title: Comparison of Etests and Vitek 2 ® to broth microdilution for the susceptibility testing of Cryptococcus neoformans.
abstract: We determined the susceptibility of 102 clinical isolates Cryptococcus neoformans from Durban, South Africa, to amphotericin B, fluconazole, flucytosine, and voriconazole using broth microdilution (BMD) according to the Clinical and Laboratory Standards Institute M27-A3 document and compared these results with Etest and Vitek 2(®). Essential agreement (EA) of Etest and Vitek 2(®) compared to BMD was determined. Low MICs that were below the epidemiological cutoff values of the 4 antifungal agents tested were demonstrated by all isolates. The EA of Etests for fluconazole, amphotericin, and voriconazole was 95.1%, 83.3%, and 91.2%, respectively, and for Vitek 2(®) EA for fluconazole, amphotericin, and flucytosine was 97.1%, 95.1%, and 97.1%, respectively. The Vitek 2(®) showed good agreement with BMD and is a suitable alternative. Etests demonstrated good EA for azoles only. Clinical cryptococcal isolates from Durban remain susceptible to current recommended antifungal therapy.
authors.affiliation: Department of Medical Microbiology, National Health Laboratory Services, Durban, South Africa; School of Laboratory Medicine and Medical Sciences, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa. Electronic address: mahab@ukzn.ac.za.
authors.forename: Yesholata
authors.initials: Y
authors.lastname: Mahabeer
authors.affiliation: Department of Infectious Diseases, Alfred Hospital, Monash University, Melbourne, Australia; Centre of Biomedical Research, Burnet Institute, Melbourne, Australia; HIV Pathogenesis Programme, University of KwaZulu-Natal, Durban, South Africa.
authors.forename: Christina C
authors.initials: CC
authors.lastname: Chang
authors.affiliation: Department of Medical Microbiology, National Health Laboratory Services, Durban, South Africa.
authors.forename: Dianithi
authors.initials: D
authors.lastname: Naidu
authors.affiliation: KwaZulu-Natal Research Institute for Tuberculosis and HIV, Durban, South Africa.
authors.forename: Afton
authors.initials: A
authors.lastname: Dorasamy
authors.affiliation: Department of Infectious Diseases, Alfred Hospital, Monash University, Melbourne, Australia; Centre of Biomedical Research, Burnet Institute, Melbourne, Australia.
authors.forename: Sharon
authors.initials: S
authors.lastname: Lewin
authors.affiliation: School of Laboratory Medicine and Medical Sciences, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa; HIV Pathogenesis Programme, University of KwaZulu-Natal, Durban, South Africa; KwaZulu-Natal Research Institute for Tuberculosis and HIV, Durban, South Africa.
authors.forename: Thumbi
authors.initials: T
authors.lastname: Ndung'u
authors.affiliation: Department of Infectious Diseases, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa.
authors.forename: Mohammed-Yunus
authors.initials: MY
authors.lastname: Moosa
authors.affiliation: School of Pathology and Laboratory Medicine, University of Western Australia, Perth, Australia; Department of Clinical Immunology, Royal Perth Hospital and PathWest Laboratory Medicine, Perth, Australia.
authors.forename: Martyn
authors.initials: M
authors.lastname: French
authors.affiliation: Department of Medical Microbiology, National Health Laboratory Services, Durban, South Africa; School of Laboratory Medicine and Medical Sciences, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa.
authors.forename: Koleka
authors.initials: K
authors.lastname: Mlisana
authors.affiliation: Department of Medical Microbiology, National Health Laboratory Services, Durban, South Africa; School of Laboratory Medicine and Medical Sciences, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa.
authors.forename: Yacoob
authors.initials: Y
authors.lastname: Coovadia
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000382:microbiology; D000666:Amphotericin B / Q000494:pharmacology; D000935:Antifungal Agents / Q000494:pharmacology*; D003453:Cryptococcosis / Q000382:microbiology* / Q000821:virology; D003455:Cryptococcus neoformans / Q000187:drug effects* / Q000302:isolation & purification; D052978:Disk Diffusion Antimicrobial Tests / Q000379:methods*; D015725:Fluconazole / Q000494:pharmacology; D005437:Flucytosine / Q000494:pharmacology; D006801:Humans; D013019:South Africa; D065819:Voriconazole / Q000494:pharmacology
chemical_list: D000935:Antifungal Agents; D000666:Amphotericin B; D015725:Fluconazole; D005437:Flucytosine; D065819:Voriconazole
keywords: Antifungal susceptibility tests; Broth microdilution; Cryptococcus neoformans; Etest; Vitek(®)