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Journal of Clinical Microbiology, July 2001, p. 2458-2462, Vol. 39, No. 7
0095-1137/01/$04.00+0   DOI: 10.1128/JCM.39.7.2458-2462.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.

Antifungal Susceptibility Testing of Fluconazole by Flow Cytometry Correlates with Clinical Outcome

Christoph Wenisch,^1,* Caroline B. Moore,² Robert Krause,¹ Elisabeth Presterl,³ Peter Pichna,³ and David W. Denning²

Division of Infectious Diseases, Department of Medicine, Karl-Franzens University, Graz,¹ and Division of Infectious Diseases, Department of Medicine, University Hospital, Vienna,³ Austria, and Department of Microbiology, Hope Hospital, Manchester, United Kingdom²

Received 5 February 2001/Returned for modification 7 March 2001/Accepted 24 April 2001

Susceptibility testing of fungi by flow cytometry (also called fluorescence-activated cell sorting [FACS]) using vital staining with FUN-1 showed a good correlation with the standard M27-A procedure for assessing MICs. In this study we determined MICs for blood culture isolates from patients with candidemia by NCCLS M27-A and FACS methods and correlated the clinical outcome of these patients with in vitro antifungal resistance test results. A total of 24 patients with candidemia for whom one or more blood cultures were positive for a Candida sp. were included. Susceptibility testing was performed by NCCLS M27-A and FACS methods. The correlation of MICs (NCCLS M27-A and FACS) and clinical outcome was calculated. In 83% of the cases, the MICs of fluconazole determined by FACS were within 1 dilution of the MICs determined by the NCCLS M27-A method. For proposed susceptibility breakpoints, there was 100% agreement between the M27-A and FACS methods. In the FACS assay, a fluconazole MIC of <1 µg/ml was associated with cure (P < 0.001) whereas an MIC of 1 µg/ml was associated with death (P < 0.001). The M27-A-derived fluconazole MICs did not correlate with outcome (P = 1 and P = 0.133).

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^* Corresponding author. Mailing address: Division of Infectious Diseases, Department of Medicine, Karl-Franzens University Graz, Auenbruggerplatz 15, A-8036 Graz, Austria. Phone: 43 0 316/385-28 63. Fax: 43 0 316/385-30 62. E-mail: christoph.wenisch{at}kfunigraz.ac.at.

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Journal of Clinical Microbiology, July 2001, p. 2458-2462, Vol. 39, No. 7
0095-1137/01/$04.00+0   DOI: 10.1128/JCM.39.7.2458-2462.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.

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