1887

Abstract

species are responsible for many opportunistic fungal infections. Fluconazole is a well-tolerated antifungal drug, commonly used in the treatment of candidiasis. However, with fluconazole resistance ever increasing, rapid detection and antifungal susceptibility testing of is imperative for proper patient treatment. This paper reports a cost-effective, simple and rapid chromogenic agar dilution method for simultaneous species identification and fluconazole susceptibility testing. The results obtained by X-Plate Technology were in absolute concordance with standard microbroth dilution assays. Analysis of 1383 clinical patient samples with suspected vulvovaginal candidiasis revealed that this technology was able to detect and speciate the isolate and determine the fluconazole susceptibility. The prevalence and susceptibility profiles of the clinical isolates using this method were highly similar to published reports using the microbroth dilution method.

Loading

Article metrics loading...

/content/journal/jmm/10.1099/jmm.0.054445-0
2013-05-01
2019-10-15
Loading full text...

Full text loading...

/deliver/fulltext/jmm/62/5/720.html?itemId=/content/journal/jmm/10.1099/jmm.0.054445-0&mimeType=html&fmt=ahah

References

  1. Alexander B. D., Byrne T. C., Smith K. L., Hanson K. E., Anstrom K. J., Perfect J. R., Reller L. B.. ( 2007;). Comparative evaluation of Etest and Sensititre 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 45:, 698–706. [CrossRef][PubMed]
    [Google Scholar]
  2. Arthington-Skaggs B. A., Lee-Yang W., Ciblak M. A., Frade J. P., Brandt M. E., Hajjeh R. A., Harrison L. H., Sofair A. N., Warnock D. W..Candidemia Active Surveillance Group ( 2002;). Comparison of visual and spectrophotometric methods of broth microdilution MIC end point determination and evaluation of a sterol quantitation method for in vitro susceptibility testing of fluconazole and itraconazole against trailing and nontrailing Candida isolates. . Antimicrob Agents Chemother 46:, 2477–2481. [CrossRef][PubMed]
    [Google Scholar]
  3. Bader M. S., Lai S. M., Kumar V., Hinthorn D.. ( 2004;). Candidemia in patients with diabetes mellitus: epidemiology and predictors of mortality. . Scand J Infect Dis 36:, 860–864. [CrossRef][PubMed]
    [Google Scholar]
  4. CLSI (2008). Reference Method for Broth Dilution Antifungal Susceptibility Testing of Yeasts. Approved Standard, 3rd edn. CLSI document M27-A3. Villanova, PA: Clinical and Laboratory Standards Institute.
  5. Dan M., Segal R., Marder V., Leibovitz A.. ( 2006;). Candida colonization of the vagina in elderly residents of a long-term-care hospital. . Eur J Clin Microbiol Infect Dis 25:, 394–396. [CrossRef][PubMed]
    [Google Scholar]
  6. de Vasconcelos A. A. Jr, Menezes E. A., Cunha F. A.. ( 2011;). Chromogenic medium for direct susceptibility testing of Candida spp. isolated from urine. . Mycopathologia 172:, 125–130. [CrossRef][PubMed]
    [Google Scholar]
  7. Goswami D., Goswami R., Banerjee U., Dadhwal V., Miglani S., Lattif A. A., Kochupillai N.. ( 2006;). Pattern of Candida species isolated from patients with diabetes mellitus and vulvovaginal candidiasis and their response to single dose oral fluconazole therapy. . J Infect 52:, 111–117. [CrossRef][PubMed]
    [Google Scholar]
  8. Gygax S. E., Vermitsky J. P., Chadwick S. G., Self M. J., Zimmerman J. A., Mordechai E., Adelson M. E., Trama J. P.. ( 2008;). Antifungal resistance of Candida glabrata vaginal isolates and development of a quantitative reverse transcription-PCR-based azole susceptibility assay. . Antimicrob Agents Chemother 52:, 3424–3426. [CrossRef][PubMed]
    [Google Scholar]
  9. Kirkpatrick W. R., Zimmerman J. D., Haikal F. P., Broker M. J., Brockway E., Fothergill A. W., McCarthy D. I., Patterson T. F., Redding S. W.. ( 2010;). Screening for drug-resistant Candida yeasts with chromogenic agar. . Med Mycol 48:, 807–816. [CrossRef][PubMed]
    [Google Scholar]
  10. Koehler A. P., Chu K. C., Houang E. T. S., Cheng A. F. B.. ( 1999;). Simple, reliable, and cost-effective yeast identification scheme for the clinical laboratory. . J Clin Microbiol 37:, 422–426.[PubMed]
    [Google Scholar]
  11. Linares M. J., Charriel G., Solís F., Casal M.. ( 2003;). [CHROMAgar Candida with fluconazole: comparison with microdilution techniques]. . Enferm Infecc Microbiol Clin 21:, 493–497 (in Spanish). [CrossRef][PubMed]
    [Google Scholar]
  12. Nelson S. M., Cartwright C. P.. ( 2003;). Detection of fluconazole-resistant isolates of Candida glabrata by using an agar screen assay. . J Clin Microbiol 41:, 2141–2143. [CrossRef][PubMed]
    [Google Scholar]
  13. Ostrosky-Zeichner L., Rex J. H., Pappas P. G., Hamill R. J., Larsen R. A., Horowitz H. W., Powderly W. G., Hyslop N., Kauffman C. A. et al. ( 2003;). Antifungal susceptibility survey of 2,000 bloodstream Candida isolates in the United States. . Antimicrob Agents Chemother 47:, 3149–3154. [CrossRef][PubMed]
    [Google Scholar]
  14. Patterson T. F., Revankar S. G., Kirkpatrick W. R., Dib O., Fothergill A. W., Redding S. W., Sutton D. A., Rinaldi M. G.. ( 1996a;). Simple method for detecting fluconazole-resistant yeasts with chromogenic agar. . J Clin Microbiol 34:, 1794–1797.[PubMed]
    [Google Scholar]
  15. Patterson T. F., Kirkpatrick W. R., Revankar S. G., McAtee R. K., Fothergill A. W., McCarthy D. I., Rinaldi M. G.. ( 1996b;). Comparative evaluation of macrodilution and chromogenic agar screening for determining fluconazole susceptibility of Candida albicans. . J Clin Microbiol 34:, 3237–3239.[PubMed]
    [Google Scholar]
  16. Pfaller M. A., Houston A., Coffmann S.. ( 1996;). Application of CHROMagar Candida for rapid screening of clinical specimens for Candida albicans, Candida tropicalis, Candida krusei, and Candida (Torulopsis) glabrata. . J Clin Microbiol 34:, 58–61.[PubMed]
    [Google Scholar]
  17. Pfaller M. A., Messer S. A., Karlsson A., Bolmström A.. ( 1998;). Evaluation of the Etest method for determining fluconazole susceptibilities of 402 clinical yeast isolates by using three different agar media. . J Clin Microbiol 36:, 2586–2589.[PubMed]
    [Google Scholar]
  18. Pfaller M. A., Diekema D. J., Gibbs D. L., Newell V. A., Ellis D., Tullio V., Rodloff A., Fu W., Ling T. A..the Global Antifungal Surveillance Group ( 2010a;). Results from the ARTEMIS DISK Global Antifungal Surveillance Study, 1997 to 2007: a 10.5-year analysis of susceptibilities of Candida species to fluconazole and voriconazole as determined by CLSI standardized disk diffusion. . J Clin Microbiol 48:, 1366–1377. [CrossRef][PubMed]
    [Google Scholar]
  19. Pfaller M. A., Andes D., Diekema D. J., Espinel-Ingroff A., Sheehan D..CLSI Subcommittee for Antifungal Susceptibility Testing ( 2010b;). Wild-type MIC distributions, epidemiological cutoff values and species-specific clinical breakpoints for fluconazole and Candida: time for harmonization of CLSI and EUCAST broth microdilution methods. . Drug Resist Updat 13:, 180–195. [CrossRef][PubMed]
    [Google Scholar]
  20. Ray D., Goswami R., Banerjee U., Dadhwal V., Goswami D., Mandal P., Sreenivas V., Kochupillai N.. ( 2007;). Prevalence of Candida glabrata and its response to boric acid vaginal suppositories in comparison with oral fluconazole in patients with diabetes and vulvovaginal candidiasis. . Diabetes Care 30:, 312–317. [CrossRef][PubMed]
    [Google Scholar]
  21. Richter S. S., Galask R. P., Messer S. A., Hollis R. J., Diekema D. J., Pfaller M. A.. ( 2005;). Antifungal susceptibilities of Candida species causing vulvovaginitis and epidemiology of recurrent cases. . J Clin Microbiol 43:, 2155–2162. [CrossRef][PubMed]
    [Google Scholar]
  22. Tan G. L., Peterson E. M.. ( 2005;). CHROMagar Candida medium for direct susceptibility testing of yeast from blood cultures. . J Clin Microbiol 43:, 1727–1731. [CrossRef][PubMed]
    [Google Scholar]
  23. Trama J. P., Mordechai E., Adelson M. E.. ( 2005;). Detection and identification of Candida species associated with Candida vaginitis by real-time PCR and pyrosequencing. . Mol Cell Probes 19:, 145–152. [CrossRef][PubMed]
    [Google Scholar]
  24. Vermitsky J. P., Earhart K. D., Smith W. L., Homayouni R., Edlind T. D., Rogers P. D.. ( 2006;). Pdr1 regulates multidrug resistance in Candida glabrata: gene disruption and genome-wide expression studies. . Mol Microbiol 61:, 704–722. [CrossRef][PubMed]
    [Google Scholar]
  25. Vermitsky J. P., Self M. J., Chadwick S. G., Trama J. P., Adelson M. E., Mordechai E., Gygax S. E.. ( 2008;). Survey of vaginal-flora Candida species isolates from women of different age groups by use of species-specific PCR detection. . J Clin Microbiol 46:, 1501–1503. [CrossRef][PubMed]
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journal/jmm/10.1099/jmm.0.054445-0
Loading
/content/journal/jmm/10.1099/jmm.0.054445-0
Loading

Data & Media loading...

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error