Abstract
When Candida albicans and Candida dubliniensis isolates were tested for susceptibility to fluconazole and echinocandins using either EUCAST or Etest methods, differential patterns of growth were observed, independently of the methods used. For C. albicans, a trailing phenomenon (incomplete growth inhibition at supra-MICs) was observed with fluconazole in 90% and 93.3% for EUCAST and Etest, respectively, but not with echinocandins (<7% for EUCAST and 0% for Etest). In contrast, for C. dubliniensis, a trailing phenomenon was very rarely observed with fluconazole (20% for EUCAST and 0% for Etest), while the opposite pattern was observed with echinocandins (>50% for EUCAST and >86% for Etest). This suggests that the pathways involved in the trailing effect might be different between these two related species. Furthermore, clinical microbiologists must be aware of these species-specific patterns for a reliable MIC determination.
Highlights
Candida dubliniensis is a commensal of the oral cavity but can colonize other anatomical sites (Loreto et al, 2010)
A trailing effect was observed with Etest for 93.3% of C. albicans isolates while no trailing was seen with the two echinocandins (Table 2 and Figure 1)
In order to confirm that the differential pattern of growth was not related to the susceptibility testing method used, all the strains were tested by EUCAST
Summary
Candida dubliniensis is a commensal of the oral cavity but can colonize other anatomical sites (Loreto et al, 2010). It can cause oropharyngeal candidiasis, mainly in HIV-positive patients (Sullivan et al, 2005; Loreto et al, 2010), and invasive candidiasis (Pfaller et al, 2014a). C. albicans and C. dubliniensis share the same in vitro antifungal susceptibility patterns (Pfaller et al, 1999; Lortholary et al, 2007). Identification of C. dubliniensis was difficult in the clinical laboratories because it shares C. albicans phenotypic characteristics (Sullivan et al, 2005; Loreto et al., 2010). Things changed with the use of Matrix-Assisted Laser Desorption Ionization–Time of Frontiers in Microbiology | www.frontiersin.org http://www.eucast.org/astoffungi/clinicalbreakpointsforantifungals/
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