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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.{triangledown}

M. A. Pfaller,1* D. J. Diekema,1 G. W. Procop,2,{dagger} 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.

* Corresponding author. Mailing address: Medical Microbiology Division, C606 GH, Department of Pathology, University of Iowa College of Medicine, 200 Hawkins, Dr., Iowa City, IA 52242. Phone: (319) 384-9566. Fax: (319) 356-4916. E-mail: michael-pfaller{at}uiowa.edu

{triangledown} Published ahead of print on 3 October 2007.

{dagger} Present address: University of Miami, Miami, FL.

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.



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