Abstract
E-test methodology was compared with Clinical and Laboratory Standards Institute (CLSI) broth microdilution, particularly concerning the detection of resistance to posaconazole among clinical fungal isolates. The susceptibility of a large set of fungal strains (n = 300) was evaluated following 24 and 48 h in two different culture media (RPMI 1640 and Sabouraud agar). Fungal strains were highly susceptible to posaconazole; however, few less susceptible strains were found, mostly regarding Candida albicans, Candida glabrata, Acremonium sp., Cladosporium sp. and Scedosporium apiospermum. Broth microdilution and E-test methods provided similar results for posaconazole-susceptible strains, while the less susceptible fungal strains (10.3% of the strains showed MIC ≥2 µg/mL) resulted in higher discrepancies between the two methodologies, particularly concerning Candida spp. E-test susceptibility values were critically affected by the pH of the culture media. Sabouraud medium provided similar susceptibility results for moulds to those for RPMI, soon after 24 h. Posaconazole resistance was rare in this study, but routine susceptibility methods, such as the E-test, should be able to detect fungal strains with reduced susceptibility. E-test methodology still needs improvements to recognise accurately strains less susceptible to posaconazole.
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Acknowledgements
The authors are grateful to Maria Luz Dias for the excellent technical assistance on susceptibility testing and to the two reviewers who made valuable suggestions that considerably improved the manuscript. RA, SCO and IC received grants from Fundação para Ciência e Tecnologia (FCT). IPATIMUP is partially supported by FCT, Programa Operacional Ciência e Inovação (POCI) and Programa Operacional do Potencial Humano (POPH – QREN).
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Araujo, R., Costa-de-Oliveira, S., Coutinho, I. et al. Evaluating the resistance to posaconazole by E-test and CLSI broth microdilution methodologies of Candida spp. and pathogenic moulds. Eur J Clin Microbiol Infect Dis 28, 1137–1140 (2009). https://doi.org/10.1007/s10096-009-0736-2
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DOI: https://doi.org/10.1007/s10096-009-0736-2