Ma. Pfaller et al., In vitro susceptibility testing of filamentous fungi: Comparison of Etest and reference microdilution methods for determining itraconazole MICs, J CLIN MICR, 38(9), 2000, pp. 3359-3361
The performance of the Etest for itraconazole susceptibility testing of 50
isolates of filamentous fungi was assessed in comparison with the National
Committee for Clinical Laboratory Standards (NCCLS) proposed standard micro
dilution broth method. The NCCLS method employed RPMI 1640 broth medium, an
d MICs were read after incubation for 48 h at 35 degrees C, Etest MICs were
determined with RPMI agar containing 2% glucose and with Casitone agar and
were read after incubation for 24 h (Aspergillus spp, and Rhizopus spp.) a
nd 48 h (all species except Rhizopus spp,) at 35 degrees C, The isolates in
cluded Aspergillus flavus, Aspergillus fumigatus, Aspergillus niger, Asperg
illus terreus, Fusarium spp,, Pseudallescheria boydii, Rhizopus spp,, Paeci
lomyces variotii, and an Acremonium sp. Overall agreement between Etest and
microdilution MICs was 96% with RPMI agar and 80% with Casitone agar, The
agreement was 100% for all species except Rhizopus spp, (83%) and Paecilomy
ces varioti (0%) with RPMI agar, When Casitone agar was used, the agreement
ranged from 50% with Rhizopus spp, to 100% with Fusarium spp,, P, boydii,
P. varioti, and an Acremonium sp. Notably, for Aspergillus spp., the agreem
ent between itraconazole Etest MICs read at 24 h and reference microdilutio
n MICs read at 48 h was 100% with both RPMI and Casitone agar, Both media s
upported the growth of all filamentous fungi tested. Where a discrepancy wa
s observed between Etest and the reference method, the Etest MIC was genera
lly higher. The Etest method using RPMI agar appears to be a useful method
for determining itraconazole susceptibilities of Aspergillus spp, and other
filamentous fungi.