COMPARATIVE-EVALUATION OF FUNGITEST AND BROTH MICRODILUTION METHODS FOR ANTIFUNGAL DRUG SUSCEPTIBILITY TESTING OF CANDIDA SPECIES AND CRYPTOCOCCUS-NEOFORMANS

The FUNGITEST method (Sanofi Diagnostics Pasteur, Paris, France) is a microplate-based procedure for the breakpoint testing of six antifunga l agents (amphotericin B, flucytosine, fluconazole, itraconazole, keto conazole, and miconazole). We compared the FUNGITEST method with a bro th microdilution test, performed according to National Committee for C linical Laboratory Standards document M27-A guidelines, for determinin g the in vitro susceptibilities of 180 isolates of Candida spp, (50 C. albicans, 50 C. glabrata, 10 C. kefyr, 20 C. krusei, 10 C. lusitaniae , 20 C. parapsilosis, and 20 C. tropicalis isolates) and 20 isolates o f Cryptococcus neoformans. Overall, there was 100% agreement between t he methods for amphotericin B, 95% agreement for flucytosine, 84% agre ement for miconazole, 83% agreement for itraconazole, 77% agreement fo r ketoconazole, and 76% agreement for fluconazole, The overall agreeme nt between the methods exceeded 80% for all species tested with the ex ception of C. glabrata (71% agreement), The poorest agreement between the results for individual agents was seen with C. glabrata (38% for f luconazole, 44% for ketoconazole, and 56% for itraconazole) and C. tro picalis (50% for miconazole), The FUNGITEST method misclassified as su sceptible 2 of 12 (16.6%) fluconazole-resistant isolates, 2 of 10 (20% ) itraconazole-resistant isolates, and 4 of 8 (50%) ketoconazole-resis tant isolates of several Candida spp, Further development of the FUNGI TEST procedure will be required before it can be recommended as an alt ernative method for the susceptibility testing of Candida spp, or C, n eoformans.