This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrowReprints and Permissions
Right arrow Copyright Information
Right arrow Books from ASM Press
Right arrow MicrobeWorld
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Pfaller, M. A.
Right arrow Articles by Diekema, D. J.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Pfaller, M. A.
Right arrow Articles by Diekema, D. J.

 Previous Article  |  Next Article 

Journal of Clinical Microbiology, August 2004, p. 3607-3612, Vol. 42, No. 8
0095-1137/04/$08.00+0     DOI: 10.1128/JCM.42.8.3607-3612.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.

Comparison of Results of Fluconazole Disk Diffusion Testing for Candida Species with Results from a Central Reference Laboratory in the ARTEMIS Global Antifungal Surveillance Program

M. A. Pfaller,1,2* K. C. Hazen,3 S. A. Messer,1 L. Boyken,1 S. Tendolkar,1 R. J. Hollis,1 and D. J. Diekema1,4

Departments of Pathology,1 Epidemiology,2 Medicine, Roy J. and Lucille A. Carver College of Medicine and College of Public Health, University of Iowa, Iowa City, Iowa 52242,4 Department of Pathology, University of Virginia, Charlottesville, Virginia3

Received 10 February 2004/ Returned for modification 4 April 2004/ Accepted 24 April 2004

The accuracy of antifungal susceptibility tests is important for accurate resistance surveillance and for the clinical management of patients with serious infections. Our main objective was to compare the results of fluconazole disk diffusion testing of Candida spp. performed by ARTEMIS participating centers with disk diffusion and MIC results obtained by the central reference laboratory. A total of 2,949 isolates of Candida spp. were tested by NCCLS disk diffusion and reference broth microdilution methods in the central reference laboratory. These results were compared to the results of disk diffusion testing performed in the 54 participating centers. All tests were performed and interpreted following NCCLS recommendations. Overall categorical agreement between participant disk diffusion test results and reference laboratory MIC results was 87.4%, with 0.2% very major errors (VME) and 3.3% major errors (ME). The categorical agreement between the disk diffusion test results obtained in the reference laboratory with the MIC test results was similar: 92.8%. Likewise, good agreement was observed between participant disk diffusion test results and reference laboratory disk diffusion test results: 90.4%, 0.4% VME, and 3.4% ME. The disk diffusion test was especially reliable in detecting those isolates of Candida spp. that were characterized as resistant by reference MIC testing. External quality assurance data obtained by surveillance programs such as the ARTEMIS Global Antifungal Surveillance Program ensure the generation of useful surveillance data and result in the continued improvement of antifungal susceptibility testing practices.

* Corresponding author. Mailing address: Medical Microbiology Division, C606 GH, Department of Pathology, University of Iowa College of Medicine, Iowa City, IA 52242. Phone: (319) 384-9566. Fax: (319) 356-4916. E-mail: michael-pfaller{at}uiowa.edu.

Journal of Clinical Microbiology, August 2004, p. 3607-3612, Vol. 42, No. 8
0095-1137/04/$08.00+0     DOI: 10.1128/JCM.42.8.3607-3612.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.



This article has been cited by other articles:

  • Pfaller, M. A., Diekema, D. J., Gibbs, D. L., Newell, V. A., Bijie, H., Dzierzanowska, D., Klimko, N. N., Letscher-Bru, V., Lisalova, M., Muehlethaler, K., Rennison, C., Zaidi, M., the Global Antifungal Surveillance Group, (2009). Results from the ARTEMIS DISK Global Antifungal Surveillance Study, 1997 to 2007: 10.5-Year Analysis of Susceptibilities of Noncandidal Yeast Species to Fluconazole and Voriconazole Determined by CLSI Standardized Disk Diffusion Testing. J. Clin. Microbiol. 47: 117-123 [Abstract] [Full Text]  
  • Pfaller, M. A., Boyken, L. B., Hollis, R. J., Kroeger, J., Messer, S. A., Tendolkar, S., Diekema, D. J. (2008). Validation of 24-Hour Fluconazole MIC Readings versus the CLSI 48-Hour Broth Microdilution Reference Method: Results from a Global Candida Antifungal Surveillance Program. J. Clin. Microbiol. 46: 3585-3590 [Abstract] [Full Text]  
  • Johnson, E. M. (2008). Issues in antifungal susceptibility testing. J Antimicrob Chemother 61: i13-i18 [Abstract] [Full Text]  
  • Pfaller, M. A., Diekema, D. J., Procop, G. W., Rinaldi, M. G. (2007). Multicenter Comparison of the VITEK 2 Antifungal Susceptibility Test with the CLSI Broth Microdilution Reference Method for Testing Amphotericin B, Flucytosine, and Voriconazole against Candida spp.. J. Clin. Microbiol. 45: 3522-3528 [Abstract] [Full Text]  
  • Pfaller, M. A., Diekema, D. J., Gibbs, D. L., Newell, V. A., Meis, J. F., Gould, I. M., Fu, W., Colombo, A. L., Rodriguez-Noriega, E., and the Global Antifungal Surveillance Group, (2007). Results from the ARTEMIS DISK Global Antifungal Surveillance Study, 1997 to 2005: an 8.5-Year Analysis of Susceptibilities of Candida Species and Other Yeast Species to Fluconazole and Voriconazole Determined by CLSI Standardized Disk Diffusion Testing. J. Clin. Microbiol. 45: 1735-1745 [Abstract] [Full Text]  
  • Pfaller, M. A., Diekema, D. J., Procop, G. W., Rinaldi, M. G. (2007). Multicenter Comparison of the VITEK 2 Yeast Susceptibility Test with the CLSI Broth Microdilution Reference Method for Testing Fluconazole against Candida spp.. J. Clin. Microbiol. 45: 796-802 [Abstract] [Full Text]  
  • Pfaller, M. A., Diekema, D. J. (2007). Epidemiology of Invasive Candidiasis: a Persistent Public Health Problem. Clin. Microbiol. Rev. 20: 133-163 [Abstract] [Full Text]  
  • Pfaller, M. A., Diekema, D. J., Mendez, M., Kibbler, C., Erzsebet, P., Chang, S.-C., Gibbs, D. L., Newell, V. A., the Global Antifungal Surveillance Group, (2006). Candida guilliermondii, an Opportunistic Fungal Pathogen with Decreased Susceptibility to Fluconazole: Geographic and Temporal Trends from the ARTEMIS DISK Antifungal Surveillance Program.. J. Clin. Microbiol. 44: 3551-3556 [Abstract] [Full Text]  
  • Pfaller, M. A., Diekema, D. J., Colombo, A. L., Kibbler, C., Ng, K. P., Gibbs, D. L., Newell, V. A., the Global Antifungal Surveillance Group, (2006). Candida rugosa, an Emerging Fungal Pathogen with Resistance to Azoles: Geographic and Temporal Trends from the ARTEMIS DISK Antifungal Surveillance Program.. J. Clin. Microbiol. 44: 3578-3582 [Abstract] [Full Text]  
  • Pfaller, M. A., Diekema, D. J., Sheehan, D. J. (2006). Interpretive Breakpoints for Fluconazole and Candida Revisited: a Blueprint for the Future of Antifungal Susceptibility Testing. Clin. Microbiol. Rev. 19: 435-447 [Abstract] [Full Text]  
  • Pfaller, M. A., Diekema, D. J., Rex, J. H., Espinel-Ingroff, A., Johnson, E. M., Andes, D., Chaturvedi, V., Ghannoum, M. A, Odds, F. C., Rinaldi, M. G., Sheehan, D. J., Troke, P., Walsh, T. J., Warnock, D. W. (2006). Correlation of MIC with Outcome for Candida Species Tested against Voriconazole: Analysis and Proposal for Interpretive Breakpoints.. J. Clin. Microbiol. 44: 819-826 [Abstract] [Full Text]  
  • Pfaller, M. A., Diekema, D. J., Rinaldi, M. G., Barnes, R., Hu, B., Veselov, A. V., Tiraboschi, N., Nagy, E., Gibbs, D. L., the Global Antifungal Surveillance Group, (2005). Results from the ARTEMIS DISK Global Antifungal Surveillance Study: a 6.5-Year Analysis of Susceptibilities of Candida and Other Yeast Species to Fluconazole and Voriconazole by Standardized Disk Diffusion Testing. J. Clin. Microbiol. 43: 5848-5859 [Abstract] [Full Text]  
  • Pfaller, M. A., Boyken, L., Messer, S. A., Tendolkar, S., Hollis, R. J., Diekema, D. J. (2005). Comparison of Results of Voriconazole Disk Diffusion Testing for Candida Species with Results from a Central Reference Laboratory in the ARTEMIS Global Antifungal Surveillance Program. J. Clin. Microbiol. 43: 5208-5213 [Abstract] [Full Text]  
  • Espinel-Ingroff, A., Barchiesi, F., Cuenca-Estrella, M., Fothergill, A., Pfaller, M. A., Rinaldi, M., Rodriguez-Tudela, J. L., Verweij, P. E. (2005). Comparison of Visual 24-Hour and Spectrophotometric 48-Hour MICs to CLSI Reference Microdilution MICs of Fluconazole, Itraconazole, Posaconazole, and Voriconazole for Candida spp.: a Collaborative Study. J. Clin. Microbiol. 43: 4535-4540 [Abstract] [Full Text]  
  • Klevay, M., Ebinger, A., Diekema, D., Messer, S., Hollis, R., Pfaller, M. (2005). Disk Diffusion Testing Using Candida sp. Colonies Taken Directly from CHROMagar Candida Medium May Decrease Time Required To Obtain Results. J. Clin. Microbiol. 43: 3497-3499 [Abstract] [Full Text]  


Copyright © 2009 by the American Society for Microbiology.   For an alternate route to Journals.ASM.org, visit: http://intl-journals.asm.org | More Info»