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A fully automated antifungal susceptibility test system recently updated to reflect the new species-specific clinical breakpoints (CBPs) of fluconazole forCandida (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 (4Candida species and 6Cryptococcus neoformans strains), and 746 isolates ofCandida species (702 isolates, 13 species) and 44 isolates ofC. neoformans against fluconazole. Excellent essential agreement (EA) (within 2 dilutions) between the reference and Vitek 2 MICs was observed for fluconazole andCandida species (94.0%). The EA was lower for fluconazole andC. neoformans at 86.4%. The mean times to a result with the Vitek 2 test were 9.1 h forCandida species and 12.1 h forC. 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, &gt;ECV) strains. The CAs between the two methods were 92.0% forCandida species (0.3% very major errors [VME] and 2.6% major errors [ME]) and 84.1% forC. 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.

Multicenter Evaluation of the New Vitek 2 Yeast Susceptibility Test Using New CLSI Clinical Breakpoints for Fluconazole