Bélik Florian, Deckers Corentin, Khourssaji Mehdi, Huang Te-Din, Denis Olivier, Montesinos Isabel
Laboratory of Clinical Microbiology, CHU UCL Namur and Université Catholique de Louvain, Avenue Dr Gaston Therasse 1, 5530, Yvoir, Belgium.
Laboratory of Clinical Microbiology, CHU UCL Namur and Université Catholique de Louvain, Avenue Dr Gaston Therasse 1, 5530, Yvoir, Belgium.
J Mycol Med. 2024 Mar;34(1):101465. doi: 10.1016/j.mycmed.2024.101465. Epub 2024 Feb 14.
Antifungal susceptibility testing (AFST) is essential to ensure appropriate antifungal therapy in candidaemia. This study compared two commercial colorimetric broth microdilution tests: Sensititre YeastOne (SYO; Thermo Scientific) and Micronaut-AM EUCAST AFST (M-AM; Bruker) for the AFST of Candida spp.
A total of 74 yeast strains, including C. albicans (n = 40) and non-albicans Candida species (NACS) (n = 34), were obtained from blood cultures of patients admitted to a tertiary care hospital in Belgium from 2017 to 2022. AFST by SYO and by M-AM were performed according to the manufacturers' protocols and interpreted using CLSI and EUCAST guidelines, respectively. Essential and categorical agreements (EA and CA), very major, major and minor discrepancies were calculated for amphotericin B, echinocandins and azoles considering SYO as the reference method.
In total, 441 and 392 isolate-antifungal results were evaluable for EA and CA, respectively. SYO and M-AM, showed a high level of concordance for C. albicans strains, with an EA and CA ≥90 % for all tested antifungals. However, we noted significant discordances for NACS, the lowest EA were observed with micafungin (50 %) and voriconazole (58.8 %). These discrepancies were likely due to differences in the raw MIC values obtained by the two methods and the different interpretation breakpoints used by CLSI and EUCAST.
Our study showed excellent agreement between SYO and M-AM for AFST of C. albicans, while the equivalency was lower for NACS. AFST method should be carefully selected, considering the results might impact the choice of antifungals for non-albicans candidaemia.
真菌药敏试验（AFST）对于确保念珠菌血症的适当抗真菌治疗至关重要。本研究比较了两种商业比色肉汤微量稀释试验：用于念珠菌属AFST的Sensititre YeastOne（SYO；赛默飞世尔科技公司）和Micronaut-AM EUCAST AFST（M-AM；布鲁克公司）。
从2017年至2022年入住比利时一家三级护理医院的患者血培养物中获得了总共74株酵母菌株，包括白色念珠菌（n = 40）和非白色念珠菌（NACS）（n = 34）。按照制造商的方案进行SYO和M-AM的AFST，并分别使用CLSI和EUCAST指南进行解读。以SYO作为参考方法，计算两性霉素B、棘白菌素和唑类药物的基本一致性和类别一致性（EA和CA）、极主要、主要和次要差异。
分别有441和392个分离株-抗真菌药物结果可用于EA和CA评估。SYO和M-AM对白色念珠菌菌株显示出高度一致性，所有测试抗真菌药物的EA和CA均≥90%。然而，我们注意到NACS存在显著差异，米卡芬净（50%）和伏立康唑（58.8%）的EA最低。这些差异可能是由于两种方法获得的原始MIC值不同以及CLSI和EUCAST使用的不同解读断点所致。
我们的研究表明，SYO和M-AM在白色念珠菌AFST方面具有极好的一致性，而对于NACS，等效性较低。应谨慎选择AFST方法，因为结果可能会影响非白色念珠菌血症抗真菌药物的选择。
