This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Reprints and Permissions Copyright Information Books from ASM Press MicrobeWorld Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Espinel-Ingroff, A. Articles by Verweij, P. E. Search for Related Content PubMed PubMed Citation Articles by Espinel-Ingroff, A. Articles by Verweij, P. E.

 Previous Article  |  Next Article 

Journal of Clinical Microbiology, September 2005, p. 4535-4540, Vol. 43, No. 9
0095-1137/05/$08.00+0     doi:10.1128/JCM.43.9.4535-4540.2005
Copyright © 2005, American Society for Microbiology. All Rights Reserved.

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

A. Espinel-Ingroff,^1* F. Barchiesi,² M. Cuenca-Estrella,³ A. Fothergill,⁴ M. A. Pfaller,⁵ M. Rinaldi,⁴ J. L. Rodriguez-Tudela,³ and P. E. Verweij⁶

VCU Medical Center, Richmond, Virginia,¹ Public Health, Ancona, Italy,² Instituto Salud Carlos III, Majadahonda, Spain,³ University of Texas Health Science Center, San Antonio, Texas,⁴ University of Iowa College of Medicine, Iowa City, Iowa,⁵ Medical Center Nijmegen, Nijmegen, The Netherlands⁶

Received 27 March 2005/ Returned for modification 31 May 2005/ Accepted 13 June 2005

A multicenter (six-center) study evaluated the performance (interlaboratory reproducibility, compatibility with reference methods, and categorical agreement) of 24-h visual and 48-h spectrophotometric MICs. MICs of fluconazole, itraconazole, voriconazole, and posaconazole were compared to reference 48-h microdilution broth visual MICs (CLSI [formerly NCCLS] M27-A2 document) for 71 isolates of Candida spp. that included 10 fluconazole-resistant strains. Twenty readings (5%) were reported as showing no growth at 24 h, mostly for Candida dubliniensis and from a single center. The overall interlaboratory agreement of 24-h visual readings and 48-h spectrophotometric MICs, as well their compatibility with reference values, were excellent with the four triazoles for most of the species (93 to 99%, within 3 dilutions). The categorical agreement between the investigational reading conditions and reference values was good with fluconazole and voriconazole (93 to 97%) but lower with itraconazole (86 to 88%), due primarily to minor errors. There were only 0 to 3% very major errors with these three triazoles; the number of substantial errors (more than three dilutions) was also low (<2%) with posaconazole. These data suggest that the performance of both investigational MIC readings gives results similar to those of reference MICs. Since spectrophotometric MICs are more objective and the 24-h time period would shorten the MIC determination of azoles, the description of either of these two reading conditions in the M27-A2 document should be considered by the CLSI subcommittee in addition to or instead of the longer, less practical, and more subjective 48-h visual MIC reading.

---

* Corresponding author. Mailing address: VCU Medical Center Medical Mycology Research Laboratory, 1101 E. Marshall St., Sanger Hall, Room 7049, P.O. Box 980049, Richmond, VA 23298-0049. Phone: (804) 828-9711. Fax: (804) 828-3097. E-mail: avingrof{at}hsc.vcu.edu.

---

Journal of Clinical Microbiology, September 2005, p. 4535-4540, Vol. 43, No. 9
0095-1137/05/$08.00+0     doi:10.1128/JCM.43.9.4535-4540.2005
Copyright © 2005, American Society for Microbiology. All Rights Reserved.

This article has been cited by other articles:

• Espinel-Ingroff, A., Canton, E., Peman, J., Rinaldi, M. G., Fothergill, A. W. (2009). Comparison of 24-Hour and 48-Hour Voriconazole MICs as Determined by the Clinical and Laboratory Standards Institute Broth Microdilution Method (M27-A3 Document) in Three Laboratories: Results Obtained with 2,162 Clinical Isolates of Candida spp. and Other Yeasts. J. Clin. Microbiol. 47: 2766-2771 [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]  
• Guo, Q., Sun, S., Yu, J., Li, Y., Cao, L. (2008). Synergistic activity of azoles with amiodarone against clinically resistant Candida albicans tested by chequerboard and time-kill methods. J Med Microbiol 57: 457-462 [Abstract] [Full Text]  
• Sun, S., Li, Y., Guo, Q., Shi, C., Yu, J., Ma, L. (2008). In Vitro Interactions between Tacrolimus and Azoles against Candida albicans Determined by Different Methods. Antimicrob. Agents Chemother. 52: 409-417 [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., 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]  
• Riggle, P. J., Kumamoto, C. A. (2006). Transcriptional Regulation of MDR1, Encoding a Drug Efflux Determinant, in Fluconazole-Resistant Candida albicans Strains through an Mcm1p Binding Site. Eukaryot Cell 5: 1957-1968 [Abstract] [Full Text]