Skip to main content

Advertisement

SpringerLink
Log in

Comparison of Commercial Methods and the CLSI Broth Microdilution to Determine the Antifungal Susceptibility of Candida parapsilosis Complex Bloodstream Isolates from Three Health Institutions in Rio de Janeiro, Brazil

  • Published:
Mycopathologia Aims and scope Submit manuscript

Abstract

Two commercial methods, the Etest and Vitek 2, were compared with the Clinical and Laboratory Standards Institute broth microdilution method to determine the susceptibility of Candida parapsilosis complex to amphotericin B, caspofungin, fluconazole, voriconazole, and itraconazole. One-hundred bloodstream isolates of C. parapsilosis complex from three hospitals in Rio de Janeiro city, Brazil, between 1998 and 2006 were analyzed. C. parapsilosis sensu stricto (61 %) was the predominant species, followed by C. orthopsilosis (37 %) and C. metapsilosis (2 %). Most isolates were susceptible to the tested drugs. However, one C. parapsilosis sensu stricto isolate was considered resistant for amphotericin B. The essential agreement was 100 % between the methods, except for itraconazole (96.3 %). The categorical agreement varied for fluconazole and itraconazole by Etest and for amphotericin B and fluconazole by Vitek 2. This study reinforces the suitability of the commercial methods in routine clinical microbiology laboratories for antifungal susceptibility testing.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Lockhart SR, Messer SA, Pfaller MA, Diekema DJ. Geographic distribution and antifungal susceptibility of the newly described species Candida orthopsilosis and Candida metapsilosis in comparison to the closely related species Candida parapsilosis. J Clin Microbiol. 2008;46:2659–64.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  2. Dizbay M, Findan I, Kalkanci A, Sari N, Yalcin B, Kustimur S, Arman D. High incidence of Candida parapsilosis candidaemia in non-neutropenic critically ill patients: epidemiology and antifungal susceptibility. Scand J Infect Dis. 2010;42(2):114–20.

    Article  CAS  PubMed  Google Scholar 

  3. Cantón E, Pemán J, Quindós G, Eraso E, Miranda-Zapico I, Álvarez M, Merino P, Campos-Herrero I, Marco F, de la Pedrosa EG, et al. Prospective multicenter study of the epidemiology, molecular identification, and antifungal susceptibility of Candida parapsilosis, Candida orthopsilosis, and Candida metapsilosis isolated from patients with candidemia. Antimicrob Agents Chemother. 2011;55:5590–6.

    Article  PubMed Central  PubMed  Google Scholar 

  4. Bonfietti LX, Martins Mdos A, Szeszs MW, Pukiskas SB, Purisco SU, Pimentel FC, Pereira GH, Silva DC, Oliveira L, Melhem Mde S. Prevalence, distribution and antifungal susceptibility profiles of Candida parapsilosis, Candida orthopsilosis and Candida metapsilosis bloodstream isolates. J Med Microbiol. 2012;6:1003–8.

    Article  Google Scholar 

  5. Nucci M, Queiroz-Telles F, Alvarado-Matute T, Tiraboschi IN, Cortes J, Zurita J, Guzman-Blanco M, Santolaya ME, Thompson L, Sifuentes-Osornio J, et al. Epidemiology of candidemia in Latin America: a laboratory-based survey. PLoS ONE. 2013;8:e59373.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  6. Tavanti A, Davison AD, Grow NAR, Maiden MCJ, Odds FC. Candida orthopsilosis and Candida metapsilosis spp. nov. to replace Candida parapsilosis groups II and III. J Clin Microbiol. 2005;43:284–92.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  7. Clinical and Laboratory Standards Institute (CLSI). Reference method for broth dilution antifungal susceptibility testing of yeasts. Approved standard, 3rd edn. CLSI document M-27A3. Wayne, PA: CLSI; 2008.

    Google Scholar 

  8. Pfaller MA, Castanheira M, Diekema DJ, Messer SA, Jones RN. Triazole and echinocandin MIC distributions with epidemiological cutoff values for differentiation of wild-type strains from non-wild-type strains of six uncommon species of Candida. J Clin Microbiol. 2011;49:3800–4.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  9. Pfaller MA, Diekema DJ. Progress in antifungal susceptibility testing of Candida spp. by use of Clinical and Laboratory Standards Institute broth microdilution methods, 2010 to 2012. J Clin Microbiol. 2010;2012(50):2846–56.

    Google Scholar 

  10. Alexander BD, Byrne TC, Smith KL, Kimberly EH, Keven JA, Perfect JR. Comparative evaluation of Etest and Sensitive YeastOne panels against the Clinical and Laboratory Standards Institute M27-A2 reference broth microdilution method for testing Candida susceptibility to seven antifungal agents. J Clin Microbiol. 2007;45:698–706.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  11. Pfaller MA, Chaturvedi V, Diekema DJ, Ghannoum MA, Holliday NM, Killian SB, Knapp CC, Messer AS, Miskou A, Ramani R. Comparison of the Sensititre YeastOne colorimetric antifungal panel with CLSI microdilution for antifungal susceptibility testing of the echinocandins against Candida spp., using new clinical breakpoints and epidemiological cutoff values. Diag Microbiol Infect Dis. 2012;73:365–8.

    Article  CAS  Google Scholar 

  12. Pfaller MA, Diekema DJ, Procop GW, Rinaldi MG. Comparison of the Vitek 2 yeast susceptibility system with CLSI microdilution for antifungal susceptibility testing of fluconazole and voriconazole against Candida spp., using new clinical breakpoints and epidemiological cutoff values. Diag Microbiol Infect Dis. 2013;77:37–40.

    Article  CAS  Google Scholar 

  13. Asadzadeh M, Ahmad S, Al-Sweih N, Han ZU. Rapid molecular differentiation and genotypic heterogeneity among Candida parapsilosis and Candida orthopsilosis strains isolates from clinical specimens in Kwait. J Med Microbiol. 2009;58:745–52.

    Article  CAS  PubMed  Google Scholar 

  14. Otto TD, Vasconcellos EA, Gomes LHF, Moreira AS, Degrave WM, Mendonça-Lima L, Alves-Ferreira M. ChromaPipe: a pipeline for analysis, quality control and management for a DNA sequencing facility. Genet Mol Res. 2008;7:861–71.

    Article  CAS  PubMed  Google Scholar 

  15. Pfaller MA, Espinel-Ingroff A, Canton E, Castanheira M, Cuenca-Estrella M, Diekema DJ, Fothergill A, Fuller J, Ghannoum M, Jones RN, et al. Wilde-type MIC distributions and epidemiological cutoff values for amphotericin B, flucytosine, and itraconazole and Candida spp. as determined by CLSI broth microdilution. J Clin Microbiol. 2012;50:2040–6.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  16. Bourgeois N, Dehandschoewercker L, Bertout S, Bousquet PJ, Rispail P, Lachaud L. Antifungal susceptibility of 205 Candida spp. isolated primarily during invasive candidiasis and comparison of the Vitek 2 system with the CLSI broth microdilution and Etest methods. J Clin Microbiol. 2010;48:154–61.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  17. Gonçalves SS, Amorim CS, Nucci M, Padovan AC, Briones MR, Melo AS, Colombo AL. Prevalence rates and antifungal susceptibility profiles of the Candida parapsilosis species complex: results from a nationwide surveillance of candidemia in Brazil. Mycology. 2010;16:885–7.

    Google Scholar 

  18. Borghi E, Sciota R, Iatta R, Biassoni C, Montagna MT, Morace G. Characterization of Candida parapsilosis complex strains isolated from invasive fungal infections. Eur J Clin Microbiol Infect Dis. 2011;30:1437–41.

    Article  CAS  PubMed  Google Scholar 

  19. Garcia-Effron G, Canton E, Pemán J, Dilger A, Romá E, Perlin DS. Epidemiology and echinocandin susceptibility of Candida parapsilosis sensu lato species isolated from bloodstream infections at a Spanish university hospital. J Antimicrob Chemother. 2012;67:2739–48.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  20. Zancopé-Oliveira RM, James MJ, Derossi AP, Sampaio JLM, Muniz MM, Li RK, Nascimento AS, Peralta JM, Reiss E. Strain characterization of Candida parapsilosis fungemia by molecular typing methods. Eur J Clin Microbiol Infect Dis. 2000;19:514–20.

    Article  PubMed  Google Scholar 

  21. Gomez-Lopez A, Alastruey-Izquierdo A, Rodriguez D, Almirante B, Pahissa A. Rodriguez-Tudela JL, Cuenca-Estrella M, Barcelona Candidemia Project Study Group. Prevalence and susceptibility profile of Candida metapsilosis and Candida orthopsilosis results from population-based surveillance of candidemia in Spain. Antimicrob Agents Chemother. 2008;52:1506–9.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  22. Borman AM, Linton CJ, Miles S-J, Johnson EM. Molecular identification of pathogenic fungi. J Antimicrob Chemother. 2008;61(Suppl 1):i7–12.

    Article  CAS  PubMed  Google Scholar 

  23. Diekema DJ, Messer SA, Boyken LB, Hollis RJ, Kroeger J, Tendolkar S, Pfaller MA. In vitro activity of seven systemically active antifungal agents against a large global collection of rare Candida species as determined by CLSI broth microdilution methods. J Clin Microbiol. 2009;47:3170–7.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  24. Chen YC, Lin YH, Chen KW, Lii J, Teng HJ, Li SY. Molecular epidemiology and antifungal susceptibility of Candida parapsilosis sensu stricto, Candida orthopsilosis and Candida metapsilosis in Taiwan. Diag Microbiol Infect Dis. 2010;68:284–92.

    Article  CAS  Google Scholar 

  25. Cuenca-Estrella M, Gomez-Lopez A, Alastruey-Izquierdo A, Bernal-Martinez L, Cuesta I, Buitrago MJ, Rodriguez-Tudela JL. Comparison of the Vitek 2 antifungal susceptibility system with the Clinical and Laboratory Standards Institute (CLSI) and European Committee on antimicrobial susceptibility testing (EUCAST) broth microdilution reference methods and with the Sensititre YeastOne and Etest techniques for in vitro detection of antifungal resistance in yeast isolates. J Clin Microbiol. 2010;48:1782–6.

    Article  PubMed Central  PubMed  Google Scholar 

  26. Silva AP, Miranda IM, Lisboa C, Pina-Vaz C, Rodriguez AG. Prevalence, distribution, and antifungal susceptibility profiles of Candida parapsilosis, C. orthopsilosis, and C. metapsilosis in a tertiary care hospital. J Clin Microbiol. 2009;47:2392–7.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  27. Purisco SU, Martins MA, Szeszs MW, Castro e Silva DM, Pukinkas SR, Bonfietti LX, et al. Comparison of the broth microdilution (BMD) method of the European Committee on Antimicrobial Susceptibility Testing and the Clinical and Laboratory Standards Institute BMD method for non-Candida albicans and non-C. tropicalis bloodstream isolates from eleven tertiary hospitals in São Paulo state, Brazil. FEMS Yeast Res 2012; 1–7.

  28. da Silva Ruiz L, Khouri S, Hahn RC, da Silva EG, de Oliveira VK, Gandra RF, Paula CR. Candidemia by species of the Candida parapsilosis complex in children’s hospital: prevalence, biofilm production and antifungal susceptibility. Mycopathologia. 2013;175:231–9.

    Article  Google Scholar 

  29. Miranda-Zapico I, Eraso E, Hernández-Almaraz JL, López-Soria LM, Carrillo-Muñoz AJ, Hernández-Molina JM, Quindós G. Prevalence and antifungal susceptibility patterns of new cryptic species complexes Candida parapsilosis and Candida glabrata among blood isolates from a Spanish tertiary hospital. J Antimicrob Chemother. 2011;66:2315–22.

    Article  CAS  PubMed  Google Scholar 

  30. Pfaller MA, Diekema DJ, Procop GW, Rinaldi MG. Multicenter comparison of the Vitek 2 antifungal susceptibility test with the CLSI broth microdilution reference for testing amphotericin B, flucytosine and voriconazole against Candida spp. J Clin Microbiol. 2007;45:3522–8.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

Download references

Acknowledgments

We thank Dr. Errol Reiss for his editorial assistance and Dr. Mauro M. Muniz for his comments and suggestions. Automated sequencing was performed using the genomic platform/DNA sequencing at Fundação Oswaldo Cruz—PDTIS/Fiocruz (RPT01A), Brazil. R.M.Z-O. is supported in part by CNPq Proc. 302739/2009-2.

Conflict of interest

None.

Author information

Authors and Affiliations

  1. Laboratório de Micologia, Instituto de Pesquisa Clínica Evandro Chagas, Fundação Oswaldo Cruz, Avenida Brasil, 4365, Manguinhos, Rio de Janeiro, RJ, 21045-900, Brazil

    Maria Helena G. Figueiredo-Carvalho, Leonardo S. Barbedo, Manoel M. E. Oliveira, Fábio Brito-Santos, Rodrigo Almeida-Paes & Rosely M. Zancopé-Oliveira

Authors
  1. Maria Helena G. Figueiredo-Carvalho
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Leonardo S. Barbedo
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Manoel M. E. Oliveira
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Fábio Brito-Santos
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Rodrigo Almeida-Paes
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Rosely M. Zancopé-Oliveira
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Rosely M. Zancopé-Oliveira.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Figueiredo-Carvalho, M.H.G., Barbedo, L.S., Oliveira, M.M.E. et al. Comparison of Commercial Methods and the CLSI Broth Microdilution to Determine the Antifungal Susceptibility of Candida parapsilosis Complex Bloodstream Isolates from Three Health Institutions in Rio de Janeiro, Brazil. Mycopathologia 178, 27–35 (2014). https://doi.org/10.1007/s11046-014-9771-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11046-014-9771-3

Keywords

Search

Navigation