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Antimicrobial Agents and Chemotherapy, June 2002, p. 1781-1784, Vol. 46, No. 6
0066-4804/02/$04.00+0     DOI: 10.1128/AAC.46.6.1781-1784.2002
Copyright © 2002, American Society for Microbiology. All Rights Reserved.

Precision and Accuracy of Fluconazole Susceptibility Testing by Broth Microdilution, Etest, and Disk Diffusion Methods

A. L. Barry,1* M. A. Pfaller,2 R. P. Rennie,3 P. C. Fuchs,1 and S. D. Brown1

The Clinical Microbiology Institute, Wilsonville, Oregon,1 University of Iowa College of Medicine, Iowa City, Iowa,2 National Center for Mycology, Edmonton, Alberta, Canada3

Received 29 November 2001/ Returned for modification 11 January 2002/ Accepted 5 March 2002

Interpretive agreements among the results of fluconazole broth microdilution tests, Etests, and disk diffusion tests were documented by evaluating 495 Candida spp. Microdilution reference test results were in agreement with 96% of the Etest results; most discrepancies were minor differences. Fluconazole resistance of Candida krusei strains often required a full 48 h of incubation in order to be observed by the standard method. For the disk diffusion tests that were performed on Mueller-Hinton agar with glucose and methylene blue, 97% of results were in agreement with those of the reference test, especially when zones of inhibition were measured after the first 24 h of incubation. Some Candida glabrata isolates failed to grow satisfactorily until a full 48 h of incubation was completed. Precision was determined by testing 50 selected isolates in triplicate in each of three laboratories. The reproducibility of results of disk diffusion tests was comparable to that of the reference method. With all procedures, determination of test results was particularly challenging with some strains, and new methods are needed in order to improve endpoint definition.

* Corresponding author. Mailing address: The Clinical Microbiology Institute, 9725 SW Commerce Circle, Suite A-1, Wilsonville, OR 97070. Phone: (503) 682-3232. Fax: (503) 682-4548 or (503) 682-2065. E-mail: cmi{at}hevanet.com.

Antimicrobial Agents and Chemotherapy, June 2002, p. 1781-1784, Vol. 46, No. 6
0066-4804/02/$04.00+0     DOI: 10.1128/AAC.46.6.1781-1784.2002
Copyright © 2002, American Society for Microbiology. All Rights Reserved.



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