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Chapter 9 : Commercial Methods for Identification and Susceptibility Testing of Fungi

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Abstract:

The methods described in this chapter are meant to represent those that are commercially available, Food and Drug Administration-approved, and published in peer-reviewed journals. The advantages of the nonautomated and automated identification systems discussed in the chapter include the fact that identification is based on databases that include a variety of substrate utilization patterns and that contain many yeast biotypes. Reproducibility was determined as results were compared in an interlaboratory study with broth macrodilution as the reference standard. In this report, the E test quality control limits were 1 dilution greater (4 dilutions overall) than those of the NCCLS broth tube macrodilution method for the following combinations: ketoconazole with and amphotericin B and ketoconazole with . When the Premier EIA method was compared to the microimmunodiffusion (MID) test and the laboratory CF test for a total of 168 sera, including 68 from proven cases of histoplasmosis, the sensitivity of the EIA for IgG was 97%and that of the MID was 100%, and the specificities were 84 and 100%, respectively. In this study, three sera from histoplasmosis patients which were positive for the histoplasmin antigens tested negative for IgG, specific precipitins, and complement-fixing antibodies. Due to the interest in rapid, cost-effective testing for fungi, the pace and number of publications devoted to diagnostic practices in clinical mycology laboratories are growing.

Citation: Wolk D, Roberts G. 2002. Commercial Methods for Identification and Susceptibility Testing of Fungi, p 225-255. In Truant A (ed), Manual of Commercial Methods in Clinical Microbiology. ASM Press, Washington, DC. doi: 10.1128/9781555817961.ch9

Key Concept Ranking

Antifungal Agents
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Fungal Infections
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Candida albicans
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Figures

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FIGURE 1

BactiCardCandida. Courtesy of Remel.

Citation: Wolk D, Roberts G. 2002. Commercial Methods for Identification and Susceptibility Testing of Fungi, p 225-255. In Truant A (ed), Manual of Commercial Methods in Clinical Microbiology. ASM Press, Washington, DC. doi: 10.1128/9781555817961.ch9
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Image of FIGURE 2
FIGURE 2

Uni-N/F Tek and Uni-Yeast-Tek plates (uninoculated and inoculated). Courtesy of Remel.

Citation: Wolk D, Roberts G. 2002. Commercial Methods for Identification and Susceptibility Testing of Fungi, p 225-255. In Truant A (ed), Manual of Commercial Methods in Clinical Microbiology. ASM Press, Washington, DC. doi: 10.1128/9781555817961.ch9
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Image of FIGURE 3
FIGURE 3

(A) Inoculation of the API 20 C (Biomerieux Vitek) strip for identification of yeast isolates. Each strip contains microcupules containing dehydrated substrates, which are rehydrated and examined to determine their ability to support the growth of yeast isolates. (B) Close-up view of substrate utilization by a yeast isolate. Positive reactions appear cloudy in comparison to the negative (0) control.

Citation: Wolk D, Roberts G. 2002. Commercial Methods for Identification and Susceptibility Testing of Fungi, p 225-255. In Truant A (ed), Manual of Commercial Methods in Clinical Microbiology. ASM Press, Washington, DC. doi: 10.1128/9781555817961.ch9
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Image of FIGURE 4
FIGURE 4

The RapID Yeast Plus System (Innovative Diagnostic Systems and Remel).

Citation: Wolk D, Roberts G. 2002. Commercial Methods for Identification and Susceptibility Testing of Fungi, p 225-255. In Truant A (ed), Manual of Commercial Methods in Clinical Microbiology. ASM Press, Washington, DC. doi: 10.1128/9781555817961.ch9
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Image of FIGURE 5
FIGURE 5

API Yeast-Ident.

Citation: Wolk D, Roberts G. 2002. Commercial Methods for Identification and Susceptibility Testing of Fungi, p 225-255. In Truant A (ed), Manual of Commercial Methods in Clinical Microbiology. ASM Press, Washington, DC. doi: 10.1128/9781555817961.ch9
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Image of FIGURE 6
FIGURE 6

Identicult-Albicans.

Citation: Wolk D, Roberts G. 2002. Commercial Methods for Identification and Susceptibility Testing of Fungi, p 225-255. In Truant A (ed), Manual of Commercial Methods in Clinical Microbiology. ASM Press, Washington, DC. doi: 10.1128/9781555817961.ch9
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Image of FIGURE 7
FIGURE 7

The Microscan Rapid Yeast Identification Panel. Courtesy of Dade Microscan.

Citation: Wolk D, Roberts G. 2002. Commercial Methods for Identification and Susceptibility Testing of Fungi, p 225-255. In Truant A (ed), Manual of Commercial Methods in Clinical Microbiology. ASM Press, Washington, DC. doi: 10.1128/9781555817961.ch9
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References

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Tables

Generic image for table
TABLE 1

Comparison of commercial methods for cryptococcal antigen testing

Citation: Wolk D, Roberts G. 2002. Commercial Methods for Identification and Susceptibility Testing of Fungi, p 225-255. In Truant A (ed), Manual of Commercial Methods in Clinical Microbiology. ASM Press, Washington, DC. doi: 10.1128/9781555817961.ch9
Generic image for table
TABLE 2

Comparison of commercial methods for antigen testing

Citation: Wolk D, Roberts G. 2002. Commercial Methods for Identification and Susceptibility Testing of Fungi, p 225-255. In Truant A (ed), Manual of Commercial Methods in Clinical Microbiology. ASM Press, Washington, DC. doi: 10.1128/9781555817961.ch9
Generic image for table
TABLE 3

Comparison of Isolator method (Wampole) with other blood culture methods and systems

Citation: Wolk D, Roberts G. 2002. Commercial Methods for Identification and Susceptibility Testing of Fungi, p 225-255. In Truant A (ed), Manual of Commercial Methods in Clinical Microbiology. ASM Press, Washington, DC. doi: 10.1128/9781555817961.ch9
Generic image for table
Table 4

Comparison of commercial fungal identification methods

Citation: Wolk D, Roberts G. 2002. Commercial Methods for Identification and Susceptibility Testing of Fungi, p 225-255. In Truant A (ed), Manual of Commercial Methods in Clinical Microbiology. ASM Press, Washington, DC. doi: 10.1128/9781555817961.ch9
Generic image for table
Table 5

Agreement of methods for susceptibility testing of yeasts

Citation: Wolk D, Roberts G. 2002. Commercial Methods for Identification and Susceptibility Testing of Fungi, p 225-255. In Truant A (ed), Manual of Commercial Methods in Clinical Microbiology. ASM Press, Washington, DC. doi: 10.1128/9781555817961.ch9

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