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- Title
Evaluation of paper gradient concentration strips for antifungal combination testing of Candida spp.
- Authors
Siopi, Maria; Siafakas, Nikolaos; Zerva, Loukia; Meletiadis, Joseph
- Abstract
In vitro combination testing with broth microdilution chequerboard ( CHEQ) method is widely used although it is time-consuming, cumbersome and difficult to apply in routine setting of clinical microbiology laboratory. A new gradient concentration paper strip method, the Liofilchem® MIC test strips ( MTS), provides an alternative easy and fast method enabling the simultaneous diffusion of both drugs in combination. We therefore tested a polyene+azole and an azole+echinocandin combination against 18 Candida isolates with the CHEQ method based on EUCAST guidelines and the MTS method in research and routine settings. Fractional inhibitory concentration ( FIC) indices were calculated after 24 and 48 h of incubation based on complete and prominent ( FIC-2) growth inhibition endpoints. Reproducibility and agreement within 1 twofold dilution was assessed. The FICs of the two methods were correlated quantitatively with t-test and Pearson analysis and qualitatively with Chi-squared test. The reproducibility of the CHEQ and MTS method was 88-100% and their agreement was 80% with 62-77% of MTS FICs being higher than the corresponding CHEQ FICs. A statistically significant Pearson correlation ( r = 0.86, P = 0.0003) and association ( χ2 = 17.05, df = 4, P = 0.002) was found between MTS FIC and CHEQ FIC-2 after 24 h. Categorical agreement was 63% with no very major or major errors. All MTS synergistic interactions were also synergistic with the CHEQ method.
- Subjects
CANDIDA; CRYPTOCOCCACEAE; CANDIDAPEPSIN; CANDIDEMIA; CANDIDA albicans
- Publication
Mycoses, 2015, Vol 58, Issue 11, p679
- ISSN
0933-7407
- Publication type
Article
- DOI
10.1111/myc.12413