title: Breakpoints for susceptibility testing should not divide wild-type distributions of important target species.
abstract: The fluconazole MIC distributions for Candida glabrata from testing 34 different clinical isolates and performing 51 tests on a single isolate mirrored each other. Since what is perceived as biological variation in isolates without resistance mechanisms is mainly methodological variation, breakpoints which divide this distribution not only lack a sound biological basis but also result in poor reproducibility of susceptibility characterization. This makes 2, 4, 8, and possibly 16 microg/ml unsuitable breakpoints for C. glabrata and fluconazole.
authors.affiliation: Unit of Mycology, Statens Serum Institut, Copenhagen, Denmark. mad@ssi.dk
authors.forename: Maiken Cavling
authors.initials: MC
authors.lastname: Arendrup
authors.forename: Gunnar
authors.initials: G
authors.lastname: Kahlmeter
authors.forename: Juan Luis
authors.initials: JL
authors.lastname: Rodriguez-Tudela
authors.forename: J Peter
authors.initials: JP
authors.lastname: Donnelly
mesh_terms: D000935:Antifungal Agents / Q000494:pharmacology*; D002175:Candida / Q000187:drug effects*; D015725:Fluconazole / Q000494:pharmacology; D006801:Humans; D008826:Microbial Sensitivity Tests / Q000379:methods*
chemical_list: D000935:Antifungal Agents; D015725:Fluconazole