECs results within 18–24 hours incubation time and correctly detected all non-WT isolates except one isolate. This colorimetric method is very promising and appears to be a suitable alternative susceptibility testing method to labor intensive broth microdilution reference method for Aspergillus species.


1999 ◽  
Vol 45 (10) ◽  
pp. 871-874 ◽  
Author(s):  
Eric Dannaoui ◽  
Florence Persat ◽  
Marie-France Monier ◽  
Elisabeth Borel ◽  
Marie-Antoinette Piens ◽  
...  

A comparative study of visual and spectrophotometric MIC endpoint determinations for antifungal susceptibility testing of Aspergillus species was performed. A broth microdilution method adapted from the National Committee for Clinical Laboratory Standards (NCCLS) was used for susceptibility testing of 180 clinical isolates of Aspergillus species against amphotericin B and itraconazole. MICs were determined visually and spectrophotometrically at 490 nm after 24, 48, and 72h of incubation, and MIC pairs were compared. The agreement between the two methods was 99% for amphotericin B and ranged from 95 to 98% for itraconazole. It is concluded that spectrophotometric MIC endpoint determination is a valuable alternative to the visual reference method for susceptibility testing of Aspergillus species.Key words: antifungal, susceptibility testing, Aspergillus, spectrophotometric reading.


2020 ◽  
Vol 75 (7) ◽  
pp. 1799-1806
Author(s):  
Joseph Meletiadis ◽  
Maria Siopi ◽  
Lamprini Kanioura ◽  
Karin Meinike Jørgensen ◽  
David S Perlin ◽  
...  

Abstract Background The determination of the minimal effective concentration (MEC) of echinocandins against Aspergillus species is subjective, time consuming and has been associated with very major errors. Methods The MECs/MICs of 40 WT [10 each of Aspergillus fumigatus species complex (SC), Aspergillus flavus SC, Aspergillus terreus SC and Aspergillus niger SC] and 4 non-WT A. fumigatus isolates were determined with EUCAST E.Def 9.3.1 read microscopically, macroscopically, spectrophotometrically and colorimetrically in three centres. The optimal conditions for spectrophotometric (single- versus multi-point readings) and colorimetric (XTT/menadione concentration and stability, incubation time) methods were evaluated in preliminary studies using different cut-offs for the determination of macroscopic, spectrophotometric and colorimetric MIC endpoints compared with the microscopically determined MEC. Inter-centre and inter-method essential (within one 2-fold dilution) agreement (EA) and categorical agreement (CA) were determined. Results Both macroscopic and spectrophotometric endpoint readings showed poor inter-centre EA (53%–66%) and low CA (41%–88%) in distinguishing WT from non-WT A. fumigatus SC isolates, while significant differences compared with the microscopic MECs were observed for all echinocandins (EA 6%–54%). For the colorimetric method, the optimal conditions were 400 mg/L XTT/6.25 μΜ menadione, incubation for 1–2 h until the drug-free control reached an absorbance at 450/630 nm of &gt;0.8 and use of 50% inhibition of XTT conversion as a cut-off for all species and echinocandins. All non-WT isolates had high XTT MICs &gt;1 mg/L, whereas the overall inter-centre EA and CA were 72%–89% and 100%, respectively. Conclusions The XTT colorimetric assay improved the antifungal susceptibility testing of echinocandins against Aspergillus spp., reliably detecting non-WT isolates.


2021 ◽  
Author(s):  
Xue Ting Tan ◽  
Stephanie Jane Ginsapu ◽  
Fairuz binti Amran ◽  
Salina binti Mohamed Sukur ◽  
Surianti binti Shukor

Abstract Background: Voriconazole is a trizaole antifungal to treat fungal infection. In this study, the susceptibility pattern of voriconazole against filamentous fungi was studied using Sensititre® YeastOne and Clinical & Laboratory Standards Institute (CLSI) M38 broth microdilution method. Methods: The suspected cultures of Aspergillus niger, A. flavus, A. fumigatus, A. versicolor, A. sydowii, A. calidoutus, A. creber, A. ochraceopetaliformis, A. tamarii, Fusarium solani, F. longipes, F. falciferus, F. keratoplasticum, Rhizopus oryzae, R. delemar, R. arrhizus, Mucor sp., Poitrasia circinans, Syncephalastrum racemosum and Sporothrix schenckii were received from hospitals. Their identification had been confirmed in our lab and susceptibility tests were performed using Sensititre® YeastOne and CLSI M38 broth microdilution method. The significant differences between two methods were calculated using Wilcoxon Sign Rank test.Results: Mean of the minimum inhibitory concentrations (MIC) for Aspergillus spp. and Fusarium were within 0.25 μg/mL-2.00 μg/mL by two methods except A. calidoutus, F. solani and F. keratoplasticum. Moreover, mean of MIC for S. schenkii were around 3.00 μg/mL by two methods. In contrast, mean of MIC for Rhizopus spp., Mucor sp., P. circinans and S. racemosum were ≥6.00 μg/mL by two methods. Generally, the MIC obtained by Sensititre YeastOne was one two-fold increase or decrease compared with the results obtained by CLSI method. The overall agreement between Sensititre YeastOne and CLSI methods to test susceptibility testing of voricaonazole was more than 70% except A. sydowii. The significant differences between two methods were significant when tested on A. niger, A. flavus, A. fumigatus, A. versicolor, A. sydowii, F. solani and S. schenkii. Conclusions: In conclusion, Sensititre YeastOne method appears to be an alternative procedure for antifungal susceptibility testing for some Malaysian moulds.


2000 ◽  
Vol 44 (10) ◽  
pp. 2752-2758 ◽  
Author(s):  
Rama Ramani ◽  
Vishnu Chaturvedi

ABSTRACT Candida species other than Candida albicansfrequently cause nosocomial infections in immunocompromised patients. Some of these pathogens have either variable susceptibility patterns or intrinsic resistance against common azoles. The availability of a rapid and reproducible susceptibility-testing method is likely to help in the selection of an appropriate regimen for therapy. A flow cytometry (FC) method was used in the present study for susceptibility testing ofCandida glabrata, Candida guilliermondii,Candida krusei, Candida lusitaniae,Candida parapsilosis, Candida tropicalis, andCryptococcus neoformans based on accumulation of the DNA binding dye propidium iodide (PI). The results were compared with MIC results obtained for amphotericin B and fluconazole using the NCCLS broth microdilution method (M27-A). For FC, the yeast inoculum was prepared spectrophotometrically, the drugs were diluted in either RPMI 1640 or yeast nitrogen base containing 1% dextrose, and yeast samples and drug dilutions were incubated with amphotericin B and fluconazole, respectively, for 4 to 6 h. Sodium deoxycholate and PI were added at the end of incubation, and fluorescence was measured with a FACScan flow cytometer (Becton Dickinson). The lowest drug concentration that showed a 50% increase in mean channel fluorescence compared to that of the growth control was designated the MIC. All tests were repeated once. The MICs obtained by FC for all yeast isolates except C. lusitaniae were in very good agreement (within 1 dilution) of the results of the NCCLS broth microdilution method. Paired ttest values were not statistically significant (P = 0.377 for amphotericin B; P = 0.383 for fluconazole). Exceptionally, C. lusitaniae isolates showed higher MICs (2 dilutions or more) than in the corresponding NCCLS broth microdilution method for amphotericin B. Overall, FC antifungal susceptibility testing provided rapid, reproducible results that were statistically comparable to those obtained with the NCCLS method.


2015 ◽  
Vol 59 (6) ◽  
pp. 3675-3682 ◽  
Author(s):  
B. Risslegger ◽  
C. Lass-Flörl ◽  
G. Blum ◽  
M. Lackner

ABSTRACTFor antifungal susceptibility testing of nonsporulating or poorly sporulating dermatophytes, a fragmented-mycelium inoculum preparation method was established and compared to broth microdilution testing according to CLSI and EUCAST guidelines. Moreover, thein vitroactivity of new antifungal agents against dermatophytes was evaluated. Agreement between the mycelial inoculum method and the CLSI broth microdilution method was high (93% to 100%). Echinocandins (minimal effective concentration [MEC], ≤0.5 mg/liter) and posaconazole (MIC, ≤3.00 mg/liter) showed good activity against all tested dermatophytes.


1998 ◽  
Vol 36 (6) ◽  
pp. 1578-1583 ◽  
Author(s):  
Anna Maria Tortorano ◽  
Maria Anna Viviani ◽  
Francesco Barchiesi ◽  
Daniela Arzeni ◽  
Anna Lisa Rigoni ◽  
...  

Three susceptibility testing procedures were compared to determine fluconazole, itraconazole, and ketoconazole MICs against 47Candida albicans strains isolated sequentially from the oral cavities of five AIDS patients undergoing azole therapy. They included the broth microdilution method (BM), performed according to the National Committee for Clinical Laboratory Standards’ tentative standard, the agar dilution method (AD), and the Etest; the latter two tests were performed both in Casitone agar (AD-Cas and Etest-Cas) and in RPMI (AD-RPMI and Etest-RPMI). Twenty-four- and 48-h MICs obtained by AD and Etest were compared with 48-h MICs obtained by BM. The MICs of all the azoles determined by BM were usually lower than those obtained by the other methods, mainly due to different reading criteria. In order to assess the most appropriate way of evaluating the agreement of MICs obtained by different methods with those produced by the proposed reference method (BM), we used the mean differences calculated according to Bland and Altman’s method. Comparison of fluconazole MICs obtained by BM and AD-Cas yielded a mean difference of 3, and the percentages of agreement within ±2 dilutions were 98 and 100% at 24 and 48 h, respectively. For ketoconazole and itraconazole MICs, lower mean differences were noted, and agreement ranged from 96 to 100%. Agreement between the AD-RPMI and BM results was poor for all azoles, and an increase in MICs was always observed between the 1st- and 2nd-day readings. Similarly, Etest-Cas gave better agreement with BM than did Etest-RPMI for all the azoles. BM, AD-Cas, and Etest-Cas each demonstrated a progressive increase in fluconazole MICs against strains isolated sequentially from a given patient, in accordance with the decreased clinical response to fluconazole.


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