Rapid antifungal susceptibility testing from positive blood cultures using direct gradient diffusion: a prospective study.

IF 2.2

Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia Pub Date : 2026-09-29 DOI:10.37201/req/196.2026

Lucía Gómez-Barral, Diego González-Polo, Blanca Burgoa-Rubido, Juan Luis Muñoz-Bellido, Josué Pendones-Ulerio

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Abstract

Objective: To evaluate the agreement between direct gradient diffusion (DGD), performed directly from positive blood culture bottles, and the Sensititre™ YeastOne™ (SYO) method for antifungal susceptibility testing in Candida spp.

Methods: A prospective observational study including blood cultures positive for yeasts between June and October 2024 was conducted. DGD (ETEST^®) was performed directly from blood culture broth and compared with SYO. The antifungal agents evaluated were anidulafungin, micafungin, caspofungin, fluconazole, voriconazole, and amphotericin B. Categorical agreement (CA) and essential agreement (EA) were analyzed.

Results: A total of 32 Candida isolates were included. Overall CA was 90%, whereas EA was 60.6%. CA was 100% for amphotericin B, 92.5% for azoles, and 86% for echinocandins. No very major errors were observed. However, all Candida parapsilosis isolates showed major errors for anidulafungin, appearing resistant by DGD and susceptible by SYO. All DGD results were interpretable after 24 hours.

Conclusions: DGD performed directly from positive blood culture bottles provides early antifungal susceptibility results with high CA and markedly reduced turnaround time. However, caution is required when interpreting anidulafungin resistance in C. parapsilosis. This approach may serve as an adjunctive tool for early optimization of antifungal therapy.

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使用直接梯度扩散的阳性血培养快速抗真菌药敏试验：一项前瞻性研究。

目的：评价直接从阳性血培养瓶中提取的直接梯度扩散法（DGD）与Sensititre™YeastOne™（SYO）法对念珠菌抗真菌药敏试验的一致性。方法：对2024年6 - 10月酵母阳性血培养物进行前瞻性观察研究。DGD （ETEST®）直接从血培养液中进行，并与SYO进行比较。评价抗真菌药物为阿尼杜冯宁、米卡冯宁、卡泊冯宁、氟康唑、伏立康唑和两性霉素b。分析了分类一致性（CA）和基本一致性（EA）。结果：共分离念珠菌32株。总的CA为90%，而EA为60.6%。两性霉素B的CA为100%，唑类为92.5%，棘白菌素为86%。没有观察到非常大的错误。然而，所有假丝酵母菌分离株对抗假丝酵母菌素均存在较大的错误，表现为DGD耐药，SYO敏感。所有DGD结果在24小时后可解释。结论：直接从阳性血培养瓶进行DGD可提供高CA的早期抗真菌药敏结果，并显著缩短周转时间。然而，在解释假丝枯菌的抗药性时需要谨慎。该方法可作为早期优化抗真菌治疗的辅助工具。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia

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