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Journal of Clinical Microbiology, July 2004, p. 3117-3119, Vol. 42, No. 7
0095-1137/04/$08.00+0 DOI: 10.1128/JCM.42.7.3117-3119.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.
Further Standardization of Broth Microdilution Methodology for In Vitro Susceptibility Testing of Caspofungin against Candida Species by Use of an International Collection of More than 3,000 Clinical Isolates
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 ofPathology,1
Epidemiology,2
Medicine, University of Iowa College of Medicine and College of Public Health, University of Iowa, Iowa City, Iowa 522423
Received 19 November 2003/
Returned for modification 12 January 2004/
Accepted 21 March 2004
The influence of test variables on in vitro susceptibility testing of caspofungin was examined with 694 isolates of Candida albicans including seven laboratory-derived glucan synthesis mutants. The conditions providing the greatest separation between the mutant strains and the clinical isolates were RPMI medium, MIC end point criterion of partial inhibition, and incubation for 24 h. These testing conditions were then applied to 3,322 isolates of Candida spp. (3,314 clinical isolates and eight glucan synthesis mutants). Among the 11 isolates for which caspofungin MICs were
2 µg/ml, eight were accounted for by the glucan synthesis mutants. The MICs for >99% of isolates were
1 µg/ml, and thus these isolates were differentiated from strains with reduced in vitro and in vivo susceptibilities to caspofungin.
* 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, July 2004, p. 3117-3119, Vol. 42, No. 7
0095-1137/04/$08.00+0 DOI: 10.1128/JCM.42.7.3117-3119.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.
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