The Advocate - June 8, 1961

Original title (1951-1987)--The Advocate: official publication of the Archdiocese of Newark (N.J.)

Short communication: Comparison of minimum inhibitory and minimum effective concentration values for the detection of in vitro susceptibilities of Aspergillus species against caspofungin

WOS: 000246913000015PubMed ID: 17682716Caspofungin is a promising echinocandin-group antifungal agent used especially in the treatment of resistant invasive aspergillosis. The guidelines for in vitro susceptibility testing of Aspergillus species against caspofungin are not described by the Clinical and Laboratory Standards Institute (CLSI). The minimum inhibitory concentration that showed a prominent reduction of growth (MIC-2) and minimum effective concentration (MEC) endpoints are frequently used for the susceptibility testing of caspofungin as MIC determination criteria. The aim of this study was to evaluate the in vitro activity of caspofungin against Aspergillus species and to compare MIC-2 and MEC endpoints in the determination of MICs. A total of 32 Aspergillus species (18 A.fumigatus, seven A.flavus, five A.niger, and two A.versicolor) isolated from different clinical samples were included to the study. In vitro susceptibilities of the strains against 0.03-16 mu g/ml caspofungin concentrations were searched by broth microdilution method as recommended by CLSI M-38A document, with the use of glucose supplemented 2% RPIVII 1640 media. The MIC-2 and MEC endpoints were determined both at 24 and 48 hours. The concordance between MIC-2 and MEC endpoints of the strains at 24 and 48 hours incubations was found as 53% and 100%, respectively, with the difference of 1 dilution. MIC-2 and MEC measurements showed the same values at the end of 48 hours, whereas 7% showed differences in 1 dilution. MEC endpoints were also found to be more stable than MIC-2 in both of the incubation periods. In conclusion, MEC value is a more objective and stable endpoint and easier to use than MIC-2 for testing in vitro caspofungin activity against Aspergillus species

Do incubation temperature, incubation time, and carbon dioxide affect the chromogenic properties of CHROMagar?

WOS: 000309796300005Aim: On CHROMagar medium Candida species form different colors; thus, the medium enables the differentiation of these species from each other as well as from other Candida species. The aim of this study is to investigate the effect of incubation temperatures, incubation times, and CO2 on the chromogenic properties of CHROMagar. Materials and methods: A total of 112 strains of Candida spp. were used. A 0.5 McFarland suspension of each strain was inoculated onto CHROMagar with a calibrated loop and incubated at 26 degrees C and 35 degrees C for 24-48 h in normal atmosphere and in an atmosphere of 5% CO2. The results were evaluated at the end of 24 and 48 h by 2 of the authors working in strict separation. Results: The chromogenic property of the medium was best observed at an incubation temperature of 35 degrees C. Incubation in an atmosphere of 5% CO2 yielded more prominent colonies at the end of 48 h. The chromogenic differentiation of C. dubliniensis from C. albicans was not easy, for C. albicans yielded a green color and C. dubliniensis a somewhat darker green color. Conclusion: To obtain the best results with CHROMagar, the medium should be incubated at 35 degrees C for 48 h in an atmosphere of 5% CO2. A control C. albicans strain should be inoculated on each medium plate to differentiate the color tones of C. albicans and C. dubliniensis

Evaluation of Antifungal Susceptibility Testing with Microdilution and Etest Methods of Candida Blood Isolates

WOS: 000293000600003PubMed ID: 21424603Candida species that show an increasing number of clinical and/or microbiological resistance to several antifungals and are the most common agents of invasive fungal infections. The aim of this study was to investigate the in vitro susceptibility of Candida blood isolates to antifungal agents (amphotericin B, fluconazole, itraconazole, and voriconazole) by comparative use of the CLSI reference microdilution method and Etest. Four hundred Candida blood isolates (215 Candida albicans, 185 non-albicans Candida strains) were included in the study. The broth microdilution test was performed according to the CLSI M27 A2 document. Etest was carried out according to the manufacturer's instructions. The MIC results obtained with reference microdilution were compared with those obtained with the Etest by using percent and categorical agreements. According to MIK90 values, voriconazole was the most active and itraconazole was the least active drug in vitro against all Candida species. Other than voriconazole, statistically significant differences were found when the susceptibility of Candida albicans and non-albicans Candida spp. to amphotericin B, fluconazole, and itraconazole were compared. These antifungal agents were found to be more active to C. albicans. Among the non-albicans Candida species, the lowest MIC values were obtained for Candida parapsilosis isolates. When the standard method was compared with Etest, the total agreement was higher for C. albicans than for non-albicans species, especially for fluconazole and voriconazole. In view of the findings, it was concluded that itraconazole showed the lowest activity against all Candida species. Etest could be an alternative method in assessing the in vitro antifungal susceptibility of Candida spp., but it is more convenient to use the microdilution method for studying in vitro susceptibility of non-albicans species, in particular for those possessing high MIC values against azoles.Ege UniversityEge University [04 TIP 029]This study was supported by Ege University Scientific Research Fund (Research 04 TIP 029). We would like to thank Gul Kitapcioglu for statistical analysis

Inguinal Flap Implementation In Diabetic Hand Infection With Complicated Invasive Candidiasis

WOS: 000219732100002Although hand infections in diabetic patients are observed less frequently than foot infections, hand infections may cause severe problems, such as stiffness and loss of skin, nerve and bone persisting even after the infection resolves. Invasive soft tissue fungal infections are very rare among diabetes-related limb infections. In this report, we present a case of diabetic hand infection with invasive candidiasis. A 53-year-old female patient was admitted to our Ege University Diabetic Foot Council with necrosis and bullae at the tip of the third finger of her right hand. For surgical treatment, wound debridement and amputation were performed and a broad-spectrum antibiotic treatment was started. The tissue culture yielded Candida albicans and the patient was successfully treated with fluconazole. Inguinal flap operation was performed after antifungal ( fluconazole) therapy. However, purulent discharge and ischemia with superficial necrosis of the flap developed on follow up. Thereupon, surgical debridement was performed again and antibiotic treatment was started. With the treatment of infection, flap success was achieved. Routine evaluation during follow-up of the patient revealed that eight months after the operation, the wound completely healed

Anidulafungin treatment for fluconazole-resistant Candida albicans vaginitis with cross-resistance to azoles: a case report

Akdag, Damla/0000-0003-1700-7578WOS: 000527580200001PubMed: 32312119[No abstract available