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. 1995 May;33(5):1104–1107. doi: 10.1128/jcm.33.5.1104-1107.1995

Quality control guidelines for National Committee for Clinical Laboratory Standards recommended broth macrodilution testing of amphotericin B, fluconazole, and flucytosine.

M A Pfaller 1, M Bale 1, B Buschelman 1, M Lancaster 1, A Espinel-Ingroff 1, J H Rex 1, M G Rinaldi 1, C R Cooper 1, M R McGinnis 1
PMCID: PMC228113  PMID: 7615713

Abstract

Amphotericin B, fluconazole, and flucytosine (5FC) were tested in a multilaboratory study to establish quality control (QC) guidelines for yeast antifungal susceptibility testing. Ten candidate QC strains were tested in accordance with National Committee for Clinical Laboratory Standards M27-P guidelines against the three antifungal agents in each of six laboratories. Each laboratory was assigned a unique lot of RPMI 1640 broth medium as well as a lot of RPMI 1640 common to all of the laboratories. The candidate QC strains were tested 20 times each against the three antifungal agents in both unique and common lots of RPMI 1640. A minimum of 220 MICs per drug per organism were generated during the study. Overall, 95% of the MICs of amphotericin B, fluconazole, and 5FC fell within the desired 3 log2-dilution range (mode +/- 1 log2 dilution). Excellent performance with all three drugs was observed for Candida parapsilosis ATCC 22019 and C. krusei ATCC 6258. With these strains, on-scale 3 log2-dilution ranges encompassing 96 to 99% of the MICs of all three drugs were established. These two strains are recommended for QC testing of amphotericin B, fluconazole, and 5FC. Reference ranges were also established for an additional four strains for use in method development and for training. Four strains failed to perform adequately for recommendation as either QC or reference strains.

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Selected References

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  1. Barry A. L., Fuchs P. C., Jones R. N. Statistical criteria for selecting quality control limits for broth microdilution susceptibility tests with 39 different antimicrobial agents. Collaborative Antimicrobial Susceptibility Testing Group. Diagn Microbiol Infect Dis. 1989 Sep-Oct;12(5):413–420. doi: 10.1016/0732-8893(89)90112-0. [DOI] [PubMed] [Google Scholar]
  2. Espinel-Ingroff A., Kish C. W., Jr, Kerkering T. M., Fromtling R. A., Bartizal K., Galgiani J. N., Villareal K., Pfaller M. A., Gerarden T., Rinaldi M. G. Collaborative comparison of broth macrodilution and microdilution antifungal susceptibility tests. J Clin Microbiol. 1992 Dec;30(12):3138–3145. doi: 10.1128/jcm.30.12.3138-3145.1992. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Fromtling R. A., Galgiani J. N., Pfaller M. A., Espinel-Ingroff A., Bartizal K. F., Bartlett M. S., Body B. A., Frey C., Hall G., Roberts G. D. Multicenter evaluation of a broth macrodilution antifungal susceptibility test for yeasts. Antimicrob Agents Chemother. 1993 Jan;37(1):39–45. doi: 10.1128/aac.37.1.39. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Galgiani J. N., Rinaldi M. G., Polak A. M., Pfaller M. A. Standardization of antifungal susceptibility testing. J Med Vet Mycol. 1992;30 (Suppl 1):213–224. doi: 10.1080/02681219280000911. [DOI] [PubMed] [Google Scholar]
  5. Galgiani J. N. Susceptibility testing of fungi: current status of the standardization process. Antimicrob Agents Chemother. 1993 Dec;37(12):2517–2521. doi: 10.1128/aac.37.12.2517. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Pfaller M. A., Bale M., Buschelman B., Lancaster M., Espinel-Ingroff A., Rex J. H., Rinaldi M. G. Selection of candidate quality control isolates and tentative quality control ranges for in vitro susceptibility testing of yeast isolates by National Committee for Clinical Laboratory Standards proposed standard methods. J Clin Microbiol. 1994 Jul;32(7):1650–1653. doi: 10.1128/jcm.32.7.1650-1653.1994. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Pfaller M. A., Barry A. L. Evaluation of a novel colorimetric broth microdilution method for antifungal susceptibility testing of yeast isolates. J Clin Microbiol. 1994 Aug;32(8):1992–1996. doi: 10.1128/jcm.32.8.1992-1996.1994. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Pfaller M. A., Buschelman B., Bale M. J., Lancaster M., Espinel-Ingroff A., Rex J. H., Rinaldi M. G. Multicenter comparison of a colorimetric microdilution broth method with the reference macrodilution method for in vitro susceptibility testing of yeast isolates. Diagn Microbiol Infect Dis. 1994 May;19(1):9–13. doi: 10.1016/0732-8893(94)90044-2. [DOI] [PubMed] [Google Scholar]
  9. Pfaller M. A., Grant C., Morthland V., Rhine-Chalberg J. Comparative evaluation of alternative methods for broth dilution susceptibility testing of fluconazole against Candida albicans. J Clin Microbiol. 1994 Feb;32(2):506–509. doi: 10.1128/jcm.32.2.506-509.1994. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Pfaller M. A., Rinaldi M. G. Antifungal susceptibility testing. Current state of technology, limitations, and standardization. Infect Dis Clin North Am. 1993 Jun;7(2):435–444. [PubMed] [Google Scholar]
  11. Rex J. H., Pfaller M. A., Rinaldi M. G., Polak A., Galgiani J. N. Antifungal susceptibility testing. Clin Microbiol Rev. 1993 Oct;6(4):367–381. doi: 10.1128/cmr.6.4.367. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Sewell D. L., Pfaller M. A., Barry A. L. Comparison of broth macrodilution, broth microdilution, and E test antifungal susceptibility tests for fluconazole. J Clin Microbiol. 1994 Sep;32(9):2099–2102. doi: 10.1128/jcm.32.9.2099-2102.1994. [DOI] [PMC free article] [PubMed] [Google Scholar]

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