Factors influencing the trailing endpoint observed in Candida albicans susceptibility testing using the CLSI procedure

Abstract

The trailing endpoint phenotype observed during testing of Candida albicans susceptibility to azoles according to the CLSI procedure is defined as a difference in MIC depending on whether the result is obtained after 24 or 48 h. This study investigated whether intrinsic differences between the EUCAST and CLSI methods could explain trailing growth. The glucose concentration in the medium and the shape of the microtitre plate wells were both found to be involved. In order to reduce the incidence of trailing growth according to the CLSI procedure, the use of higher glucose concentrations and flat-bottomed microtitre plates could be valuable improvements.