Abstract
Two colorimetric broth microdilution antifungal susceptibility tests were compared, Sensititre YeastOne and MICRONAUT-AM for nine antifungal agents. One hundred clinical Candida isolates were tested, representing a realistic population for susceptibility testing in daily practice. The reproducibility characteristics were comparable. Only for fluconazole, caspofungin, 5-flucytosine and amphotericin B, an essential agreement of ≥90% could be demonstrated. Sensititre minimal inhibitory concentrations (MICs) were systematically higher than MICRONAUT MICs for all antifungals, except for itraconazole. CLSI clinical breakpoints (CBPs) and epidemiological cut-off values (ECVs) were used for Sensititre MICs while for MICRONAUT the EUCAST CBPs and ECVs were used. Only fluconazole, micafungin, and amphotericin B had a categorical agreement of ≥90%. For fluconazole, micafungin, and amphotericin B the susceptibility proportions were comparable. Susceptibility proportion of posaconazole and voriconazole was higher using the MICRONAUT system. For itraconazole and anidulafungin, the susceptibility proportion was higher using Sensititre. It was not possible to determine the true MIC values or the correctness of a S/I/R result since both commercial systems were validated against a different reference method. These findings show that there is a significant variability in susceptibility pattern and consequently on use of antifungals in daily practice, depending on the choice of commercial system.
Highlights
IntroductionThe increased use of antifungal prophylaxis and empirical treatment in high-risk populations for candidiasis gave rise to fungal organisms with decreased susceptibility or resistance and in some cases, cross-resistance exists between antifungal agents [7,8]
Resistance usually involves the transfer of mobile genetic elements between strains or species, while Candida yeasts have a high genomic plasticity and resistance is usually based on genetic alterations
The objective of this study was to compare Sensititre YeastOne, which is further indicated in the text as “SY”, with MICRONAUT-AM, which is further indicated in the text as “M-AM”
Summary
The increased use of antifungal prophylaxis and empirical treatment in high-risk populations for candidiasis gave rise to fungal organisms with decreased susceptibility or resistance and in some cases, cross-resistance exists between antifungal agents [7,8]. Because of these increasing numbers of multi-drug resistant organisms, a reliable, reproducible, and clinically relevant antifungal susceptibility test (AFST) is crucial to guide antifungal therapy [7,9,10]. The Sensititre YeastOne (Thermo Fisher Scientific, Waltham, MA, USA) and the MICRONAUT-AM
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