This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrowReprints and Permissions
Right arrow Copyright Information
Right arrow Books from ASM Press
Right arrow MicrobeWorld
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Park, B. J.
Right arrow Articles by Warnock, D. W.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Park, B. J.
Right arrow Articles by Warnock, D. W.

 Previous Article  |  Next Article 

Antimicrobial Agents and Chemotherapy, April 2006, p. 1287-1292, Vol. 50, No. 4
0066-4804/06/$08.00+0     doi:10.1128/AAC.50.4.1287-1292.2006
Copyright © 2006, American Society for Microbiology. All Rights Reserved.

Evaluation of Amphotericin B Interpretive Breakpoints for Candida Bloodstream Isolates by Correlation with Therapeutic Outcome

Benjamin J. Park,1* Beth A. Arthington-Skaggs,1 Rana A. Hajjeh,1 Naureen Iqbal,1 Meral A. Ciblak,1 Wendy Lee-Yang,1 Mario D. Hairston,1 Maureen Phelan,2 Brian D. Plikaytis,2 Andre N. Sofair,3 Lee H. Harrison,4 Scott K. Fridkin,1 and David W. Warnock1

Mycotic Diseases Branch,1 Biostatistics and Information Management Branch, Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia,2 Yale University School of Medicine, New Haven, Connecticut,3 Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland4

Received 28 January 2005/ Returned for modification 21 February 2005/ Accepted 12 December 2005

One hundred seven Candida bloodstream isolates (51 C. albicans, 24 C. glabrata, 13 C. parapsilosis, 13 C. tropicalis, 2 C. dubliniensis, 2 C. krusei, and 2 C. lusitaniae strains) from patients treated with amphotericin B alone underwent in vitro susceptibility testing against amphotericin B using five different methods. Fifty-four isolates were from patients who failed treatment, defined as death 7 to 14 days after the incident candidemia episode, having persistent fever of ≥5 days' duration after the date of the incident candidemia, or the recurrence of fever after two consecutive afebrile days while on antifungal treatment. MICs were determined by using the Clinical Laboratory Standards Institute (formally National Committee for Clinical Laboratory Standards) broth microdilution procedure with two media and by using Etest. Minimum fungicidal concentrations (MFCs) were also measured in two media. Broth microdilution tests with RPMI 1640 medium generated a restricted range of MICs (0.125 to 1 µg/ml); the corresponding MFC values ranged from 0.5 to 4 µg/ml. Broth microdilution tests with antibiotic medium 3 produced a broader distribution of MIC and MFC results (0.015 to 0.25 µg/ml and 0.06 to 2 µg/ml, respectively). Etest produced the widest distribution of MICs (0.094 to 2 µg/ml). However, none of the test formats studied generated results that significantly correlated with therapeutic success or failure.

* Corresponding author. Mailing address: Mycotic Diseases Branch, Centers for Disease Control and Prevention, 1600 Clifton Rd., N.E., Mailstop C-09, Atlanta, GA 30333. Phone: (404) 639-1619. Fax: (404) 639-3059. E-mail: bip5{at}cdc.gov.

Antimicrobial Agents and Chemotherapy, April 2006, p. 1287-1292, Vol. 50, No. 4
0066-4804/06/$08.00+0     doi:10.1128/AAC.50.4.1287-1292.2006
Copyright © 2006, American Society for Microbiology. All Rights Reserved.



This article has been cited by other articles:

  • Lignell, A., Lowdin, E., Cars, O., Sjolin, J. (2008). Characterization of the inhibitory effect of voriconazole on the fungicidal activity of amphotericin B against Candida albicans in an in vitro kinetic model. J Antimicrob Chemother 62: 142-148 [Abstract] [Full Text]  
  • Johnson, E. M. (2008). Issues in antifungal susceptibility testing. J Antimicrob Chemother 61: i13-i18 [Abstract] [Full Text]  
  • Pfaller, M. A., Diekema, D. J., Procop, G. W., Rinaldi, M. G. (2007). Multicenter Comparison of the VITEK 2 Antifungal Susceptibility Test with the CLSI Broth Microdilution Reference Method for Testing Amphotericin B, Flucytosine, and Voriconazole against Candida spp.. J. Clin. Microbiol. 45: 3522-3528 [Abstract] [Full Text]  
  • Torres-Rodriguez, J. M., Alvarado-Ramirez, E. (2007). In vitro susceptibilities to yeasts using the ATB(R) FUNGUS 2 method, compared with Sensititre Yeast One(R) and standard CLSI (NCCLS) M27-A2 methods. J Antimicrob Chemother 60: 658-661 [Abstract] [Full Text]  
  • Fleck, R., Dietz, A., Hof, H. (2007). In vitro susceptibility of Candida species to five antifungal agents in a German university hospital assessed by the reference broth microdilution method and Etest. J Antimicrob Chemother 59: 767-771 [Abstract] [Full Text]  
  • Espinel-Ingroff, A., Canton, E., Gibbs, D., Wang, A. (2007). Correlation of Neo-Sensitabs Tablet Diffusion Assay Results on Three Different Agar Media with CLSI Broth Microdilution M27-A2 and Disk Diffusion M44-A Results for Testing Susceptibilities of Candida spp. and Cryptococcus neoformans to Amphotericin B, Caspofungin, Fluconazole, Itraconazole, and Voriconazole. J. Clin. Microbiol. 45: 858-864 [Abstract] [Full Text]  
  • Pfaller, M. A., Diekema, D. J. (2007). Epidemiology of Invasive Candidiasis: a Persistent Public Health Problem. Clin. Microbiol. Rev. 20: 133-163 [Abstract] [Full Text]  


Copyright © 2009 by the American Society for Microbiology.   For an alternate route to Journals.ASM.org, visit: http://intl-journals.asm.org | More Info»