Abstract：
OBJECTIVE: Due to the potential for Aspergillus species to cause lethal infections and the rising rates of antifungal resistance, the significance of antifungal susceptibility tests has increased. We aimed to assess the sensitivities of Aspergillus species to amphotericin B (AMB), voriconazole (VOR), itraconazole (ITZ), and caspofungin (CAS) using disk diffusion (DD) and gradient diffusion (GD) methods and compare them with broth microdilution (BMD) as the reference susceptibility method.
METHODS: The study involved 62 Aspergillus fumigatus, 28 Aspergillus flavus, and 16 Aspergillus terreus isolates, totaling 106 Aspergillus isolates. BMD and DD methods were performed in accordance with CLSI M38-A2 and CLSI M51-A documents, respectively. The GD method utilized nonsupplemented Mueller Hinton agar (MHA) as the medium.
RESULTS: In the BMD method, the lowest minimal inhibitory concentration (MIC)90 or minimal effective concentration (MEC)90 values were observed for VOR and CAS (0.5 μg/mL and 0.06 μg/mL, respectively). AMB and ITZ MIC90 values were both 2 μg/mL. In our comparison of the GD method with the BMD method at ±2 dilution, we observed essential agreement rates of 91.6%, 99.1%, 100%, and 38.6% for AMB, VOR, ITZ, and CAS, respectively. When comparing DD and BMD methods, we found categorical agreement rates of 65.1%, 99.1%, 77.3%, and 100% for AMB, VOR, ITZ, and CAS, respectively. For GD and BMD methods, these rates were 79.2%, 99.1%, 87.8%, and 100%.
CONCLUSIONS: Given the high essential and categorical agreement rates, we posit that the GD method is a viable alternative to the BMD method for AMB, ITZ and VOR but not for CAS. In addition, the use of nonsupplemented MHA in the GD method proves advantageous due to its cost-effectiveness and widespread availability compared to other growth media.
METHODS: The study involved 62 Aspergillus fumigatus, 28 Aspergillus flavus, and 16 Aspergillus terreus isolates, totaling 106 Aspergillus isolates. BMD and DD methods were performed in accordance with CLSI M38-A2 and CLSI M51-A documents, respectively. The GD method utilized nonsupplemented Mueller Hinton agar (MHA) as the medium.
RESULTS: In the BMD method, the lowest minimal inhibitory concentration (MIC)90 or minimal effective concentration (MEC)90 values were observed for VOR and CAS (0.5 μg/mL and 0.06 μg/mL, respectively). AMB and ITZ MIC90 values were both 2 μg/mL. In our comparison of the GD method with the BMD method at ±2 dilution, we observed essential agreement rates of 91.6%, 99.1%, 100%, and 38.6% for AMB, VOR, ITZ, and CAS, respectively. When comparing DD and BMD methods, we found categorical agreement rates of 65.1%, 99.1%, 77.3%, and 100% for AMB, VOR, ITZ, and CAS, respectively. For GD and BMD methods, these rates were 79.2%, 99.1%, 87.8%, and 100%.
CONCLUSIONS: Given the high essential and categorical agreement rates, we posit that the GD method is a viable alternative to the BMD method for AMB, ITZ and VOR but not for CAS. In addition, the use of nonsupplemented MHA in the GD method proves advantageous due to its cost-effectiveness and widespread availability compared to other growth media.
摘要：
目的：由于曲霉菌可能导致致死性感染和抗真菌耐药率上升，抗真菌药敏试验的重要性增加。我们旨在评估曲霉对两性霉素B（AMB）的敏感性，伏立康唑(VOR),伊曲康唑（ITZ），和卡泊芬净（CAS）使用圆盘扩散（DD）和梯度扩散（GD）方法，并将其与肉汤微量稀释（BMD）作为参考磁化率方法进行比较。
方法：本研究涉及62种烟曲霉，28黄曲霉，和16个土曲霉分离株，总计106株曲霉分离物。BMD和DD方法根据CLSIM38-A2和CLSIM51-A文件进行，分别。GD方法使用未补充的MuellerHinton琼脂（MHA）作为培养基。
结果：在BMD方法中，观察到VOR和CAS的最低最低抑制浓度（MIC）90或最低有效浓度（MEC）90值（0.5μg/mL和0.06μg/mL，分别)。AMB和ITZMIC90值均为2μg/mL。在我们对GD方法与BMD方法在±2稀释度的比较中，我们观察到基本协议率为91.6%，99.1%,100%,AMB为38.6%，VOR,ITZ,和CAS,分别。比较DD和BMD方法时，我们发现分类协议率为65.1%，99.1%,77.3%,和100%的AMB，VOR,ITZ,和CAS,分别。对于GD和BMD方法，这些比率是79.2%，99.1%,87.8%,和100%。
结论：鉴于较高的基本和分类协议率，我们认为GD方法是AMBBMD方法的可行替代方法，ITZ和VOR，但不用于CAS。此外,与其他生长培养基相比，在GD方法中使用未补充的MHA具有成本效益和广泛的可用性，因此被证明是有利的。
方法：本研究涉及62种烟曲霉，28黄曲霉，和16个土曲霉分离株，总计106株曲霉分离物。BMD和DD方法根据CLSIM38-A2和CLSIM51-A文件进行，分别。GD方法使用未补充的MuellerHinton琼脂（MHA）作为培养基。
结果：在BMD方法中，观察到VOR和CAS的最低最低抑制浓度（MIC）90或最低有效浓度（MEC）90值（0.5μg/mL和0.06μg/mL，分别)。AMB和ITZMIC90值均为2μg/mL。在我们对GD方法与BMD方法在±2稀释度的比较中，我们观察到基本协议率为91.6%，99.1%,100%,AMB为38.6%，VOR,ITZ,和CAS,分别。比较DD和BMD方法时，我们发现分类协议率为65.1%，99.1%,77.3%,和100%的AMB，VOR,ITZ,和CAS,分别。对于GD和BMD方法，这些比率是79.2%，99.1%,87.8%,和100%。
结论：鉴于较高的基本和分类协议率，我们认为GD方法是AMBBMD方法的可行替代方法，ITZ和VOR，但不用于CAS。此外,与其他生长培养基相比，在GD方法中使用未补充的MHA具有成本效益和广泛的可用性，因此被证明是有利的。
