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JAC Advance Access originally published online on November 16, 2004
Journal of Antimicrobial Chemotherapy 2005 55(1):106-109; doi:10.1093/jac/dkh492
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JAC vol.55 no.1 © The British Society for Antimicrobial Chemotherapy 2004; all rights reserved

Rapid flow-cytometric susceptibility testing of Candida species

Bernard Rudensky1, Ellen Broidie1, Amos M. Yinnon2, Tanya Weitzman1, Esther Paz1, Nathan Keller3 and David Raveh2,*

1 Clinical Microbiology Laboratory, and 2 Infectious Disease Unit, Shaare Zedek Medical Center, Jerusalem, affiliated with the Faculty of Health Sciences, Ben Gurion University of the Negev, Be'er Sheva; 3 Infectious Disease Unit, Sheba Medical Center, Tel Aviv, Israel

* Corresponding author. Infectious Diseases Unit, Shaare Zedek Medical Center, P.O. Box 3235, Jerusalem, Israel 91031. Tel: +972-2-6555111; Fax: +972-2-6666342; Email: ravehmed{at}hotmail.com

Objectives: To develop a rapid flow-cytometric antifungal susceptibility test and to compare results with the standard methods.

Methods: Reference and laboratory strains of Candida were tested for susceptibility to fluconazole and echinocandin by fluorescent flow cytometry using Acridine Orange as indicator of viability. Flow cytometry results were compared with MICs as determined by macrodilution and/or Etest.

Results: Seventy Candida strains were tested for susceptibility to fluconazole, and 74 strains for susceptibility to echinocandin. Minimal concentration of fluconazole causing 40% cell damage, as determined by flow cytometry, showed excellent association with MIC, as determined by other methods. The flow method, completed within 5 h, had excellent sensitivity and specificity to distinguish between sensitive, susceptible dose-dependent and resistant strains. The flow cytometry method for echinocandin was completed within 3 h, and minimal concentration causing 50% cell damage was associated with MIC as determined by macrodilution.

Conclusions: Antifungal susceptibility testing by FACS is a reliable, rapid method for determining susceptibility of Candida to fluconazole and echinocandin. The method allows same-day results, assisting in the selection of appropriate antifungal therapy.

Keywords: fungal , MIC , FACS , fluconazole , echinocandin


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