title: Invitro antifungal susceptibilities of Candida species to liposomal amphotericin B, determined using CLSI broth microdilution, and amphotericin B deoxycholate, measured using the Etest.
abstract: The antifungal susceptibilities of 598 isolates of Candida spp. (bloodstream and other sterile sites) to liposomal amphotericin B (L-AmB) versus amphotericin B (AmB) were determined. MICs were calculated using the Clinical and Laboratory Standards Institute broth microdilution (M27-A3) method for L-AmB and the Etest method for AmB. The MIC50/MIC90 (µg ml-1) values for L-AmB broth microdilution and AmB Etest were 0.25/1 and 0.19/0.5, respectively. The overall essential agreement (±2 dilutions) was 91.5 %, ranging from 37.5 % (Candida lusitaniae) to 100 % (Candida glabrata and Candida krusei). Categorical agreement between the two methods was categorized based on a previously published breakpoint (susceptible/resistant MIC cut-off of 1 µg ml-1). The overall categorical agreement at the 48 h reading was 97.3 %, ranging from 72.7 % (C. krusei) to 100 % (Candida albicans). Major and very major discrepancies occurred in 2.3 and 0.3 %, respectively. Spearman's ρ was 0.48 (P<0.0001). These results demonstrate the utility of the AmB Etest as a surrogate marker to predict the sensibility and resistance of Candida spp. to L-AmB and thus to support its use in antifungal treatment.
authors.affiliation: Department of Biomedical Science and Human Oncology, Hygiene Section, Università degli Studi of Bari 'Aldo Moro', Bari, Italy.
authors.forename: Grazia
authors.initials: G
authors.lastname: Lovero
authors.affiliation: Department of Biomedical Science and Human Oncology, Hygiene Section, Università degli Studi of Bari 'Aldo Moro', Bari, Italy.
authors.forename: Osvalda De
authors.initials: O
authors.lastname: Giglio
authors.affiliation: Department of Biomedical Science and Human Oncology, Hygiene Section, Università degli Studi of Bari 'Aldo Moro', Bari, Italy.
authors.forename: Serafina
authors.initials: S
authors.lastname: Rutigliano
authors.affiliation: Department of Biomedical Science and Human Oncology, Hygiene Section, Università degli Studi of Bari 'Aldo Moro', Bari, Italy.
authors.forename: Giusy
authors.initials: G
authors.lastname: Diella
authors.affiliation: Department of Biomedical Science and Human Oncology, Hygiene Section, Università degli Studi of Bari 'Aldo Moro', Bari, Italy.
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Caggiano
authors.affiliation: Department of Biomedical Science and Human Oncology, Hygiene Section, Università degli Studi of Bari 'Aldo Moro', Bari, Italy.
authors.forename: Maria Teresa
authors.initials: MT
authors.lastname: Montagna
mesh_terms: D000666:Amphotericin B / Q000494:pharmacology*; D000935:Antifungal Agents / Q000494:pharmacology; D002175:Candida / Q000145:classification / Q000187:drug effects*; D002176:Candida albicans / Q000187:drug effects; D041221:Candida glabrata / Q000187:drug effects; D003840:Deoxycholic Acid / Q000494:pharmacology*; D052978:Disk Diffusion Antimicrobial Tests / Q000379:methods*; D004338:Drug Combinations; D025141:Drug Resistance, Fungal; D006801:Humans; D008826:Microbial Sensitivity Tests
chemical_list: D000935:Antifungal Agents; D004338:Drug Combinations; C068538:liposomal amphotericin B; D003840:Deoxycholic Acid; D000666:Amphotericin B; C059765:amphotericin B, deoxycholate drug combination