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, F. Barchiesi, M. Cuenca-Estrella, A. Fothergill, M. A. Pfaller, M. Rinaldi, J. L. Rodriguez-Tudela, P. E. Verweij

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)4535-4540
Number of pages6
JournalJournal of Clinical Microbiology
Volume43
Issue number9
DOIs
StatePublished - Sep 2005

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Itraconazole
Fluconazole
Candida
Reading
Triazoles
varespladib methyl
Reference Values
Azoles
Voriconazole
posaconazole
Growth

ASJC Scopus subject areas

  • Microbiology (medical)
  • Microbiology

Cite this

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. / Espinel-Ingroff, A.; Barchiesi, F.; Cuenca-Estrella, M.; Fothergill, A.; Pfaller, M. A.; Rinaldi, M.; Rodriguez-Tudela, J. L.; Verweij, P. E.

In: Journal of Clinical Microbiology, Vol. 43, No. 9, 09.2005, p. 4535-4540.

Research output: Contribution to journalArticle

Espinel-Ingroff, A. ; Barchiesi, F. ; Cuenca-Estrella, M. ; Fothergill, A. ; Pfaller, M. A. ; Rinaldi, M. ; Rodriguez-Tudela, J. L. ; Verweij, P. E. / 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. In: Journal of Clinical Microbiology. 2005 ; Vol. 43, No. 9. pp. 4535-4540.
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abstract = "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.",
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