title: Well diffusion for antifungal susceptibility testing.
abstract: BACKGROUND
  The increasing clinical and microbiologic resistance of Candida spp. isolates to several antifungal agents is becoming a serious problem. It is now reasonable to propose the use of antifungal susceptibility testing in Candida spp. isolates from patients who have failed conventional therapy, before the selection of an empirical therapy.
  
  
  METHODS
  One hundred and fifty eight isolates of Candida spp. were evaluated simultaneously by broth microdilution (NCCLS standard) and well diffusion testing (WD), a diffusion method similar to disc diffusion.
  
  
  RESULTS
  According to the Wilcoxon Signed Ranks test performed, there was no significant difference (p>0.05) between both methodologies for all antifungal agents tested (fluconazole, itraconazole, posaconazole, caspofungin and amphotericin B, with C. tropicalis, C. krusei, C. dubliniensis, C. guillermondii, C. parapsilosis, C. albicans and C. glabrata). A significant difference was observed when comparing well diffusion with NCCLS for fluconazole WD 80% (p=0.008) in C. glabrata, as well as WD 80% (p=0.002) and WD 50% (p=0.002) in C. albicans.
  
  
  CONCLUSIONS
  The well diffusion test is simple, easy to reproduce, inexpensive, easy both to read and interpret, and has a good correlation to the reference NCCLS microdilution test and may represent an alternative method for antifungal drug susceptibility testing of Candida spp., mainly in laboratories with few resources.
authors.affiliation: Instituto de Medicina Tropical, Universidad Central de Venezuela, Caracas, Venezuela.
authors.forename: S
authors.initials: S
authors.lastname: Magaldi
authors.forename: S
authors.initials: S
authors.lastname: Mata-Essayag
authors.forename: C
authors.initials: C
authors.lastname: Hartung de Capriles
authors.forename: C
authors.initials: C
authors.lastname: Perez
authors.forename: M T
authors.initials: MT
authors.lastname: Colella
authors.forename: Carolina
authors.initials: C
authors.lastname: Olaizola
authors.forename: Yudith
authors.initials: Y
authors.lastname: Ontiveros
mesh_terms: D000935:Antifungal Agents / Q000494:pharmacology*; D002175:Candida / Q000187:drug effects* / Q000302:isolation & purification; D002177:Candidiasis / Q000382:microbiology; D006801:Humans; D008826:Microbial Sensitivity Tests / Q000379:methods*
chemical_list: D000935:Antifungal Agents