Annals of Clinical Microbiology, The official Journal of the Korean Society of Clinical Microbiology

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pISSN 2288-0585 eISSN 2288-6850

The Evaluation of Clinical Utility of ATB FUNGUS 2 for Antifungal Susceptibility Testing in Candida Species

Original article

Annals of Clinical Microbiology (Ann Clin Microbiol) 2004 December Volume 7, Issue 2, pages 156-163.


https://doi.org/10.5145/ACM.2004.07.2.156

The Evaluation of Clinical Utility of ATB FUNGUS 2 for Antifungal Susceptibility Testing in Candida Species

Hye Gyung Bae1, Yong-Hak Sohn1, Jong Hee Shin2, Mi-Na Kim1
Department of Laboratory Medicine1, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea; Department of Laboratory Medicine2, Chonnam National University Medical School, Gwanju, Korea

Abstract

Background : Although the National Committee for Clinical Laboratory Standards (NCCLS) defined a standard reference broth microdilution method for testing the susceptibility of Candida species to antifungal drugs, many clinical laboratories require easier but reliable alternatives for routine antifungal susceptibility testing. We evaluated ATB FUNGUS 2 (bioMerieux, France.; ATB) compared to the method recommended by the NCCLS (NCCLS).

Methods : A total of 28 strains of Candidaspecies consecutively isolated from blood and CSF cultures at Asan Medical Center from April to June 2004 were tested. In addition, 12 strains comprising C. krusei (3), C. glabrata (7) and C. guilliermondii (2) from the collection of Chonnam National University Hospital were included in the study. These strains were tested for minimum inhibitory concentrations (MICs) against flucytosine (FC), fluconazole (FZ), itraconazole (IZ) and amphotericin B (AB) by both of ATB and NCCLS. In NCCLS, MICs were read using a spectrophotometer after 24 and 48 hour-incubation.

Results : The concordance rates of MICs between ATB and NCCLS after 24 hour-incubation were 100%, 75%, 89% and 96% within two-fold dilution and 100%, 97%, 97%, 100% within four-fold dilution for FC, FZ, IZ and AB, respectively. For C. krusei, all three FC and FZ-resistant strains were either intermediate or SDD and one IZ-resistant strain was SDD in ATB, respectively. One C. tropicalis strain resulted in AB MICs of 0.5 μg/mL in NCCLS, but 2 μg/mL in ATB.

Conclusions : ATB showed good concordance rates with NCCLS after 24 hour-incubation. ATB appears to be a useful alternatives to NCCLS for routine antifungal susceptibility tests. However, ATB needs further evaluation with more clinical strains, especially those resistant to antifungal agents. (Korean J Clin Microbiol 2004;7(2):156-163)

Keywords

Antifungal susceptibility test, Candida species, ATB FUNGUS 2, NCCLS broth microdilution method