The Influence of Medium Composition on EUCAST and Etest Antifungal Susceptibility Testing

There is an ongoing effort to optimize and revise antifungal susceptibility testing (AFST) methods due to the rising number of fungal infections and drug-resistant fungi. The rising antifungal resistance within Candida and Aspergillus species, which are common contributors to invasive fungal infecti...

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Bibliographic Details
Published in:Journal of fungi (Basel) 2023-09, Vol.9 (10), p.973
Main Authors: Vahedi-Shahandashti, Roya, Stubenböck, Melanie Maria, Lass-Flörl, Cornelia
Format: Article
Language:English
Subjects:
Amphotericin B
Antifungal agents
antifungal susceptibility testing (AFST)
Aspergillus
Candida
Caspofungin
CLSI
Communication
complex medium
defined medium
Drug resistance
Fungal infections
Health aspects
Infection
Laboratories
Minimum inhibitory concentration
Posaconazole
Quality control
Quality standards
RPMI 1640
Solvents
tested medium
Voriconazole
Yeast
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Summary:There is an ongoing effort to optimize and revise antifungal susceptibility testing (AFST) methods due to the rising number of fungal infections and drug-resistant fungi. The rising antifungal resistance within Candida and Aspergillus species, which are common contributors to invasive fungal infections (IFIs), is a cause for concern, prompting an expanding integration of in vitro AFST to guide clinical decisions. To improve the relevance of in vitro AFST results to therapy outcomes, influential factors should be taken into account. The tested medium is one of several factors that could affect the results of AFST. The present study evaluated the effect of two complex media (Sabouraud dextrose and Columbia) versus the standard defined medium (RPMI 1640) on the AFST results of amphotericin B, posaconazole, and voriconazole against Candida spp. and Aspergillus spp. representatives, utilizing the European Committee on Antimicrobial Susceptibility Testing (EUCAST) and the Etest methods. Overall, Candida species exhibited higher variability in minimum inhibitory concentration (MIC) across different media (more than three log2 dilutions) comparing to Aspergillus spp., while quality control isolates showed consistency regardless of tested media, antifungals, and methods. When comparing tested methods, MIC variation was mostly detected using EUCAST than it was using Etest.
ISSN:2309-608X
2309-608X
DOI:10.3390/jof9100973