Clinical evaluation of a dried commercially-prepared microdilution panel for antifungal susceptibility testing.

A commercially-prepared dried broth microdilution panel (Sensititre) was compared with a reference microdilution method for antifungal susceptibility testing of two reference yeast strains and 98 clinical isolates of Candida spp. The antifungal agents tested include 5-fluorocytosine (5FC), fluconazole, itraconazole, and D0870. Microdilution testing was performed according to National Committee for Clinical Laboratory Standards (NCCLS) recommendations. Minimum inhibitory concentration (MIC) endpoints were read visually after 48 hours of incubation and were assessed independently for each microdilution panel. The MICs for the reference strains were within published control limits for both reference and Sensititre microdilution panels. Discrepancies among MIC endpoints of no more than two dilutions (two wells) were used to calculate the percent agreement. An acceptable level of agreement between Sensititre and reference panels was observed for all antifungal agents when tested against the 98 clinical isolates. Agreement ranged from 83% for itraconazole to 93% for 5FC. The Sensititre dried microdilution panel appears to be a viable alternative to inhouse prepared microdilution panels and to the NCCLS microdilution reference method.