Multicenter evaluation of the new Vitek 2 yeast susceptibility test using new CLSI clinical breakpoints for fluconazole

M A Pfaller; D J Diekema; G W Procop; N P Wiederhold

doi:10.1128/JCM.00658-14

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Multicenter evaluation of the new Vitek 2 yeast susceptibility test using new CLSI clinical breakpoints for fluconazole

Journal article

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Peer reviewed

Multicenter evaluation of the new Vitek 2 yeast susceptibility test using new CLSI clinical breakpoints for fluconazole

M A Pfaller, D J Diekema, G W Procop and N P Wiederhold

Journal of clinical microbiology, Vol.52(6), pp.2126-2130

06/2014

DOI: 10.1128/JCM.00658-14

PMCID: PMC4042772

PMID: 24719450

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Abstract

A fully automated antifungal susceptibility test system recently updated to reflect the new species-specific clinical breakpoints (CBPs) of fluconazole for Candida (Vitek 2 AF03 yeast susceptibility test; bioMérieux, Inc., Durham, NC) was compared in three different laboratories with the Clinical and Laboratory Standards Institute (CLSI) reference broth microdilution (BMD) method by testing 2 quality control strains, 10 reproducibility strains (4 Candida species and 6 Cryptococcus neoformans strains), and 746 isolates of Candida species (702 isolates, 13 species) and 44 isolates of C. neoformans against fluconazole. Excellent essential agreement (EA) (within 2 dilutions) between the reference and Vitek 2 MICs was observed for fluconazole and Candida species (94.0%). The EA was lower for fluconazole and C. neoformans at 86.4%. The mean times to a result with the Vitek 2 test were 9.1 h for Candida species and 12.1 h for C. neoformans. Categorical agreement (CA) between the two methods was assessed by using the new species-specific CBPs. For less common species without fluconazole CBPs, the epidemiological cutoff values (ECVs) were used to differentiate wild-type (WT; MIC, ≤ ECV) from non-WT (MIC, >ECV) strains. The CAs between the two methods were 92.0% for Candida species (0.3% very major errors [VME] and 2.6% major errors [ME]) and 84.1% for C. neoformans (4.5% VME and 11.4% ME). The updated Vitek 2 AF03 IUO yeast susceptibility system is comparable to the CLSI BMD reference method for testing the susceptibility of clinically important yeasts to fluconazole when using the new (lower) CBPs and ECVs.

Antifungal Agents - pharmacology

Cryptococcus neoformans - isolation & purification

Fluconazole - pharmacology

Time Factors

Humans

Candida - drug effects

Candida - isolation & purification

Microbial Sensitivity Tests - methods

Automation, Laboratory - methods

Cryptococcus neoformans - drug effects

Details

Title: Subtitle: Multicenter evaluation of the new Vitek 2 yeast susceptibility test using new CLSI clinical breakpoints for fluconazole
Creators: M A Pfaller - University of Iowa College of Medicine, Iowa City, Iowa, USA
D J Diekema - University of Iowa College of Medicine, Iowa City, Iowa, USA daniel-diekema@uiowa.edu
G W Procop - Cleveland Clinic Foundation, Cleveland, Ohio, USA
N P Wiederhold - University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
Resource Type: Journal article
Publication Details: Journal of clinical microbiology, Vol.52(6), pp.2126-2130
Publisher: United States
DOI: 10.1128/JCM.00658-14
PMID: 24719450
PMCID: PMC4042772
ISSN: 1098-660X
eISSN: 1098-660X
Language: English
Date published: 06/2014
Academic Unit: Infectious Diseases; Epidemiology; Pathology; Internal Medicine
Record Identifier: 9983986267802771

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