Evaluation of Etest Method for Determining Fluconazole and Voriconazole MICs for 279 Clinical Isolates of Candida Species Infrequently Isolated from Blood

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Abstract
The performance of Etest in fluconazole and voriconazole testing of 279 isolates of uncommon Candida spp. was assessed in comparison with the National Committee for Clinical Laboratory Standards (NCCLS)-approved standard broth microdilution (BMD) method. The NCCLS method employed RPMI 1640 broth medium, and MICs were read after incubation for 48 h at 35°C. Etest MICs were determined with RPMI agar containing 2% glucose and were read after incubation for 48 h at 35°C. The isolates include Candida krusei , C. lusitaniae , C. guilliermondii , C. kefyr , C. rugosa , C. lipolytica , C. pelliculosa , C. dubliniensis , C. famata , C. zeylanoides , C. inconspicua , and C. norvegensis . Overall agreement between Etest and BMD MICs was 96% for fluconazole and 95% for voriconazole. Where a discrepancy was observed between Etest and the reference method, the Etest tended to give lower values with both fluconazole and voriconazole. The Etest method using RPMI agar appears to be a useful method for determining fluconazole and voriconazole susceptibilities of uncommon species of Candida .

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