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Antimicrobial Agents and Chemotherapy, October 2000, p. 2715-2718, Vol. 44, No. 10
0066-4804/00/$04.00+0
Copyright © 2000, American Society for Microbiology. All rights reserved.

Clinical Correlates of Antifungal Macrodilution Susceptibility Test Results for Non-AIDS Patients with Severe Candida Infections Treated with Fluconazole

Sai-Cheong Lee,1,* Chang-Phone Fung,2 Jen-Seng Huang,3 Chi-Jen Tsai,3 Kuo-Su Chen,3 Huang-Yang Chen,4 Ning Lee,5 Lai-Chu See,6 and Wen-Ben Shieh3

Division of Infectious Diseases,1 Department of Internal Medicine,3 Department of General Surgery,4 and Department of Pathology,5 Chang Gung Memorial Hospital, Keelung, Department of Public Health, Chang Gung University, Linkou,6 and Division of Infectious Diseases, Veterans General Hospital, Taipei,2 Taiwan, Republic of China

Received 4 April 2000/Returned for modification 26 May 2000/Accepted 6 July 2000

Although the clinical correlates of the reference antifungal susceptibility test results in hematogenous and deep-seated Candida infection are still controversial, we evaluated the clinical correlates of this test in deep-seated Candida infections in non-AIDS patients. Thirty-two non-AIDS patients with hematogenous or deep-seated Candida infections were treated with intravenous fluconazole (400 mg a day), and the clinical outcomes were evaluated. Coexisting bacterial infections were treated with appropriate antibiotics, superinfection or reinfection was excluded, inadequate fluconazole therapy was avoided, and essential surgical intervention was performed. The MICs of fluconazole for these 32 Candida isolates were determined according to the M27-A procedure approved by the National Committee on Clinical Laboratory Standards. MICs were interpreted as susceptible (<= 8 µg/ml), dose-dependent susceptible (16 to 32 µg/ml), and resistant (>= 64 µg/ml) according to the criteria of the M27-A standard. The success rates were 79% (19 of 24; 95% confidence interval [CI], 59 to 93%) in the susceptible category, 66% (4 of 6; 95% CI, 19 to 95%) in the dose-dependent susceptible category, and 0% (0 of 2; 95% CI, 0 to 84%) in the resistant category. We conclude that the clinical correlation of the reference antifungal susceptibility test results is high in hematogenous and deep-seated Candida infections.

* Corresponding author. Mailing address: Division of Infectious Diseases, Chang Gung Memorial Hospital, 222 Mai Chin Rd., Keelung, Taiwan, Republic of China. Phone: 886-02-24313131. Fax: 886-02-24332882. E-mail: Ruby800{at}adm.cgmh.com.tw.

Antimicrobial Agents and Chemotherapy, October 2000, p. 2715-2718, Vol. 44, No. 10
0066-4804/00/$04.00+0
Copyright © 2000, American Society for Microbiology. All rights reserved.


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