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Revista CON-CIENCIA
versão impressa ISSN 2310-0265
Resumo
CALDERON MORALES, Raquel e VARGAS NATTEZ, Sandra Grisel. Validation of the commercial method ATB FUNGUS 3 against the reference method M27-A2, to determine the susceptibility of Candida albicans to different antifungals. Rev.Cs.Farm. y Bioq [online]. 2021, vol.9, n.1, pp.46-62. ISSN 2310-0265.
ABSTRACT Introduction: The higher incidence of mycoses has generated the need to develop in vitro techniques for susceptilility study to antifungal agents. CLSI M27-A2 is a reference method for yeast susceptibility studies. However, this method does not meet the needs of routine laboratories because it is difficult to follow all the processes. Consequently, alternative methods arise due to the need for simpler techniques. Then, one of them is ATB FUNGUS 3 which allows determining Candida’s sensitivity to different antifungal agents. Objective: Validate the commercial method ATB FUNGUS 3 compared with the reference method M27-A2 in order to know its diagnostic value. Material and Methods: Efficacy was determined by diagnostic test parameters. Moreover, sensitivity of 50 strains of Candida albicans at Fluconazole (FLZ) and Itraconazole (ITZ) was evaluated by the commercial and reference methods. Results: ATB - FUNGUS 3 presents a specificity for FLZ of 100%, sensitivity of 91%, positive predictive value (PPV) 56%, negative predictive value (NPV) 100% with a diagnostic efficacy of 92 %, calculated for a 95% confidence interval (CI). For ITZ, the specificity and sensitivity were 88% and 90% respectively, with a PPV 64%, a NPV 97% with a diagnostic efficacy of 90%, 95% CI. For the concordance tests, the Kappa index for FLZ and ITZ was 0.67 and 0.68 respectively. The Likelihood ratio test for FLZ was (LR +) of 11.25 while the (LR-) was 0; for ITZ (LR +) of 9.19 and the (LR-) was 0.14. Reproducibility of 90% (FLZ) and 85% (ITZ). Conclusions: The ATB FUNGUS 3 is a fast, easy and reproducible technique. However the overall performance of the technique suggests that this method hasn’t been reliable for diagnostic laboratorie yet, because PPVS obtained low values. These PPVS indicate that it could lead to errors when determining a strain as sensitive or resistant. This is an important point when deciding the therapeutic conduct.
Palavras-chave : Candida albicans; Antifungals; Susceptibility studies; Reference method M27 -A2; Diagnostic test.
