Interpretive criteria for Candida susceptibility testing were recently revised with the establishment of speciesspecific
epidemiological cutoff values (ECV). To assess the effect of modified cutoff values on Candida glabrata
resistance rates and agreement between testing methods, we tested the susceptibility of 598 clinical isolates
to fluconazole, itraconazole, voriconazole, posaconazole, caspofungin, and amphotericin B using CLSI M27-A3
and E-testmethods. The caspofunginMICs clustered above the ECV and belowthe CLSI cutoff (MIC50, 0.5 μg/mL).
Applying the ECV reduced the proportion of itraconazole-nonsusceptible strains from 83% to 0.3% but
minimally affected resistance rates of other drugs. Categorical agreement between broth microdilution and Etest
was increased for itraconazole and reduced for voriconazole and caspofungin. The current caspofungin
ECV may not reproducibly differentiate resistant and susceptible C. glabrata strains in hospitals with varying
MIC distributions.
Interpretive criteria for Candida susceptibility testing were recently revised with the establishment of speciesspecific
epidemiological cutoff values (ECV). To assess the effect of modified cutoff values on Candida glabrata
resistance rates and agreement between testing methods, we tested the susceptibility of 598 clinical isolates
to fluconazole, itraconazole, voriconazole, posaconazole, caspofungin, and amphotericin B using CLSI M27-A3
and E-testmethods. The caspofunginMICs clustered above the ECV and belowthe CLSI cutoff (MIC50, 0.5 μg/mL).
Applying the ECV reduced the proportion of itraconazole-nonsusceptible strains from 83% to 0.3% but
minimally affected resistance rates of other drugs. Categorical agreement between broth microdilution and Etest
was increased for itraconazole and reduced for voriconazole and caspofungin. The current caspofungin
ECV may not reproducibly differentiate resistant and susceptible C. glabrata strains in hospitals with varying
MIC distributions.
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