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Journal of Clinical Microbiology, January 2004, p. 380-383, Vol. 42, No. 1
0095-1137/04/$08.00+0 DOI: 10.1128/JCM.42.1.380-383.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.
Evaluation of the NCCLS M44-P Disk Diffusion Method for Determining Susceptibilities of 276 Clinical Isolates of Cryptococcus neoformans to Fluconazole
M. A. Pfaller,1,2* S. A. Messer,1 L. Boyken,1 C. Rice,1 S. Tendolkar,1 R. J. Hollis,1 and D. J. Diekema1,3
Departments of Pathology,1
Medicine, Roy J. and Lucille A. Carver College of Medicine,3
Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa 522422
Received 22 July 2003/
Returned for modification 22 September 2003/
Accepted 7 October 2003
We evaluated the NCCLS M44-P fluconazole disk diffusion method in comparison with the NCCLS M27-A2 broth microdilution method for determining the susceptibility of 276 isolates of Cryptococcus neoformans. Disk diffusion testing was performed using Mueller-Hinton agar supplemented with 2% glucose and 0.5 µg of methylene blue/ml. Among the 276 isolates, 259 (93.8%) were susceptible, 16 (5.8%) were susceptibledose dependent, and 1 (0.4%) was resistant to fluconazole as determined by the NCCLS broth microdilution method. The overall categorical agreement between the two methods was 86%, with 0% very major errors, 2% major errors, and 12% minor errors. The disk diffusion method using Mueller-Hinton agar supplemented with glucose and methylene blue appears to be a useful approach for determining the fluconazole susceptibility of C. neoformans.
* Corresponding author. Mailing address: Medical Microbiology Division, C606 GH, Department of Pathology, University of Iowa College of Medicine, Iowa City, Iowa 52242. Phone: (319) 384-9566. Fax: (319) 356-4916. E-mail:
michael-pfaller{at}uiowa.edu.
Journal of Clinical Microbiology, January 2004, p. 380-383, Vol. 42, No. 1
0095-1137/04/$08.00+0 DOI: 10.1128/JCM.42.1.380-383.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.
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