Comparison of three methods for in vitro susceptibility testing of Candida species with XXXX .

@entity9841 @entity7408 @entity4895 @entity7409 @entity5132 @entity19323
Optimal methods for susceptibility testing of Candida spp. with @entity4895 have not been determined. Breakpoints were recommended in 1984, but never validated. In this study, we compared the 1984 recommended macrodilution broth method (using an 80% endpoint) with a modification of the more recent NCCLS-recommended microdilution broth method with three endpoints-spectrophotometric 50% and 80% and a no growth endpoint determined by eye. NCCLS and British Society for Medical Mycology (BSMM) breakpoints were also compared. One hundred and fifty isolates comprised of @entity5132 , @entity9841 , Candida krusei, @entity7408 , @entity7409 and @entity19323 were tested. Reproducibility was excellent. For @entity5132 (n = 65), the correlation between tests was excellent (>75%), with few major discrepancies (<5%). For @entity9841 (n = 27), correlation was good (59%), but there were a small number of major discrepancies (up to 11%, depending on breakpoint used). Results by the broth macrodilution method were generally higher than both microdilution methods for @entity7408 (n = 16; correlation of 18.8%), but only one major discrepancy was seen. Ten of the 11 @entity7409 isolates tested were susceptible by all methods, regardless of breakpoint chosen, with a correlation of 18.2%, but no major discrepancies were seen. A correlation between all methods (50%) was seen with @entity19323 (n = 10), with many isolates resistant or intermediate. In contrast, correlation between methods for C. krusei was poor (<5%); NCCLS microtitre modification produced results that were classified as intermediate or resistant, regardless of the breakpoint used. The methodology for susceptibility testing @entity5132 is robust. Additional work to optimize susceptibility testing with @entity4895 is necessary for non-albicans Candida species, especially C. krusei.
