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Michael J Rybak - One of the best experts on this subject based on the ideXlab platform.
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evaluation of the Etest grd for the detection of staphylococcus aureus with reduced susceptibility to glycopeptides
Journal of Antimicrobial Chemotherapy, 2009Co-Authors: Steven N Leonard, Kerri L Rossi, Karly L Newton, Michael J RybakAbstract:Objectives: Continued glycopeptide-selective pressure has led to non-susceptible strains of Staphylococcus aureus including heterogeneously vancomycin-intermediate S. aureus (hVISA). The gold standard for identification of hVISA is the population analysis profile area under the curve ratio (PAP-AUC), though this method is time-consuming and labour-intensive. The objective of this study was to compare a new method for detection of hVISA, the Etest GRD, to PAP-AUC and to macro Etest. Methods: One hundred clinical hVISA and 50 clinical fully vancomycin-susceptible S. aureus (VSSA), confirmed by PAP-AUC, were evaluated. Microtitre and Etest MICs were determined by standard testing procedures on all isolates. Macro Etest was performed according to referenced procedures. The Etest GRD was tested using a 0.5 McFarland standard on Mueller-Hinton agar + 5% blood and read at 24 and 48 h. If either the vancomycin or the teicoplanin end of the GRD strip was >8 and the vancomycin Etest was ≤4, the isolate was considered hVISA. Results: Vancomycin MIC 50 /MIC 90 for hVISA and VSSA was 1.5/2mg/L and 1/1.5mg/L, respectively, by Etest and vancomycin MIC 50 /MIC 90 for hVISA and VSSA was 1/2 mg/L for both by microtitre; MIC values for hVISA being significantly higher (P< 0.023). At 24 h, the Etest GRD was 77% sensitive and 98% specific, and at 48 h, it was 93% sensitive and 82% specific compared with PAP-AUC. Macro Etest was 83% sensitive and 94% specific at 48 h. Conclusions: Etest GRD was simple to perform and may be feasible for clinical microbiology laboratories. This test may be useful for clinical detection of hVISA.
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Evaluation of the Etest GRD for the detection of Staphylococcus aureus with reduced susceptibility to glycopeptides
Journal of Antimicrobial Chemotherapy, 2009Co-Authors: Steven N Leonard, Kerri L Rossi, Karly L Newton, Michael J RybakAbstract:OBJECTIVES Continued glycopeptide-selective pressure has led to non-susceptible strains of Staphylococcus aureus including heterogeneously vancomycin-intermediate S. aureus (hVISA). The gold standard for identification of hVISA is the population analysis profile area under the curve ratio (PAP-AUC), though this method is time-consuming and labour-intensive. The objective of this study was to compare a new method for detection of hVISA, the Etest GRD, to PAP-AUC and to macro Etest. METHODS One hundred clinical hVISA and 50 clinical fully vancomycin-susceptible S. aureus (VSSA), confirmed by PAP-AUC, were evaluated. Microtitre and Etest MICs were determined by standard testing procedures on all isolates. Macro Etest was performed according to referenced procedures. The Etest GRD was tested using a 0.5 McFarland standard on Mueller-Hinton agar + 5% blood and read at 24 and 48 h. If either the vancomycin or the teicoplanin end of the GRD strip was >or=8 and the vancomycin Etest was
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Etest synergy testing of clinical isolates of Staphylococcus aureus demonstrating heterogeneous resistance to vancomycin.
Diagnostic Microbiology and Infectious Disease, 2005Co-Authors: Brian T. Tsuji, Michael J RybakAbstract:In search for potential synergistic antimicrobial combinations against Staphylococcus aureus isolates, which display heterogeneous resistance to vancomycin, we evaluated the activities of 21 various combinations involving ampicillin/sulbactam, daptomycin, gentamicin, linezolid, quinupristin/dalfopristin, rifampin, and vancomycin by Etest and time-kill methods. A number of combinations demonstrated either synergistic or additive effects against hGISA SA118 and GISA SA179. Agreement between the Etest and time-kill methods for detecting antimicrobial synergy ranged from 66.6% to 71.4%. The Etest method appears promising, and further investigations are warranted.
Deborah S Ashcraft - One of the best experts on this subject based on the ideXlab platform.
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Colistin and Polymyxin B Minimal Inhibitory Concentrations Determined by Etest Found Unreliable for Gram-Negative Bacilli.
The Ochsner journal, 2017Co-Authors: Shelby Simar, Deborah S Ashcraft, Diane Sibley, George A PankeyAbstract:Background: A reliable method of polymyxin B and E (colistin) susceptibility testing remains elusive. These drugs diffuse poorly into agar, creating potentially inaccurate Etest and disk diffusion results, and testing by these methods is not recommended. Broth microdilution is the reference testing method, although it can be sometimes difficult to interpret. Currently, when a colistin susceptibility test is ordered for a patient in the Ochsner Health System, our diagnostic microbiology laboratory performs the Etest. As an in-house quality assessment project, we compared colistin and polymyxin B minimal inhibitory concentrations (MICs) determined by Etest with MICs determined by broth microdilution to evaluate whether colistin MICs are accurately being reported by Etest. Methods: A total of 143 nonduplicate clinical isolates from Ochsner patients during 2015-2016 were tested: Acinetobacter baumannii (n=60), Pseudomonas aeruginosa (n=44), and Enterobacteriaceae (n=39) (13 Escherichia coli, 15 Klebsiella spp, and 11 Enterobacter spp). Colistin and polymyxin B MICs were determined by Etest and broth microdilution. Results: Using broth microdilution, 16/143 (11%) isolates were nonsusceptible to colistin, and 12/143 (8%) were nonsusceptible to polymyxin B. With Etest, 4/143 (3%) isolates were nonsusceptible to colistin, and 7/143 (5%) were nonsusceptible to polymyxin B. Essential agreement of colistin and polymyxin B MICs between broth microdilution and Etest was 84/143 (59%) and 87/143 (61%), respectively. Categorical agreement for colistin and polymyxin B was 127/143 (89%) and 126/143 (88%), respectively. Conclusion: We found a high rate of discrepancy between colistin and polymyxin B Etest and broth microdilution MICs. Very major errors (colistin/polymyxin B-susceptible by Etest, colistin/polymyxin B-resistant by broth microdilution) were detected in 10% of isolates tested with colistin and 8% of polymyxin B-tested isolates. The data from this study confirm that broth microdilution should be performed for susceptibility testing of polymyxins.
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Time-Kill Assay and Etest Evaluation for Synergy with Polymyxin B and Fluconazole against Candida glabrata
Antimicrobial Agents and Chemotherapy, 2014Co-Authors: George A Pankey, Deborah S Ashcraft, Heather P. Kahn, Abdulrahim IsmailAbstract:Fluconazole-resistant Candida glabrata is an emerging pathogen that causes fungemia. Polymyxin B, a last-resort antibiotic used to treat multidrug-resistant Gram-negative bacterial infections, has been found to possess in vitro fungicidal activity and showed synergy with fluconazole against a single strain of C. glabrata. Since both agents may be used simultaneously in intensive care unit (ICU) patients, this study was performed to test for possible synergy of this combination against 35 C. glabrata blood isolates, using 2 methods: a time-kill assay and an experimental MIC-MIC Etest method. Thirty-five genetically unique C. glabrata bloodstream isolates were collected from 2009 to 2011, identified using an API 20C system, and genotyped by repetitive sequence-based PCR (rep-PCR). MICs were determined by Etest and broth microdilution methods. Synergy testing was performed using a modified bacterial Etest synergy method and time-kill assay, with final results read at 24 h. The Etest method showed synergy against 19/35 (54%) isolates; the time-kill assay showed synergy against 21/35 (60%) isolates. Isolates not showing drug synergy had an indifferent status. Concordance between methods was 60%. In vitro synergy of polymyxin B and fluconazole against the majority of C. glabrata isolates was demonstrated by both methods. The bacterial Etest synergy method adapted well when used with C. glabrata. Etest was easier to perform than time-kill assay and may be found to be an acceptable alternative to time-kill assay with antifungals.
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in vitro synergy of ciprofloxacin and gatifloxacin against ciprofloxacin resistant pseudomonas aeruginosa
Antimicrobial Agents and Chemotherapy, 2005Co-Authors: George A Pankey, Deborah S AshcraftAbstract:Multidrug-resistant Pseudomonas aeruginosa with combined decreased susceptibility to ceftazidime, ciprofloxacin, imipenem, and piperacillin is increasingly being found as a cause of nosocomial infections. It is important to look for combinations of drugs that might be synergistic. Ciprofloxacin resistance by P. aeruginosa is mediated in part by an efflux pump mechanism. Gatifloxacin, an 8-methoxyfluoroquinolone, inhibits a staphylococcal efflux pump. An earlier in vitro study using an Etest synergy method and time-kill assay suggested synergy of ciprofloxacin and gatifloxacin against P. aeruginosa. Synergy testing was performed by Etest and time-kill assay for 31 clinically unique, plasmid DNA distinct, U.S. P. aeruginosa isolates. Etest MICs for ciprofloxacin were 4 to >32 μg/ml, and for gatifloxacin they were >32 μg/ml. Ciprofloxacin plus gatifloxacin showed synergy by the Etest method for 6 (19%) of the 31 P. aeruginosa isolates using a summation fractional inhibitory concentration of ≤0.5 for synergy. Synergy was demonstrated for 13/31 (42%) of isolates by time-kill assay. No antagonism was detected. The remaining isolates were indifferent to the combination. The Etest method and time-kill assay were 65% (20/31) concordant. The mechanism of the in vitro synergy may include P. aeruginosa ciprofloxacin efflux pump inhibition by gatifloxacin.
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in vitro synergy of ciprofloxacin and gatifloxacin against ciprofloxacin resistant pseudomonas aeruginosa
Antimicrobial Agents and Chemotherapy, 2005Co-Authors: George A Pankey, Deborah S AshcraftAbstract:Multidrug-resistant Pseudomonas aeruginosa with combined decreased susceptibility to ceftazidime, ciprofloxacin, imipenem, and piperacillin is increasingly being found as a cause of nosocomial infections. It is important to look for combinations of drugs that might be synergistic. Ciprofloxacin resistance by P. aeruginosa is mediated in part by an efflux pump mechanism. Gatifloxacin, an 8-methoxyfluoroquinolone, inhibits a staphylococcal efflux pump. An earlier in vitro study using an Etest synergy method and time-kill assay suggested synergy of ciprofloxacin and gatifloxacin against P. aeruginosa. Synergy testing was performed by Etest and time-kill assay for 31 clinically unique, plasmid DNA distinct, U.S. P. aeruginosa isolates. Etest MICs for ciprofloxacin were 4 to >32 μg/ml, and for gatifloxacin they were >32 μg/ml. Ciprofloxacin plus gatifloxacin showed synergy by the Etest method for 6 (19%) of the 31 P. aeruginosa isolates using a summation fractional inhibitory concentration of ≤0.5 for synergy. Synergy was demonstrated for 13/31 (42%) of isolates by time-kill assay. No antagonism was detected. The remaining isolates were indifferent to the combination. The Etest method and time-kill assay were 65% (20/31) concordant. The mechanism of the in vitro synergy may include P. aeruginosa ciprofloxacin efflux pump inhibition by gatifloxacin.
George A Pankey - One of the best experts on this subject based on the ideXlab platform.
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Colistin and Polymyxin B Minimal Inhibitory Concentrations Determined by Etest Found Unreliable for Gram-Negative Bacilli.
The Ochsner journal, 2017Co-Authors: Shelby Simar, Deborah S Ashcraft, Diane Sibley, George A PankeyAbstract:Background: A reliable method of polymyxin B and E (colistin) susceptibility testing remains elusive. These drugs diffuse poorly into agar, creating potentially inaccurate Etest and disk diffusion results, and testing by these methods is not recommended. Broth microdilution is the reference testing method, although it can be sometimes difficult to interpret. Currently, when a colistin susceptibility test is ordered for a patient in the Ochsner Health System, our diagnostic microbiology laboratory performs the Etest. As an in-house quality assessment project, we compared colistin and polymyxin B minimal inhibitory concentrations (MICs) determined by Etest with MICs determined by broth microdilution to evaluate whether colistin MICs are accurately being reported by Etest. Methods: A total of 143 nonduplicate clinical isolates from Ochsner patients during 2015-2016 were tested: Acinetobacter baumannii (n=60), Pseudomonas aeruginosa (n=44), and Enterobacteriaceae (n=39) (13 Escherichia coli, 15 Klebsiella spp, and 11 Enterobacter spp). Colistin and polymyxin B MICs were determined by Etest and broth microdilution. Results: Using broth microdilution, 16/143 (11%) isolates were nonsusceptible to colistin, and 12/143 (8%) were nonsusceptible to polymyxin B. With Etest, 4/143 (3%) isolates were nonsusceptible to colistin, and 7/143 (5%) were nonsusceptible to polymyxin B. Essential agreement of colistin and polymyxin B MICs between broth microdilution and Etest was 84/143 (59%) and 87/143 (61%), respectively. Categorical agreement for colistin and polymyxin B was 127/143 (89%) and 126/143 (88%), respectively. Conclusion: We found a high rate of discrepancy between colistin and polymyxin B Etest and broth microdilution MICs. Very major errors (colistin/polymyxin B-susceptible by Etest, colistin/polymyxin B-resistant by broth microdilution) were detected in 10% of isolates tested with colistin and 8% of polymyxin B-tested isolates. The data from this study confirm that broth microdilution should be performed for susceptibility testing of polymyxins.
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Time-Kill Assay and Etest Evaluation for Synergy with Polymyxin B and Fluconazole against Candida glabrata
Antimicrobial Agents and Chemotherapy, 2014Co-Authors: George A Pankey, Deborah S Ashcraft, Heather P. Kahn, Abdulrahim IsmailAbstract:Fluconazole-resistant Candida glabrata is an emerging pathogen that causes fungemia. Polymyxin B, a last-resort antibiotic used to treat multidrug-resistant Gram-negative bacterial infections, has been found to possess in vitro fungicidal activity and showed synergy with fluconazole against a single strain of C. glabrata. Since both agents may be used simultaneously in intensive care unit (ICU) patients, this study was performed to test for possible synergy of this combination against 35 C. glabrata blood isolates, using 2 methods: a time-kill assay and an experimental MIC-MIC Etest method. Thirty-five genetically unique C. glabrata bloodstream isolates were collected from 2009 to 2011, identified using an API 20C system, and genotyped by repetitive sequence-based PCR (rep-PCR). MICs were determined by Etest and broth microdilution methods. Synergy testing was performed using a modified bacterial Etest synergy method and time-kill assay, with final results read at 24 h. The Etest method showed synergy against 19/35 (54%) isolates; the time-kill assay showed synergy against 21/35 (60%) isolates. Isolates not showing drug synergy had an indifferent status. Concordance between methods was 60%. In vitro synergy of polymyxin B and fluconazole against the majority of C. glabrata isolates was demonstrated by both methods. The bacterial Etest synergy method adapted well when used with C. glabrata. Etest was easier to perform than time-kill assay and may be found to be an acceptable alternative to time-kill assay with antifungals.
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in vitro synergy of ciprofloxacin and gatifloxacin against ciprofloxacin resistant pseudomonas aeruginosa
Antimicrobial Agents and Chemotherapy, 2005Co-Authors: George A Pankey, Deborah S AshcraftAbstract:Multidrug-resistant Pseudomonas aeruginosa with combined decreased susceptibility to ceftazidime, ciprofloxacin, imipenem, and piperacillin is increasingly being found as a cause of nosocomial infections. It is important to look for combinations of drugs that might be synergistic. Ciprofloxacin resistance by P. aeruginosa is mediated in part by an efflux pump mechanism. Gatifloxacin, an 8-methoxyfluoroquinolone, inhibits a staphylococcal efflux pump. An earlier in vitro study using an Etest synergy method and time-kill assay suggested synergy of ciprofloxacin and gatifloxacin against P. aeruginosa. Synergy testing was performed by Etest and time-kill assay for 31 clinically unique, plasmid DNA distinct, U.S. P. aeruginosa isolates. Etest MICs for ciprofloxacin were 4 to >32 μg/ml, and for gatifloxacin they were >32 μg/ml. Ciprofloxacin plus gatifloxacin showed synergy by the Etest method for 6 (19%) of the 31 P. aeruginosa isolates using a summation fractional inhibitory concentration of ≤0.5 for synergy. Synergy was demonstrated for 13/31 (42%) of isolates by time-kill assay. No antagonism was detected. The remaining isolates were indifferent to the combination. The Etest method and time-kill assay were 65% (20/31) concordant. The mechanism of the in vitro synergy may include P. aeruginosa ciprofloxacin efflux pump inhibition by gatifloxacin.
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in vitro synergy of ciprofloxacin and gatifloxacin against ciprofloxacin resistant pseudomonas aeruginosa
Antimicrobial Agents and Chemotherapy, 2005Co-Authors: George A Pankey, Deborah S AshcraftAbstract:Multidrug-resistant Pseudomonas aeruginosa with combined decreased susceptibility to ceftazidime, ciprofloxacin, imipenem, and piperacillin is increasingly being found as a cause of nosocomial infections. It is important to look for combinations of drugs that might be synergistic. Ciprofloxacin resistance by P. aeruginosa is mediated in part by an efflux pump mechanism. Gatifloxacin, an 8-methoxyfluoroquinolone, inhibits a staphylococcal efflux pump. An earlier in vitro study using an Etest synergy method and time-kill assay suggested synergy of ciprofloxacin and gatifloxacin against P. aeruginosa. Synergy testing was performed by Etest and time-kill assay for 31 clinically unique, plasmid DNA distinct, U.S. P. aeruginosa isolates. Etest MICs for ciprofloxacin were 4 to >32 μg/ml, and for gatifloxacin they were >32 μg/ml. Ciprofloxacin plus gatifloxacin showed synergy by the Etest method for 6 (19%) of the 31 P. aeruginosa isolates using a summation fractional inhibitory concentration of ≤0.5 for synergy. Synergy was demonstrated for 13/31 (42%) of isolates by time-kill assay. No antagonism was detected. The remaining isolates were indifferent to the combination. The Etest method and time-kill assay were 65% (20/31) concordant. The mechanism of the in vitro synergy may include P. aeruginosa ciprofloxacin efflux pump inhibition by gatifloxacin.
M. A. Pfaller - One of the best experts on this subject based on the ideXlab platform.
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In vitro susceptibility testing of filamentous fungi: comparison of Etest and reference M38-A microdilution methods for determining posaconazole MICs.
Diagnostic Microbiology and Infectious Disease, 2003Co-Authors: M. A. Pfaller, Linda Boyken, Shawn A. Messer, Richard J Hollis, Daniel J. DiekemaAbstract:The performance of the Etest for posaconazole susceptibility testing of 72 isolates of filamentous fungi was assessed in comparison with the National Committee for Clinical Laboratory Standards (NCCLS) approved standard broth microdilution method (M38-A). The NCCLS method employed RPMI 1640 broth medium, and MICs were read after incubation for 48h at 35°C. Etest MICs were determined with RPMI agar containing 2% glucose and were read after incubation for 48h at 35°C. The isolates included Aspergillus fumigatus, A. flavus, A. nidulans, A. niger, A. versicolor, A. oryzae, A. terreus, Cladosporium spp., Curvularia sp., Exophiala sp., Fusarium spp., Paecilomyces spp., Pithomyces sp., Penicillium spp. and Scedosporium apiospermum. Overall agreement between Etest and microdilution MICs was 84% for Aspergillus spp. and 100% for the less common opportunistic molds, with the exception of Penicillium spp. (67%). Where a discrepancy was observed between Etest and the reference method, the Etest tended to give lower values. The Etest method using RPMI agar appears to be a useful method for determining posaconazole susceptibilities of filamentous fungi.
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In Vitro Susceptibility Testing of Aspergillus spp.: Comparison of Etest and Reference Microdilution Methods for Determining Voriconazole and Itraconazole MICs
Journal of Clinical Microbiology, 2003Co-Authors: J. B. Pfaller, Shawn A. Messer, Richard J Hollis, Daniel J. Diekema, M. A. PfallerAbstract:The performance of the Etest for voriconazole and for itraconazole susceptibility testing of 376 isolates of Aspergillus spp. was assessed in comparison with the National Committee for Clinical Laboratory Standards (NCCLS) proposed standard microdilution broth method. The NCCLS method employed RPMI 1640 broth medium, and MICs were read after incubation for 48 h at 35°C. Etest MICs were determined with RPMI agar containing 2% glucose and were read after incubation for 48 h at 35°C. The isolates included A. fumigatus, A. flavus, A. niger, A. terreus, A. versicolor, A. glaucus, A. nidulans, A. ustus, and A. sydowii. Overall agreement percentages between the Etest and microdilution MICs were 97.6% for voriconazole and 95.8% for itraconazole. Where a discrepancy was observed between Etest and the reference method, the Etest tended to give lower values with voriconazole and higher values with itraconazole. The Etest method using RPMI agar appears to be a useful method for determining the voriconazole and itraconazole susceptibilities of Aspergillus spp.
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evaluation of Etest method for determining fluconazole and voriconazole mics for 279 clinical isolates of candida species infrequently isolated from blood
Journal of Clinical Microbiology, 2003Co-Authors: M. J. Maxwell, Linda Boyken, S. Tendolkar, Daniel J. Diekema, S A Messer, R J Hollis, M. A. PfallerAbstract:The performance of Etest in fluconazole and voriconazole testing of 279 isolates of uncommon Candida spp. was assessed in comparison with the National Committee for Clinical Laboratory Standards (NCCLS)-approved standard broth microdilution (BMD) method. The NCCLS method employed RPMI 1640 broth medium, and MICs were read after incubation for 48 h at 35°C. Etest MICs were determined with RPMI agar containing 2% glucose and were read after incubation for 48 h at 35°C. The isolates include Candida krusei, C. lusitaniae, C. guilliermondii, C. kefyr, C. rugosa, C. lipolytica, C. pelliculosa, C. dubliniensis, C. famata, C. zeylanoides, C. inconspicua, and C. norvegensis. Overall agreement between Etest and BMD MICs was 96% for fluconazole and 95% for voriconazole. Where a discrepancy was observed between Etest and the reference method, the Etest tended to give lower values with both fluconazole and voriconazole. The Etest method using RPMI agar appears to be a useful method for determining fluconazole and voriconazole susceptibilities of uncommon species of Candida.
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precision and accuracy of fluconazole susceptibility testing by broth microdilution Etest and disk diffusion methods
Antimicrobial Agents and Chemotherapy, 2002Co-Authors: A L Barry, Peter C. Fuchs, M. A. Pfaller, Robert Rennie, Steven D. BrownAbstract:Interpretive agreements among the results of fluconazole broth microdilution tests, Etests, and disk diffusion tests were documented by evaluating 495 Candida spp. Microdilution reference test results were in agreement with 96% of the Etest results; most discrepancies were minor differences. Fluconazole resistance of Candida krusei strains often required a full 48 h of incubation in order to be observed by the standard method. For the disk diffusion tests that were performed on Mueller-Hinton agar with glucose and methylene blue, 97% of results were in agreement with those of the reference test, especially when zones of inhibition were measured after the first 24 h of incubation. Some Candida glabrata isolates failed to grow satisfactorily until a full 48 h of incubation was completed. Precision was determined by testing 50 selected isolates in triplicate in each of three laboratories. The reproducibility of results of disk diffusion tests was comparable to that of the reference method. With all procedures, determination of test results was particularly challenging with some strains, and new methods are needed in order to improve endpoint definition.
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Evaluation of Etest method for determining caspofungin (MK-0991) susceptibilities of 726 clinical isolates of Candida species.
Journal of Clinical Microbiology, 2001Co-Authors: M. A. Pfaller, Shawn A. Messer, A. Bolmström, K. Mills, R. N. JonesAbstract:The performance of the Etest for testing the susceptibilities to caspofungin (MK-0991) of 726 isolates of Candida spp. was assessed against the National Committee for Clinical Laboratory Standards (NCCLS) microdilution broth method. The NCCLS method employed RPMI 1640 broth medium, and MICs were read after incubation for 48 h at 35°C. MICs were determined by Etest for all 726 isolates with RPMI agar containing 2% glucose (RPG) and were read after incubation for 48 h at 35°C. The Candida isolates included Candida albicans (n = 486), Candida glabrata (n = 96), Candida tropicalis (n = 51), Candida parapsilosis (n = 47), Candida krusei (n = 11), Candida lusitaniae (n = 2), and Candida guilliermondii (n = 33). In addition, a subset of 314 isolates were also tested by Etest using Casitone agar (CAS) and antibiotic medium 3 agar (AM3). The Etest results obtained using RPG correlated well with reference MICs. Overall agreement was 94% with RPG, 82% with CAS, and 79% with AM3. When RPG was used, agreement ranged from 79% for C. parapsilosis to 100% for C. krusei, C. lusitaniae, and C. guilliermondii. When CAS was used, agreement ranged from 0% for C. lusitaniae to 100% for C. glabrata. With AM3, agreement ranged from 0% for C. lusitaniae to 100% for C. guilliermondii. All three media supported growth of each of the Candida species. Etest results were easy to read, with sharp zones of inhibition. In most instances (75%) where a discrepancy was observed between the Etest and the reference method, the Etest MIC was lower. The Etest method using RPG appears to be useful for determining caspofungin susceptibilities of Candida species.
Yasuo Tano - One of the best experts on this subject based on the ideXlab platform.
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utility of Etest in choosing appropriate agents to treat fungal keratitis
Cornea, 2001Co-Authors: Tomoyuki Inoue, Yoshikazu Shimomura, Shuji Yamamoto, Naoyuki Maeda, Yoshitsugu Inoue, Atsuko Sunada, Seishi Asari, Kohji Nishida, Hitoshi Watanabe, Yasuo TanoAbstract:PURPOSE: To evaluate the utility of Etest in choosing the appropriate treatment of fungal keratitis. METHODS: Etest was used to determine the drug sensitivities of isolates from the eyes of three patients with fungal keratitis, and the clinical outcomes of treatment with selected drugs were evaluated. RESULTS: In all cases, drug sensitivity demonstrated by Etest accorded with clinical efficacy of the drugs. CONCLUSION: The results in these cases suggest that evaluating drug sensitivities with Etest is an efficient means of selecting optimal pharmacotherapy for fungal keratitis.
