Candida 균종의 Fluconazole 감수성 검사 시 Glucose와 Methylene blue를 첨가한 Mueller-Hinton 배지에서의 디스크 확산법 평가 = Evaluation of Disk Diffusion Test with Glucose- and Methylene blue-Enriched Mueller-Hinton Agar for SusceptibilityTesting of Fluconazole against Candida Isolates

다국어 초록 (Multilingual Abstract)

Background : Recently, the disk diffusion testing of fluconazole against Candida spp. has been attempted in order to provide a simple inexpensive method in the routine laboratory. We investigated the possibility and reliability of a fluconazole disk diffusion method using a Mueller-Hinton agar supplemented with glucose and methylene blue (GM-MH). Methods : One hundred and seven isolates of Candida spp. (54 C. albicans, 21 C. glabrata, 20 C. tropicalis, 6 C. parapsilosis, 4 C. krusei, and 2 C. lusitaniae) were tested with the broth microdilution method of National Committee for Clinical Laboratory Standards (NCCLS) document M27-A2 and a disk diffusion test using GM-MH agar. Results : The overall categorical agreement between the NCCLS method and the disk diffusion method was 89.8% for fluconazole, with 0.9% very major errors and 9.3% minor errors; no major errors were detected. Conclusions : These data suggest that the fluconazole disk diffusion test on GM-MH agar can be used as a routine screening procedure for susceptibility of Candida spp. in the clinical laboratory.

국문 초록 (Abstract)

배경 : 디스크 확산을 이용한 항진균제 감수성 검사는 경제적이고 간편하여 일상 검사실에서 사용하기에 적합하므로, 최근 Can-dida 균종에서의 fluconazole 디스크 확산법이 시도되고 있다. 이에 본 연구에서는 Candida 균종을 대상으로 glucose와 methyleneblue를 첨가한 Mueller-Hinton (GM-MH) 배지를 이용한 flucona-zole 디스크 확산법의 검사실 도입 시 그 유용성을 평가하고자 하였다.방법 : 각종 임상검체에서 분리된 107균주(C. albicans 54균주,C. glabrata 21균주, C. tropicalis20균주, C. parapsilosis6균주,C. krusei 4균주, C. lusitaniae 2균주)의 Candida 균종에서 GM-MH 배지를 사용한 디스크 확산법과 National Committee forClinical Laboratory Standards (NCCLS) document M27-A2에 의한 항진균제 감수성 검사를 시행하였다.결과 : Fluconazole에 대한 항진균제 감수성 검사는 89.8%의 일치율을 보였으며, 두 방법간 불일치를 보인 균주들은 broth mic-rodilution법으로 내성인 균주가 디스크확산법에서 감수성으로 판Fluconazole 감수성 검사를 위한 GM-MH 디스크 확산법 251독된 경우(very major error, VME)가 0.9%, 한 방법에서 약용량의존 감수성을 보인 균주가 다른 방법에서 감수성 또는 내성으로판독된 경우(minor error, M)가 9.3%였으며, broth microdilu-tion법에서 감수성인 균주가 디스크 확산법에서 내성으로 판독된경우(major error, ME)는 없었다.
결론 : Candida 균종에서의 GM-MH 배지를 사용한 디스크 확산법은 표준 검사법과 좋은 일치를 보여 항생제 검사와 마찬가지로 일반 검사실에 도입하기에 적합한 것으로 사료되었다.

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