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Journal of Clinical Microbiology, November 2007, p. 3522-3528, Vol. 45, No. 11
0095-1137/07/$08.00+0     doi:10.1128/JCM.00403-07
Copyright © 2007, American Society for Microbiology. All Rights Reserved.

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.

M. A. Pfaller,^1* D. J. Diekema,¹ G. W. Procop,^2, and M. G. Rinaldi³

University of Iowa College of Medicine, Iowa City, Iowa,¹ Cleveland Clinic Foundation, Cleveland, Ohio,² University of Texas Health Science Center, San Antonio, Texas³

Received 21 February 2007/ Returned for modification 17 April 2007/ Accepted 18 June 2007

A fully automated commercial antifungal susceptibility test system (VITEK 2; bioMérieux, Inc., Hazelwood, MO) was compared in three different laboratories with the Clinical and Laboratory Standards Institute (formerly the NCCLS) reference broth microdilution method (BMD) by testing 2 quality control strains, 10 reproducibility strains, and 426 isolates of Candida spp. against amphotericin B, flucytosine, and voriconazole. Reference BMD MIC endpoints were established after 24 and 48 h of incubation. VITEK 2 system MIC endpoints were determined spectrophotometrically after 9.1 to 27.1 h of incubation (mean, 12 to 14 h). Excellent essential agreement (within 2 dilutions) between the VITEK 2 system and the 24- and 48-h BMD MICs was observed for all three antifungal agents: amphotericin B, 99.1% and 97%, respectively; flucytosine, 99.1% and 98.8%, respectively; and voriconazole, 96.7% and 96%, respectively. Both intra- and interlaboratory agreements were >98% for all three drugs. The overall categorical agreements between the VITEK 2 system and BMD for flucytosine and voriconazole were 98.1 to 98.6% at the 24-h BMD time point and 96.9 to 97.4% at the 48-h BMD time point. The VITEK 2 system reliably detected flucytosine and voriconazole resistance among Candida spp. and demonstrated excellent quantitative and qualitative agreement with the reference BMD method.

Published ahead of print on 3 October 2007.

Present address: University of Miami, Miami, FL.