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CLSI guidelines for antifungal susceptibility testing for Candida

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  3. In 2017, CLSI combined broth and disk susceptibility testing recommendations for Candida and species-specific MIC interpretive breakpoints into CLSI document M60. 7 This document includes breakpoints for the most frequent Candida species for selected agents (echinocandins, fluconazole, and voriconazole, see Table 1)
  4. All Candida auris isolates should undergo antifungal susceptibility testing according to CLSI guidelines. Although C. auris is commonly multidrug resistant, levels of antifungal resistance can vary widely across isolates. There are currently no established C. auris -specific susceptibility breakpoints

CLSI Publishes New Antifungal Guideline 12/21/2018 Wayne, Pennsylvania, USA—The Clinical and Laboratory Standards Institute announces the publication of CLSI guideline M44— Method for Antifungal Disk Diffusion Susceptibility Testing of Yeasts 1 Pfaller MA, DJ Diekema, JD Turnidge, M Castanheira, and RN Jones (2019) Twenty years of the SENTRY antifungal surveillance program: results for Candida species from 1997-2016. Open Forum Infect Dis. 6(Suppl 1):S79-S94. 2 CLSI. Performance Standards for Antifungal Susceptibility Testing of Yeasts, 2nd Ed. CLSI supplement M60 Performance Standards for Antifungal Susceptibility Testing of Yeasts. includes the minimal inhibitory concentration, zone diameter, and QC tables developed following the standards described in CLSI documents M27. 1. and M44. 2. The tabular information in this document is valid only when the methodology is followed a Method for Antifungal Disk Diffusion Susceptibility Testing of Yeasts; Approved Guideline - Second Edition. CLSI document M44-S3 (2009). Clinical and Laboratory Standards Institute, 950 West.

About CLSI's Subcommittee on Antifungal Susceptibility Testing About the Subcommittee on Antifungal Susceptibility Testing. Volunteers for CLSI's Subcommittee on Antifungal Susceptibility Tests collaborate to develop standards and guidelines that promote accurate antifungal susceptibility testing and appropriate reporting Clinical and Laboratory Standards Institute standard M27— Reference Method for Broth Dilu tion Antifungal Susceptibility Testing of Yeasts describes a method for testing the susceptibility to antifungal agents of yeasts that cause invasive fungal infections, including Candida spp. and Cryptococcus neoformans

Like the CLSI, EUCAST recommends that completely synthetic growth medium be used for antifungal susceptibility testing and mandates the use of RPMI 1640 medium supplemented with glucose and MOPS buffered to a pH of 7 Clinical and Laboratory Standards Institute (CLSI). Performance Standards for Antifungal Susceptibility Testing of Filamentous Fungi. 1st ed. CLSI supplement M61 (ISBN 1-56238-832- [Print]; ISBN 1-56238-833-9 [Electronic]). Clinical and Laboratory Standards Institute, 950 West Valley Road, Suite 2500, Wayne, Pennsylvania 19087 USA, 2017 Antifungal susceptibility testing has become an important tool for ­physicians faced with making difficult treatment decisions regarding treatment of patients with fungal infections. The Clinical Laboratory and Standards Institute (CLSI) has approved methods for testing of both yeast and moulds Epidemiological Cutoff Values for Antifungal Susceptibility Testing. 2nd ed. CLSI supplement M59 (ISBN 1-56238-840-1 [Print]; ISBN 1-56238-841-X [Electronic]). Clinical and Laboratory Standards Institute, 950 West Valley Road, Suite 2500, Wayne, Pennsylvania 19087 USA, 2018 Performance Standards for Antifungal Susceptibility Testing of Yeasts; approved, 2017). Slow-growing strains that could not be visually evaluated after 24 h, were analyzed after 48 h incubation at 37°C. So far, respective breakpoints for susceptibility/resistance classification have not been defined by CLSI and are suggested in this study

Forty-one institutions participated in the Candida Surveillance Study. All isolates were submitted to a central laboratory for identification and susceptibility testing. Susceptibility testing was performed in compliance with CLSI guidelines using a custom, broth dilution, microtiter system ) susceptibility testing. For antifungal susceptibility testing to become more readily available to medical microbiology laboratories, simple, rapid, and cost-effective alternative approaches are needed. The disk diffusion method used for antibacterial testing (see CLSI document M02. 3) has provided the basis for a simple method for. Find the latest news and updates from CLSI's Microbiology committee and subcommittees. View our Antifungal Susceptibility Testing files and resources Performance Standards for Antifungal Susceptibility Testing of Yeasts. 1st ed. CLSI supplement M60 (ISBN 1-56238- 828-2 [Print]; ISBN 1-56238-829- [Electronic]). Clinical and Laboratory Standards Institute, 950 West Valley Road, Suite 2500, Wayne, Pennsylvania 19087 USA, 2017 Candida Inpatient Antibiogram for Nebraska Medical Center (2016- 2018) Isolates Included in Analysis . Candida. species isolated from sterile sites (blood, cerebral spinal fluid, joint fluid, pleural fluid, and pericardial fluid) routinely undergo susceptibility testing per CLSI guidelines using the Sensititre YeastOn

Clinical and Laboratory Standards Institute. Performance standards for antifungal susceptibility testing of filamentous fungi, 2nd ed. CLSI supplement M61 Clinical and Laboratory Standards Institute, Wayne, PA 2020. Kanafani ZA, Perfect JR. Antimicrobial resistance: resistance to antifungal agents: mechanisms and clinical impact There are two internationally recognized standard methods for the performance of antifungal susceptibility testing of Candida spp. using broth microdilution (BMD): that of the Clinical and Laboratory Standards Institute (CLSI) (13, 14) and that of the European Committee on Antimicrobial Susceptibility Testing (EUCAST) (23, 24, 87) We investigated the antifungal susceptibility profiles of 207 independent Candida albicans strains isolated from patients with vulvovaginal candidiasis (VVC) in Xinjiang Province of China. Using CLSI M27-A3 and M27-S4 guidelines, anidulafungin and micafungin were the most active drugs against C. alb and compared their antifungal susceptibility according to clinical breakpoints defined by the European Committee on Antimicrobial Susceptibility Testing (EUCAST) in 2013, and the Clinical and Laboratory Standards Institute (CLSI) in 2008 (old CLSI breakpoints) and 2012 (new CLSI breakpoints) The isolates were identified by conventional methods, and susceptibility testing was performed against fluconazole, itraconazole and voriconazole, by the 24-h CLSI broth microdilution (BMD) method. Azole resistance rates for all Candida species were determined using the new species-specific CLSI CBPs and ECVs criteria, when appropriate

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Agar disk diffusion testing is a simple, flexible, and cost-effective alternative to broth dilution methodology. The Clinical and Laboratory Standards Institute (CLSI) Subcommittee on Antifungal Susceptibility Testing has developed a disk diffusion method for testing Candida spp. with fluconazole and voriconazole (M44-A document) Performance Standards for Antimicrobial Susceptibility Testing. This document includes updated tables for the Clinical and Laboratory Standards Institute antimicrobial susceptibility testing standards M02, M07, and M11. A CLSI supplement for global application. 30th Edition. New Recommendations: • Colistin agar test for . Enterobacterales. an Shop Devices, Apparel, Books, Music & More. Free UK Delivery on Eligible Order

When Should Antifungal Susceptibility Testing Be Performed

Antifungal Susceptibility Testing and Interpretation

CLSI Publishes New Antifungal Guideline, M4

Performance Standards for Antifungal Susceptibility Testing of Yeasts. This document provides updated minimal inhibitory concentration, zone diameter, and quality control tables for the Clinical and Laboratory Standards Institute antifungal . susceptibility testing documents M27 and M44. A CLSI supplement for global application. Sample. 2nd Editio CLSI M27-A3 Reference Method for Broth Dilution Antifungal Susceptibility Testing of Yeasts; Approved Standard-Third Edition. The standard describes a method for testing the susceptibility of antifungal agents to yeast that cause invasive fungal infections, including Candida species (and Candida glabrata), and Cryptococcus neoformans Epidemiological Cutoff Values for Antifungal Susceptibility Testing, 3rd Edition View Sample Pages This document provides epidemiological cutoff values developed according to the criteria in the Clinical and Laboratory Standards Institute (CLSI) guideline M57 and generated according to the reference broth dilution methods described in the CLSI.

Antifungal Sensitivity Testing

Applying Susceptibility Interpretations to the Candida

To make antifungal susceptibility testing more readily available to clinical microbiology laboratories, the Clinical and Laboratory Standards Institute (CLSI, formerly NCCLS) has proposed a standardized disk diffusion method for susceptibility testing of Candida spp Chapter 64 Antifungal Susceptibility Testing, Therapy, and Prevention Objectives 1. Name the documents available that contain the current guidelines for antifungal susceptibility testing. 2. Identify three circumstances in which antifungal susceptibility testing may be valuable. 3. List three areas of concern that complicate interpretive guidelines The HUP Clinical Microbiology Laboratory determines the fluconazole MIC for blood and invasive isolates of Candida spp., using a FDA-cleared commercial microtiter panel. Other invasive isolates are tested on request. The methodology adheres to CLSI guidelines (M27-S4, Dec 2012) for antifungal susceptibility testing of yeasts In this work, we evaluated the reliability of the Etest® in comparison with the two reference broth microdilution methods, Clinical and Laboratory Standards Institute (CLSI) and European Committee on Antimicrobial Susceptibility Testing (EUCAST), to assess the caspofungin resistance of 193 isolates of Candida glabrata Performance Standards for Antifungal Susceptibility Testing of Yeasts This document includes updated minimal inhibitory concentration, zone diameter, and quality control tables for the Clinical and Laboratory Standards Institute antifungal susceptibility testing documents M27 and M44. A CLSI supplement for global application. 1st Editio

hours sooner than the standard CLSI document M381 method. • use of nonsupplemented Mueller-Hinton agar should make antifungal susceptibility testing more readily available to clinical laboratories at a reduced cost. • Although clinical breakpoints have not been assigned, tentative epidemiological cutoff values (ECVs) have been developed protocol. Antifungal susceptibility testing of the Candida species isolated was carried out by broth microdilution method as per CLSI M27-A3, USA, 2008 guidelines [5] and VITEK 2 system (BioMerieux, France). CLSI Broth Microdilution Method (M27-A3): Antifungal agents used were amphotericin B The Clinical and Laboratory Standards Institute (CLSI) (formerly the National Committee for Clinical Laboratory Standards [NCCLS]) Subcommittee for Antifungal Testing has developed and standardized broth microdilution (BMD), broth macrodilution, and disk diffusion methods for in vitro susceptibility testing of Candida spp. (and other yeasts. Echinocandin susceptibility testing of Candida species: comparison of EUCAST EDef 7.1, CLSI M27-A3, Etest, disk diffusion, and agar dilution methods with RPMI and isosensitest media. Arendrup MC(1), Garcia-Effron G, Lass-Flörl C, Lopez AG, Rodriguez-Tudela JL, Cuenca-Estrella M, Perlin DS

Routine antifungal susceptibility testing is not recommended. Testing may be warranted under certain circumstances such as: • Aid in patient management of refractory oropharyngeal infections due to Candida spp in patients who appear to be experiencing therapeutic failure of the standard antifungal agents at standard dose cally and that allows fully automated antifungal susceptibility testing of Candida spp. by use of the VITEK 2 microbiology system (42). The fully automated VITEK 2 system allows the standardization of all the critical parameters known for anti-fungal susceptibility testing: inoculum preparation, filling o Antifungal Susceptibility Testing of Yeasts; Third Informational Supplement This document provides updated tables for the CLSI antimicrobial susceptibility testing standard M27-A3. An informational supplement for global application developed through the Clinical and Laboratory Standards Institute consensus process. (Formerly NCCLS Antifungal susceptibility testing revealed that fluconazole was exceedingly resistant against Candida species (62%), followed by clotrimazole (59.3%) and nystatin (58.3%). On the contrary, voriconazole had the highest antimicrobial activity against Candida species (85.2%) susceptibility testing methods for fungi, with the ultimate goal of establishing CBPs for fungal pathogens. Early efforts focused on the develop-ment of guidelines for in vitro susceptibility test-ing methods. These were published in 1997 as document M27-A for testing fluconazole suscep-tibility against Candida species, and later, in doc

The development of the Clinical and Laboratory Standards Institute (CLSI) reference method M27-A3 has improved the reproducibility of in vitro antifungal susceptibility data and facilitated the establishment of interpretive breakpoints for the triazoles fluconazole, itraconazole, and voriconazole and the echinocandins Routine antifungal susceptibility testing is not recommended. Testing may be warranted under certain circumstances such as: • aid in patient management of refractory oropharyngeal infections due to Candida spp in patients who appear to be experiencing therapeutic failure of the standard antifungal agents at standard doses; • aid in management of invasive infections due to Candida spp when. and interpretation of test procedures; and quality control requirements for susceptibility testing of yeasts that cause invasive fungal infections. A standard for global application developed through the Clinical and Laboratory Standards Institute consensus process. (Formerly NCCLS) This is a preview of CLSI M27-A3

Abstract. Objective.The study aims to speciate clinical Candida isolates and detect their biofilm-forming ability and antifungal resistance.Methods.All the Candida spp. isolated from different clinical samples like pus, urine, blood, and body fluid were included in the study. Biofilm production was tested by the microtiter plate method. Antifungal susceptibility was studied by the disk. Minimum inhibitory concentration (MIC) interpretive guidelines are based substantially on experience with mucosal infections but are consistent with limited information for invasive infections due to Candida species. The clinical relevance of testing non-Candida isolates and non−FDA-approved drugs remains uncertain at this time.MIC values without interpretations are reported for non−FDA. Abstract. Antifungal susceptibility testing is a very dynamic field of medical mycology. Standardization of in vitro susceptibility tests by the Clinical and Laboratory Standards Institute (CLSI) and the European Committee for Antimicrobial Susceptibility Testing (EUCAST), and current availability of reference methods constituted the major remarkable steps in the field In this article, an update of recent changes to the CLSI antifungal standards for susceptibility testing of yeasts is presented. We also summarise current Australian antifungal susceptibility data for Candida and Cryptococcus. A. CLSI M27-A3 and M27-S3 broth dilution standard for yeasts1, A simple method that is suitable for water-soluble agents such as flucytosine, fluconazole and voriconazole is disc diffusion and there is an NCCLS method for in vitro susceptibility testing of Candida species. 17 This provides a zone of inhibition, the measurement of which can be correlated with the MIC value as has been demonstrated with.

Conclusions. Whilst most results are similar to other large surveys of fungal susceptibility, the new CLSI interpretive criteria significantly altered the proportion of non-susceptible isolates to fluconazole, voriconazole and caspofungin for several Candida spp. Application of CLSI and YeastOne-derived ECVs revealed the presence of a low proportion of non-WT isolates for many species The antifungal susceptibility tests of C. albicans isolates revealed 97.5, 90, 87.5 and 97.5% susceptibility to AMB, FCZ, ICZ and VCZ, respectively. The current study revealed high incidence of both C. albicans and non-C. albicans Candida strains causing vulvovaginitis among pregnant women in Beirut, Lebanon

Background . Candida -associated denture stomatitis (CADS) is a common fungal infection in people who wear dentures. The main objective of this study was to make molecular identification of causative agents of CADS and in vitro antifungal susceptibility testing (AFST) in the Iranian patients with denture stomatitis. Methods The NCCLS Subcommittee on Antifungal Susceptibility Testing has developed a disk diffusion method for testing Candida species to fluconazole and voriconazole. Zone interpretive criteria (breakpoints) have been approved for fluconazole as well as quality control parameters for both fluconazole and voriconazole Pre-clinical Development of Susceptibility Testing Methods for the Novel Antifungal E1210 Tested against Candida: Comparison of CLSI and EUCAST Methods. MA PFALLER, SA MESSER, N WATANABE, K HATA, RN JONES, AND M CASTANHEIRA. JMI Laboratories, North Liberty, Iowa, 52317, USA; Eisai, Tsukuba, Japan. 51st ICAAC. F1-1374. Mariana Castanheira, PhD. All isolates were submitted to a central laboratory for identification and susceptibility testing. Susceptibility testing was performed in compliance with CLSI guidelines using a custom, broth dilution, microtiter system. There were 5,900 isolates submitted for identification and antifungal susceptibility testing The CLSI first published methods for antifungal susceptibility testing of Candida spp. and Cryptococcus neoformans in 1997, whereas the methods for filamentous fungi were approved in 2002. A macrodilution method for susceptibility testing was approved first, quickly followed by a microdilution method that is simpler and equally effective

The technical parameters for antifungal susceptibility testing with Candida species were reexamined to determine the optimal conditions for testing with semiautomated preparations of broth. Etest of Oral Candida species Vol. 27, No. 6, 2015717 Table 3. Quality control ranges of Candida albicans ATCC 90028, a reference strain for antifungal susceptibility test by CLSI

Antifungal Susceptibility Test Interpretive Criteria FD

Using 15 different Candida strains, an overall agreement within±2 dilutions by the CLSI method at 24h in RPMI and the μ-dependent method for three antifungal agents (fluconazole- itraconazole and.. Materials and Methods: Antifungal susceptibility testing of the yeasts was done in accordance with the proposed guidelines for antifungal disk diffusion susceptibility testing of yeasts based on the CLSI document M44-A. Results: A total of 206 yeast isolates were assessed

Candida species were identified by conventional, biochemical and molecular methods. Antifungal susceptibility tests for amphotericin B, fluconazole, voriconazole, posaconazole, caspofungin and anidulafungin were performed with broth microdilution method according to the Clinical and Laboratory Standards Institute M27-A3 document The in vitro antifungal susceptibility testing of amphotericin B (AMB) and fluconazole (FCZ) were performed by 3 methods (standard broth microdilution, Etest and candifast) on the tested Candida. The standard method of blood culture involves at least overnight agar medium subculture and then identification and antifungal susceptibility testing after a bottle is signaled as positive for Candida; it is time consuming and can delay the appropriate therapy Test ing r esult s for 14 Candida is olate s showing a catego rical dis agreement of anti fungal MIC resul ts be tween VITEK-2 AST-YS01 and CLSI BMD metho d Test in

testing of yeast. Standardised guidelines using microdilution methods (M27-A2) has been developed by clinical laboratory standard institute (CLSI), it is not being routinely used in majority of laboratories because of its complexity and cost.8,9 Recently CLSI has given guidelines for antifungal susceptibility testing of yeast b Susceptibility to 9 antifungal agents, including 4 azoles (fluconazole, voriconazole, itraconazole, and posaconazole), 3 echinocandins (caspofungin, micafungin, and anidulafungin), 5-flucytosine, and amphotericin B were determined, using in-house prepared 96-well plates following Clinical and Laboratory Standards Institute (CLSI) broth.

Antifungal susceptibility testing was performed and interpreted for all the isolates of Candida using disc diffusion method as recommended by Clinical and Laboratory Standards Institute (CLSI) M44-A document guidelines . The inoculum was prepared by suspending five colonies of growth in 5 ml of sterile saline and compared the turbidity to 0.5. Each laboratory tested at least 100 clinical isolates of Candida spp. (range 100 to 103 isolates) with the Sensititre YeastOne and the CLSI BMD frozen reference panel (a total of 304 clinical isolates). In addition, a challenge set of 100 well-characterized isolates was tested by both methods in all 3 laboratories Background: Antifungal susceptibility testing is a subject of interest in the field of medical mycology. The aim of the present study were the distributions and antifungal susceptibility patterns of various Candida species isolated from colonized and infected immunocompromised patients admitted to ten university hospitals in Iran

(PDF) Molecular Identification and Antifungal

CLSI Subcommittee on Antifungal Susceptibility Test

Standardization of antifungal susceptibility testing is an area of active research since the availability of reference methods for the testing of yeasts (Clinical and Laboratory Standards Institute [CLSI] M27-A2 method) and molds (CLSI M38-A method) (17) pachydermatis using the CLSI Broth Microdilution method that has been adapted for this yeast species (NCCLS, 2002). Based on this test, the Minimum Inhibitory Concentrations (MIC) of thiabendazol was calculated. Subsequently, the susceptibility of each isolate against this antifungal was determined. It wa Antifungal susceptibility testing has become an important tool for ­physicians faced with making difficult treatment decisions regarding treatment of patients with fungal infections. The Clinical Laboratory and Standards Institute (CLSI) has approved methods for testing of both yeast and moulds. Testing may be accomplished via macrobroth, microbroth, or disk methods

Antifungal Susceptibility Testing: Current Approaches

Etest is an agar-based gradient technique for quantitative antifungal susceptibility testing (AFST). The system comprises a predefined resistance to azoles in Candida krusei and C. glabrata. Although processed like the disc diffusion test, the preformed and stable and equivalent to those of the CLSI. treatment led to a demand for susceptibility testing of fungi13. For this purpose, the Clinical and Laboratorial Standards Institute (CLSI) approved a reference method for antifungal susceptibility testing of yeasts, the National Committee for Clinical and Laboratorial Standards (NCCLS) M-27 A2 document14. The E test1 has been introduced as a For an antifungal broth dilution susceptibility testing reference method for filamentous fungi, refer to CLSI document M38. 15. Commercially available susceptibility test systems are out of scope for this standard. It is recommended that users of these systems refer to the manufacturer's instructions as outlined in the package insert Susceptibility Test. AFST, by the Clinical and Laboratory Standards Institute (CLSI) broth microdilution (BMD) minimum inhibitory concentration (MIC) (M27-A2) method, was performed on hospital-isolated Candida species.The medium for testing antifungal agent constituted synthetic complete medium and RPMI-1640 (Sigma-Aldrich), supplemented with glutamine but without bicarbonate, as recommended alternative method for antifungal susceptibility testing and is commonly used all over the world. The aim of the present study was to compare the performance of the SYO microdilution assay with that of the reference CLSI M27-A3 BMD method in antifungal susceptibility testing of 129 Candida isolates. 2. Materials and methods 2.1. Candida isolate

Antifungal Susceptibility Testing: Clinical Laboratory and

Antifungal susceptibility testing and determination of MICs. MICs were determined according to CLSI methodologies (CLSI M27-A4, 20) in round-bottomed 96-well microtitre plates with yeast suspensions prepared in saline and then diluted into RPMI 1640 and adjusted to final concentrations of 0.5-2.5 × 10 3 cfu/mL. Inoculated plates were. Antifungal Susceptibility Methods CLSI and EUCAST Parameters for Testing Candidaspp. The CLSI and EUCAST broth microdilution standardized methodologies have been discussed in detail elsewhere [10•, 11•, 39, 40], as well in the CLSI (M27-A3) and EUCAST (EDef 7.2) documents [5-9] In vitro antifungal susceptibility testing of Candida isolates to polyenes (amphotericin B), azoles (fluconazole, voriconazole, itraconazole and posaconazole) and echinocandins (caspofungin and micafungin) was performed by the reference broth microdilution (BMD) method described in the CLSI standard M27. 20 MICs for all antifungal agents were determined after 24 h of incubation

Candida auris Identification and Rapid Antifungal

Clinical and Laboratory Standards Institute (CLSI) recently published Method for Antifungal Disk Diffusion Susceptibility Testing of Nondermatophyte Filamentous Fungi; Approved Guideline (M51-A) to respond to the need for alternative, simple, rapid, and cost-effective approaches for determining the antifungal susceptibility of nondermatophyte filamentous fungi CLSI M27-P standard by providing data which allowed the standardization of antifungal susceptibility testing of yeasts. As a result of the mentioned collaborative studies by the subcommittee, the CLSI published a reference method for determining the sensitivity of Candida spp. in liquid medium in 1992, which resulted in the proposed standard. The in-vitro antifungal susceptibility testing was carried out with the ocular fungal isolates obtained between December 1999 and May 2002 in Larsen and Toubro. Microbiology was used to dissolve amphotericin B following CLSI Candida parapsilosis guidelines.8 Fluconazole (Cipla Pharmaceuticals Limited, India) stock was 2 mg/mL. The aqueous.

(PDF) A simple and reproducible 96-well plate-based method

Antifungal susceptibility testing (AFST) has progressed in recent decades to finally become standardized and available as both Clinical and Laboratory Standards Institute (CLSI) and European Committee on Antimicrobial Susceptibility Testing (EUCAST) reference methods and in commercial manual/automated phenotypic methods Reference method for broth dilution antifungal susceptibility testing of yeasts, M27-A2. Wayne, PA: NCCLS, 2002. 3. Subcommittee on Antifungal Susceptibility Testing (AFST) of the ESCMID European Committee for Antimicrobial Susceptibility Testing (EUCAST). EUCAST Definitive Document E Def 7.1: method for the determination o known susceptibility and the patient's clinical condition. The Clinical and Laboratory Standards Institute (CLSI) recently defined new clinical breakpoints (CBP) for the most common Candida species to categorize them into resistant, intermediate and susceptible and guide anti-fungal therapy, these breakpoints are now drug and spe-cies. Methodology: Clinical and Laboratory Standards Institute [CLSI] broth microdilution and disk diffusion methods were used for testing fluconazole against C. albicans ATCC 10231 and additional 5 clinical isolates in presence of wide range of glucose concentrations [0 mg/dl-8000 mg/dl]

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