Abstract
We determined the susceptibility of 102 clinical isolates Cryptococcus neoformans from Durban, South Africa, to amphotericin B, fluconazole, flucytosine, and voriconazole using broth microdilution (BMD) according to the Clinical and Laboratory Standards Institute M27-A3 document and compared these results with Etest and Vitek 2®. Essential agreement (EA) of Etest and Vitek 2® compared to BMD was determined. Low MICs that were below the epidemiological cutoff values of the 4 antifungal agents tested were demonstrated by all isolates. The EA of Etests for fluconazole, amphotericin, and voriconazole was 95.1%, 83.3%, and 91.2%, respectively, and for Vitek 2® EA for fluconazole, amphotericin, and flucytosine was 97.1%, 95.1%, and 97.1%, respectively. The Vitek 2® showed good agreement with BMD and is a suitable alternative. Etests demonstrated good EA for azoles only. Clinical cryptococcal isolates from Durban remain susceptible to current recommended antifungal therapy.
•Low MIC of antifungal drugs was exhibited by isolates of C. neoformans from Durban.•Vitek 2® compared well with broth microdilution (BMD) for fluconazole, amphotericin, and flucytosine.•Etests can be used instead of BMD for testing fluconazole and voriconazole.•Amphotericin B Etests were less reliable and gave lower MIC results than BMD.•MIC testing using flucytosine Etests cannot be recommended for C. neoformans.