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Journal of Clinical Microbiology, November 2008, p. 3585-3590, Vol. 46, No. 11
0095-1137/08/$08.00+0     doi:10.1128/JCM.01391-08
Copyright © 2008, American Society for Microbiology. All Rights Reserved.

Validation of 24-Hour Fluconazole MIC Readings versus the CLSI 48-Hour Broth Microdilution Reference Method: Results from a Global Candida Antifungal Surveillance Program {triangledown}

M. A. Pfaller,1,2* L. B. Boyken,1 R. J. Hollis,1 J. Kroeger,1 S. A. Messer,1 S. Tendolkar,1 and D. J. Diekema1,3

Departments of Pathology,1 Epidemiology,2 Internal Medicine, Roy J. and Lucille A. Carver College of Medicine and College of Public Health, University of Iowa, Iowa City, Iowa 522423

Received 21 July 2008/ Accepted 3 September 2008

We performed 24- and 48-h MIC determinations and disk diffusion testing of fluconazole against more than 11,000 clinical isolates of Candida species. By using the reference MIC breakpoints, the categorical agreement between the 24-h and reference 48-h broth microdilution results ranged from 93.8% (all Candida species) to 94.9% (all Candida species minus Candida krusei), with only 0.1% very major errors (VME). The essential agreement (within 2 log2 dilutions) between the 24-h and 48-h results was 99.6%. The categorical agreement between the 24-h disk diffusion results and the 24-h MIC results, using the previously established breakpoints, was 94.4%, with 0.1% VME. Both the MIC and the disk diffusion results obtained for fluconazole after only 24 h of incubation may be used to determine the susceptibilities of Candida spp. to this widely used antifungal agent.

* Corresponding author. Mailing address: Medical Microbiology Division, C606 GH, Department of Pathology, University of Iowa College of Medicine, Iowa City, IA 52242. Phone: (319) 356-8615. Fax: (319) 356-4916. E-mail: michael-pfaller{at}uiowa.edu

{triangledown} Published ahead of print on 10 September 2008.

Journal of Clinical Microbiology, November 2008, p. 3585-3590, Vol. 46, No. 11
0095-1137/08/$08.00+0     doi:10.1128/JCM.01391-08
Copyright © 2008, American Society for Microbiology. All Rights Reserved.



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