Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 Nov;9(11):DC01-4.
doi: 10.7860/JCDR/2015/14119.6735. Epub 2015 Nov 1.

Comparative Analysis of Disc Diffusion and E-test with Broth Micro-dilution for Susceptibility Testing of Clinical Candida Isolates Against Amphotericin B, Fluconazole, Voriconazole and Caspofungin

Deepak Kumar  1 , Sayan Bhattacharyya  2 , Prashant Gupta  3 , Gopa Banerjee  4 , Mastan Singh  5
Affiliations

Comparative Analysis of Disc Diffusion and E-test with Broth Micro-dilution for Susceptibility Testing of Clinical Candida Isolates Against Amphotericin B, Fluconazole, Voriconazole and Caspofungin

Deepak Kumar et al. J Clin Diagn Res. 2015 Nov.

Abstract

Background: Antifungal susceptibility testing remains an area of intense interest because of the increasing number of clinical isolates resistant to antifungal therapy. Clinical and Laboratory Standards Institute has proposed reference broth micro dilution (BMD) method for susceptibility testing. The reference method is time-consuming and poorly suited for the routine clinical laboratory setting. Agar-based susceptibility testing methods, disk diffusion (DD) method and the E-test method can be an easier, reliable and less time consuming alternative for the BMD method.

Aim: To compare the results of Amphotericin B, fluconazole, voriconazole, and Caspofungin susceptibility testing by DD, and the E-test method with the CLSI reference method for clinical Candida isolates.

Materials and methods: Broth Microdilution (BMD), E-test and Disk diffusion testing of the various clinical Candida isolates was performed in accordance with CLSI documents. The results obtained were analysed and compared.

Results: The categorical agreement for Amphotericin B, fluconazole, voriconazole, and Caspofungin susceptibility results by E-test and DD method was 65.2%, 67.4%; 100%, 82.6%; 100%, 100%; 100%, 97.8% respectively.

Conclusion: The agar-based E-test and disk diffusion methods are reliable alternatives to the BMD method for Candida isolates when test susceptible to fluconazole, voriconazole, and Caspofungin, however the susceptibility testing results must be interpreted with caution in case of Amphotericin B.

Keywords: Antifungal susceptibility testing; Antifungal therapy; CLSI reference method.

PubMed Disclaimer

References

    1. Abi-Said D, Anaissie E, Uzun O, Raad I, Pinzcowski H, Vartivarian S. The Epidemiology of Hematogenous Candidiasis Caused by Different Candida Species. Clin Infect Dis. 1997;24(6):1122–28. - PubMed
    1. Banarjee S. Secular trends in nosocomial primary bloodstream infections in the United States, 1980-1989. The American Journal of Medicine. 1991;91(3):S86–S89. - PubMed
    1. Trick W, Fridkin S, Edwards J, Hajjeh R, Gaynes R. Secular Trend of Hospital-Acquired Candidemia among Intensive Care Unit Patients in the United States during 1989–1999. Clin Infect Dis. 2002;35(5):627–30. - PubMed
    1. Redding S, Smith J, Farinacci G, Rinaldi M, Fothergill A, Rhine-Chalberg J, et al. Resistance of Candida albicans to Fluconazole During Treatment of Oropharyngeal Candidiasis in a Patient with AIDS: Documentation by In Vitro Susceptibility Testing and DNA Subtype Analysis. Clin Infect Dis. 1994;18(2):240–42. - PubMed
    1. Gupta P, Khare V, Kumar D, Ahmad A, Banerjee G, Singh M. Comparative Evaluation of Disc Diffusion and E-test with Broth Micro-dilution in Susceptibility testing of Amphotericin B, Voriconazole and Caspofungin against Clinical Aspergillus isolates. Journal of Clinical and Diagnostic Research:JCDR. 2015;9(1):DC04–DC07. doi:10.7860/JCDR/2015/10467.5395. - PMC - PubMed

LinkOut - more resources