scholarly journals Ευαισθησίες των υφομυκήτων σε νεότερα αντιμυκητικά φάρμακα

2014 ◽  
Author(s):  
Ευαγγελία Πετρίκκου
Keyword(s):  
Filamentous Fungi ◽  
Susceptibility Testing ◽  
Antifungal Susceptibility ◽  
Inoculum Size ◽  
Tween 20 ◽  
Second Phase ◽  
Registry Study ◽  
Broth Microdilution Method ◽  
Invasive Mycoses ◽  
Inoculum Preparation

The continuing increase of systemic and invasive mycoses due to filamentous fungi (moulds) such as species of Aspergillus, zygomycetes of the order Mucorales (Rhizopus, Mucor, θιπ.) and rare hyalohyphomycetes such as Fusarium and Scedosporium, and their difficult management because of their resistance in most antifungals, needed the development and standardization of a method to determine susceptibility to these drugs. The present dissertation aimed to the development of an antifungal susceptibility testing method which would be reliable and reproducible, in order to be used as a standard method. This method should be applicable to all filamentous fungi,The strains used for this study were isolates from cases with systemic mycoses with known antifungal susceptibility and outcome, as well as from a prospective registry study. The experiments of the first phase of the study aimed to verify the optimal conditions for the preparation of the inoculum of conidia to be tested for antifungal susceptibility with the broth microdilution method. The main conclusions of this phase were that the haemocytometer counting of conidia was a more reliable method of inoculum preparation than the spectrophotometric adjustment, and that Tween 20, a nonionic surfactant, should be used as a dispersing agent for the optimal suspension of hydrophobic conidia. The ideal inoculum size was 1.0 × 106 -5.0 × 106 CFU/ml. In the second phase, this new method was evaluated in three independent laboratories and its reliability and reproducibility were confirmed, with interlaboratory agreement of 89.2% and a narrow 95% CI (2.20 -2.65). In the third phase of the study the method was used for the susceptibility testing of strains from a prospective registry study of rare invasive mycoses and performed very well. The results of this study have been adopted by the EUCAST and constitute the basis of the guidelines for the determination of the MICs of antifungals against conidia forming moulds (EUCAST DEFINITIVE DOCUMENT E.DEF 9.1).

Susceptibility of Filamentous Fungi to Voriconazole in Malaysia Tested by Sensititre YeastOne and CLSI Microdilution Methods

2021 ◽  
Author(s):  
Xue Ting Tan ◽  
Stephanie Jane Ginsapu ◽  
Fairuz binti Amran ◽  
Salina binti Mohamed Sukur ◽  
Surianti binti Shukor
Keyword(s):  
Filamentous Fungi ◽  
Susceptibility Testing ◽  
Rhizopus Oryzae ◽  
Antifungal Susceptibility ◽  
Sporothrix Schenckii ◽  
Rank Test ◽  
Broth Microdilution ◽  
Syncephalastrum Racemosum ◽  
Microdilution Method ◽  
Broth Microdilution Method

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.

scholarly journals Evaluation of a Modified EUCAST Fragmented-Mycelium Inoculum Method forIn VitroSusceptibility Testing of Dermatophytes and the Activity of Novel Antifungal Agents

2015 ◽  
Vol 59 (6) ◽  
pp. 3675-3682 ◽  
Author(s):  
B. Risslegger ◽  
C. Lass-Flörl ◽  
G. Blum ◽  
M. Lackner
Keyword(s):  
Antifungal Agents ◽  
Susceptibility Testing ◽  
Preparation Method ◽  
Antifungal Susceptibility ◽  
Broth Microdilution ◽  
Microdilution Method ◽  
Broth Microdilution Method ◽  
Inoculum Preparation ◽  
Minimal Effective Concentration

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.

Use of spectrophotometric reading for in vitro antifungal susceptibility testing ofAspergillusspp.

1999 ◽  
Vol 45 (10) ◽  
pp. 871-874 ◽  
Author(s):  
Eric Dannaoui ◽  
Florence Persat ◽  
Marie-France Monier ◽  
Elisabeth Borel ◽  
Marie-Antoinette Piens ◽  
...  
Keyword(s):  
Amphotericin B ◽  
Susceptibility Testing ◽  
Clinical Laboratory ◽  
Antifungal Susceptibility ◽  
Reference Method ◽  
Antifungal Susceptibility Testing ◽  
Aspergillus Species ◽  
National Committee ◽  
Broth Microdilution Method

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.

scholarly journals Flow Cytometry Antifungal Susceptibility Testing of Pathogenic Yeasts other than Candida albicans and Comparison with the NCCLS Broth Microdilution Test

2000 ◽  
Vol 44 (10) ◽  
pp. 2752-2758 ◽  
Author(s):  
Rama Ramani ◽  
Vishnu Chaturvedi
Keyword(s):  
Flow Cytometry ◽  
Candida Albicans ◽  
Amphotericin B ◽  
Susceptibility Testing ◽  
Antifungal Susceptibility ◽  
Antifungal Susceptibility Testing ◽  
Broth Microdilution ◽  
Nitrogen Base ◽  
Microdilution Method ◽  
Broth Microdilution Method

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.

scholarly journals Antifungal Susceptibility Testing of Malassezia spp. with an Optimized Colorimetric Broth Microdilution Method

2017 ◽  
Vol 55 (6) ◽  
pp. 1883-1893 ◽  
Author(s):  
Cheryl Leong ◽  
Antonino Buttafuoco ◽  
Martin Glatz ◽  
Philipp P. Bosshard
Keyword(s):  
Susceptibility Testing ◽  
Skin Diseases ◽  
Antifungal Susceptibility ◽  
Drug Susceptibility ◽  
Drug Susceptibility Testing ◽  
Broth Microdilution ◽  
Content Type ◽  
Microdilution Method ◽  
Broth Microdilution Method ◽  
Colorimetric Indicator

ABSTRACTMalasseziais a genus of lipid-dependent yeasts. It is associated with common skin diseases such as pityriasis versicolor and atopic dermatitis and can cause systemic infections in immunocompromised individuals. Owing to the slow growth and lipid requirements of these fastidious yeasts, convenient and reliable antifungal drug susceptibility testing assays forMalasseziaspp. are not widely available. Therefore, we optimized a broth microdilution assay for the testing ofMalasseziathat is based on the CLSI and EUCAST assays forCandidaand other yeasts. The addition of ingredients such as lipids and esculin provided a broth medium formulation that enabled the growth of allMalasseziaspp. and could be read, with the colorimetric indicator resazurin, by visual and fluorescence readings. We tested the susceptibility of 52 strains of 13Malasseziaspecies to 11 commonly used antifungals. MIC values determined by visual readings were in good agreement with MIC values determined by fluorescence readings. The lowest MICs were found for the azoles itraconazole, posaconazole, and voriconazole, with MIC90values of 0.03 to 1.0 μg/ml, 0.06 to 0.5 μg/ml, and 0.03 to 2.0 μg/ml, respectively. AllMalasseziaspp. were resistant to echinocandins and griseofulvin. SomeMalasseziaspp. also showed high MIC values for ketoconazole, which is the most widely recommended topical antifungal to treatMalasseziaskin infections. In summary, our assay enables the fast and reliable susceptibility testing ofMalasseziaspp. with a large panel of different antifungals.

scholarly journals Evaluation of ID Fungi Plates Medium for Identification of Molds by MALDI Biotyper

2020 ◽  
Vol 58 (5) ◽  
Author(s):  
Marie Gladys Robert ◽  
Charlotte Romero ◽  
Céline Dard ◽  
Cécile Garnaud ◽  
Odile Cognet ◽  
...  
Keyword(s):  
Filamentous Fungi ◽  
Susceptibility Testing ◽  
Antifungal Susceptibility ◽  
Antifungal Susceptibility Testing ◽  
Maldi Tof Ms ◽  
Extraction Protocol ◽  
Maldi Tof ◽  
Morphological Aspects ◽  
Routine Identification ◽  
Tof Ms

ABSTRACT MALDI-TOF mass spectrometry (MS) identification of pathogenic filamentous fungi is often impaired by difficulties in harvesting hyphae embedded in the medium and long extraction protocols. The ID Fungi Plate (IDFP) is a novel culture method developed to address such difficulties and improve the identification of filamentous fungi by MALDI-TOF MS. We cultured 64 strains and 11 clinical samples on IDFP, Sabouraud agar-chloramphenicol (SAB), and ChromID Candida agar (CAN2). We then compared the three media for growth, ease of harvest, amount of material picked, and MALDI-TOF identification scores after either rapid direct transfer (DT) or a long ethanol-acetonitrile (EA) extraction protocol. Antifungal susceptibility testing and microscopic morphology after subculture on SAB and IDFP were also compared for ten molds. Growth rates and morphological aspects were similar for the three media. With IDFP, harvesting of fungal material for the extraction procedure was rapid and easy in 92.4% of cases, whereas it was tedious on SAB or CAN2 in 65.2% and 80.3% of cases, respectively. The proportion of scores above 1.7 (defined as acceptable identification) were comparable for both extraction protocols using IDFP (P = 0.256). Moreover, rates of acceptable identification after DT performed on IDFP (93.9%) were significantly higher than those obtained after EA extraction with SAB (69.7%) or CAN2 (71.2%) (P = <0.001 and P = 0.001, respectively). Morphological aspects and antifungal susceptibility testing were similar between IDFP and SAB. IDFP is a culture plate that facilitates and improves the identification of filamentous fungi, allowing accurate routine identification of molds with MALDI-TOF-MS using a rapid-extraction protocol.

scholarly journals Antifungal susceptibility testing.

1993 ◽  
Vol 6 (4) ◽  
pp. 367-381 ◽  
Author(s):  
J H Rex ◽  
M A Pfaller ◽  
M G Rinaldi ◽  
A Polak ◽  
J N Galgiani
Keyword(s):  
Susceptibility Testing ◽  
Incubation Temperature ◽  
Clinical Laboratory ◽  
Antifungal Susceptibility ◽  
Inoculum Size ◽  
Antifungal Susceptibility Testing ◽  
National Committee ◽  
Candida Spp ◽  
Interlaboratory Variability ◽  
Future Work

Unlike antibacterial susceptibility testing, reliable antifungal susceptibility testing is still largely in its infancy. Many methods have been described, but they produce widely discrepant results unless such factors as pH, inoculum size, medium formulation, incubation time, and incubation temperature are carefully controlled. Even when laboratories agree upon a common method, interlaboratory agreement may be poor. As a result of numerous collaborative projects carried out both independently and under the aegis of the Subcommittee on Antifungal Susceptibility Testing of the National Committee for Clinical Laboratory Standards, the effects of varying these factors have been extensively studied and a standard method which minimizes interlaboratory variability during the testing of Candida spp. and Cryptococcus neoformans has been proposed. This review summarizes this work, reviews the strengths and weaknesses of the proposed susceptibility testing standard, and identifies directions for future work.

scholarly journals Comparing Etest and Broth Microdilution for Antifungal Susceptibility Testing of the Most-Relevant Pathogenic Molds

2015 ◽  
Vol 53 (10) ◽  
pp. 3176-3181 ◽  
Author(s):  
Frédéric Lamoth ◽  
Barbara D. Alexander
Keyword(s):  
Amphotericin B ◽  
Antifungal Therapy ◽  
Susceptibility Testing ◽  
Antifungal Susceptibility ◽  
Multidrug Resistant ◽  
Antifungal Susceptibility Testing ◽  
Diffusion Method ◽  
Broth Microdilution ◽  
Content Type ◽  
Broth Microdilution Method

Invasive mold infections are life-threatening diseases for which appropriate antifungal therapy is crucial. Their epidemiology is evolving, with the emergence of triazole-resistantAspergillusspp. and multidrug-resistant non-Aspergillusmolds. Despite the lack of interpretive criteria, antifungal susceptibility testing of molds may be useful in guiding antifungal therapy. The standard broth microdilution method (BMD) is demanding and requires expertise. We assessed the performance of a commercialized gradient diffusion method (Etest method) as an alternative to BMD. The MICs or minimal effective concentrations (MECs) of amphotericin B, voriconazole, posaconazole, caspofungin, and micafungin were assessed for 290 clinical isolates of the most representative pathogenic molds (154Aspergillusand 136 non-Aspergillusisolates) with the BMD and Etest methods. Essential agreements (EAs) within ±2 dilutions of ≥90% between the two methods were considered acceptable. EAs for amphotericin B and voriconazole were >90% for most potentially susceptible species. For posaconazole, the correlation was acceptable forMucoromycotinabut Etest MIC values were consistently lower forAspergillusspp. (EAs of <90%). Excellent EAs were found for echinocandins with highly susceptible (MECs of <0.015 μg/ml) or intrinsically resistant (MECs of >16 μg/ml) strains. However, MEC determinations lacked consistency between methods for strains exhibiting mid-range MECs for echinocandins. We concluded that the Etest method is an appropriate alternative to BMD for antifungal susceptibility testing of molds under specific circumstances, including testing with amphotericin B or triazoles for non-Aspergillusmolds (MucoromycotinaandFusariumspp.). Additional study of molecularly characterized triazole-resistantAspergillusisolates is required to confirm the ability of the Etest method to detect voriconazole and posaconazole resistance amongAspergillusspp.

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