Article Figures & Data
Tables
- TABLE 1.
Susceptibilities of 400 Candida spp. to fluconazole and voriconazole as determined by three methods at two incubation times
Species (no. of isolates tested) Time (h) Method Fluconazolea Voriconazolea Range 50% 90% Rangea 50% 90% C. albicans (205) 24 MD 0.125-128 0.125 0.25 0.031-16 0.031 0.031 ET 0.125-24 1.5 2 0.008-0.750 0.032 0.047 DD 45-21 33 29 45-25 34 30 48 MD 0.125-128 0.25 0.5 0.031-32 0.031 0.06 ET 0.094->256 1.5 3 0.008-64 0.032 0.064 DD 47-NZ 33 29 45-15 34 30 C. parapsilosis (66) 24 MD 0.125-64 0.25 1 0.031-2 0.031 0.125 ET 0.38->256 1.5 6 0.008-2 0.032 0.094 DD 43-NZ 36 26 45-12 39 31 48 MD 0.250-128 0.5 4 0.031-4 0.031 0.25 ET 0.38->256 2 16 0.008-64 0.032 0.25 DD 44-NZ 36 22 45-NZ 38 25 C. tropicalis (56) 24 MD 0.125-128 0.25 1 0.031-32 0.031 0.125 ET 0.380->256 1.5 4 0.016-1.5 0.064 0.19 DD 40-10 33 28 40-12 30 25 48 MD 0.125-128 1 16 0.031-32 0.125 1 ET 0.750-512 2 6 0.019-64 0.19 0.75 DD 38-NZ 28 24 37-NZ 24 18 C. glabrata (39) 24 MD 0.250-64 4 8 0.031-2 0.125 1 ET 2-512 8 32 0.047-2 0.125 0.38 DD 38-NZ 27 20 35-12 29 24 48 MD 0.250-128 8 32 0.031-8 0.5 2 ET 4-512 24 64 0.094-3 0.38 1 DD 32-NZ 19 12 32-NZ 20 15 C. krusei (24) 24 MD 0.5-128 16 16 0.031-1 0.125 0.25 ET 1.5->256 48 96 0.016-105 0.19 0.38 DD 38-NZ 18 14 42-12 28 23 48 MD 1-128 32 64 0.031-2 0.5 0.5 ET 2-512 512 512 0.016-12 0.75 2 DD 38-NZ 0 0 42-NZ 16 13 Other species (10) 24 MD 0.125-2 0.25 0.5 0.031 0.031 0.031 ET 0.5-2 0.75 1 0.006-0.023 0.016 0.016 DD 45-36 40 38 44-38 41 38 48 MD 0.125-4 0.5 1 0.031-0.125 0.031 0.031 ET 0.5-4 1 1 0.006-0.023 0.016 0.016 DD 45-36 42 40 45-38 43 40 ↵ a The values are MICs (in micrograms per milliliter) for the MD and ET methods and inhibition zone diameter (in millimeters) for the DD method. The value shown is the lowest MIC that was greater than (for the MD and ET methods) or the greatest zone diameter that was less than (for the DD method) 50 or 90% of the observed values, as indicated. NZ, no zone.
- TABLE 2.
Percentage of paired MD and ET MICs within 2 doubling dilutions
Time (h) of ET reading Correlation (%) of ET and MD MICs Fluconazole Voriconazole 24 h 48 h 24 h 48 h 24 99.5 96.5 98.0 87.0 48 99.8 97.0 98.8 93.3 - TABLE 3.
Comparison of interpretive categories for fluconazole and rates of interpretive agreementa
Method Incubation time (h) Category Fluconazole MIC50 (μg/ml) at 48 h by MD Predictive values (%) No. (%) of discrepant resultsb No. (%) of total agreement S S-DD R Minor Major Very major DD 24 S 337 23 15 96.0c 30 (7.5) 0 (0.0) 15 (3.8) 355 (88.8) I 1 8 4 R 0 2 10 83.0d 48 S 329 5 10 97.1c 27 (6.7) 4 (1.0) 10 (2.5) 359 (89.8) I 5 11 0 R 4 17 19 47.5d ET 24 S 334 14 11 97.0c 32 (8.0) 1 (0.3) 11 (2.8) 356 (89.0) I 3 9 5 R 1 10 13 54.2d 48 S 319 0 9 97.3c 43 (10.7) 5 (1.3) 9 (2.3) 343 (85.8) I 14 5 1 R 5 28 19 36.5d ↵ a S, susceptible; I, intermediate; R, resistant; S-DD, susceptible-dose dependent; MIC50, MIC at which 50% of isolates are inhibited.
↵ b Minor discrepancies, susceptible-dose dependant by one method but susceptible or resistant by the other; Major discrepancies, resistant by the test method but susceptible by the reference test; very major discrepancies, susceptible by the test method but resistant by the reference test.
↵ c The value shown is the percentage of the time that a result of susceptible by the agar-based method correlated with a susceptible or susceptible-dose dependent result by the reference MD method.
↵ d The value shown is the percentage of the time that a result of resistant by the agar-based method correlated with a result of resistance by the reference MD method.
- TABLE 4.
Correlation between results of MD and DD methods for voriconazole after 24 and 48 h of incubation
Time and disk zone diam (mm) No. of isolates for which the MD MIC (μg/ml) at the indicated times was as follows: 24 h MD MICs 48 h MD MICs 0.031 0.062 0.125 0.250 0.5 1.0 2.0 >4.0 Total 0.031 0.062 0.125 0.250 0.5 1.0 2.0 >4.0 Total 24 h 45 3 3 3 3 44 8 8 8 8 43 6 6 6 6 42 11 11 10 1 11 41 8 1 1 10 9 1 10 40 17 17 14 1 1 1 17 39 14 1 15 13 1 1 15 38 24 24 17 3 1 3 24 37 15 1 16 11 3 1 1 16 36 22 22 21 1 22 35 38 1 39 30 6 1 1 1 39 34 37 37 33 2 1 1 37 33 27 3 30 19 3 1 5 1 1 30 32 33 2 1 36 27 3 1 1 1 1 2 36 31 13 2 4 1 20 9 3 1 3 3 1 20 30 17 3 4 2 1 27 12 1 2 2 6 3 1 27 29 6 2 4 12 4 2 1 1 3 1 12 28 7 7 2 2 18 2 3 3 1 5 3 1 18 27 4 1 4 2 1 12 3 2 4 1 2 12 26 1 1 4 1 7 2 2 1 2 7 25 1 2 4 3 1 1 12 1 3 3 2 1 2 12 24 1 1 1 1 23 2 1 1 4 1 1 1 1 4 22 1 1 1 3 1 2 3 21 1 1 1 1 1 20 1 1 1 1 18 1 1 1 1 16 1 1 1 1 12 2 3 1 6 1 4 1 6 Total for 24 h 312 28 31 15 3 5 2 4 400 248 39 16 20 37 15 12 13 400 48 h 45 7 7 7 7 44 10 10 9 1 10 43 14 14 14 14 42 5 5 5 5 41 5 5 5 5 40 11 1 1 13 11 1 1 13 39 10 10 9 1 10 38 15 1 16 13 1 1 1 16 37 12 12 10 1 1 12 36 24 24 22 1 1 24 35 26 26 21 3 2 26 34 39 39 37 1 1 39 33 21 21 18 2 1 21 32 29 2 31 25 5 1 31 31 6 6 5 1 6 30 24 24 20 2 1 1 24 29 8 1 9 4 3 1 1 9 28 10 4 14 4 3 1 2 2 2 14 27 5 1 6 1 2 1 1 1 6 26 4 1 5 2 2 1 5 25 6 1 1 1 1 9 3 1 1 3 1 9 24 2 3 1 2 8 1 1 1 2 3 8 23 5 2 7 2 2 3 7 22 6 3 1 10 1 1 1 1 3 1 2 10 21 3 3 6 4 1 1 6 20 4 3 6 13 1 2 2 1 3 4 13 19 1 1 2 1 1 2 18 1 4 5 1 1 1 13 1 3 3 5 1 13 17 1 1 2 4 3 1 4 16 4 6 10 1 5 2 2 10 15 5 1 6 4 2 6 14 1 2 3 3 3 13 1 2 1 4 1 1 2 4 0 1 1 2 3 1 8 1 1 5 1 8 Total for 48 h 312 28 31 15 3 5 2 4 400 248 39 16 20 37 15 12 13 400