Philips Sophie, Van Hoecke Frederik, De Laere Emmanuel, Vervaeke Steven, De Smedt Roos, Boelens Jerina, De Geyter Deborah, Piérard Denis, Lagrou Katrien
Department of Laboratory Medicine, AZ Delta Hospital, Deltalaan 1, 8800 Roeselare, Belgium.
Department of Microbiology and Infection Control, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan 101, 1090 Brussels, Belgium.
J Fungi (Basel). 2021 May 1;7(5):356. doi: 10.3390/jof7050356.
Two colorimetric broth microdilution antifungal susceptibility tests were compared, Sensititre YeastOne and MICRONAUT-AM for nine antifungal agents. One hundred clinical isolates were tested, representing a realistic population for susceptibility testing in daily practice. The reproducibility characteristics were comparable. Only for fluconazole, caspofungin, 5-flucytosine and amphotericin B, an essential agreement of ≥90% could be demonstrated. Sensititre minimal inhibitory concentrations (MICs) were systematically higher than MICRONAUT MICs for all antifungals, except for itraconazole. CLSI clinical breakpoints (CBPs) and epidemiological cut-off values (ECVs) were used for Sensititre MICs while for MICRONAUT the EUCAST CBPs and ECVs were used. Only fluconazole, micafungin, and amphotericin B had a categorical agreement of ≥90%. For fluconazole, micafungin, and amphotericin B the susceptibility proportions were comparable. Susceptibility proportion of posaconazole and voriconazole was higher using the MICRONAUT system. For itraconazole and anidulafungin, the susceptibility proportion was higher using Sensititre. It was not possible to determine the true MIC values or the correctness of a S/I/R result since both commercial systems were validated against a different reference method. These findings show that there is a significant variability in susceptibility pattern and consequently on use of antifungals in daily practice, depending on the choice of commercial system.
对两种比色肉汤微量稀释抗真菌药敏试验（Sensititre YeastOne和MICRONAUT-AM）进行了九种抗真菌药物的比较。测试了100株临床分离株，代表了日常实践中进行药敏试验的实际群体。两种方法的重复性特征相当。仅对于氟康唑、卡泊芬净、5-氟胞嘧啶和两性霉素B，可证明基本一致性≥90%。除伊曲康唑外，所有抗真菌药物的Sensititre最低抑菌浓度（MIC）系统地高于MICRONAUT的MIC。Sensititre MIC使用CLSI临床断点（CBP）和流行病学截断值（ECV），而MICRONAUT使用EUCAST CBP和ECV。仅氟康唑、米卡芬净和两性霉素B的分类一致性≥90%。对于氟康唑、米卡芬净和两性霉素B，药敏比例相当。使用MICRONAUT系统时，泊沙康唑和伏立康唑的药敏比例更高。对于伊曲康唑和阿尼芬净，使用Sensititre时药敏比例更高。由于两种商业系统均针对不同的参考方法进行验证，因此无法确定真正的MIC值或S/I/R结果的正确性。这些发现表明，根据商业系统的选择，日常实践中抗真菌药物的药敏模式存在显著差异，因此在抗真菌药物的使用上也存在显著差异。
