Abstract
The feasibility of flow cytometric antifungal susceptibility testing has been
studied using the fluorescent anionic membrane potential probe,
bis-(1,3-dibutylbarbituric acid) trimethine oxonol [DiBAC4(3)]. The in vitro
antifungal susceptibility testing of amphotericin B was performed on 8 Candida
isolates from clinical specimens and 2 ATCC strains by flow cytometry with the
results compared to those of the National Committee of Clinical Laboratory
Standards (NCCLS) M27-T, broth macrodilution method. The flow cytometric method
is based on an increase of fluorescence given out by DiBAC4(3) in fungi when
they are killed by antifungal agents. Minimum inhibitory concentration (MIC) of
amphotericin B ranged from 0.25 to 1 µg/mL. All results agreed within ±2
dilution between the flow cytometric method and the M27-T method. MIC with ATCC
strains were within recommended ranges of M27-T. The new flow cytometric method
revealed a clear and distinct reproducible test end point. A four hr of
incubation was sufficient for the test. In conclusion, flow cytometry using
DiBAC4(3) is a rapid and accurate in vitro antifungal susceptibility testing
method.