Is a New Standard Needed for Diffusion Methods for In Vitro Susceptibility Testing of Fosfomycin against Pseudomonas aeruginosa?

We analyzed fosfomycin susceptibility results in Pseudomonas aeruginosa clinical isolates obtained by MIC gradient strips and disk diffusion methods using two different inocula, 10(8) and 10(6) CFU/ml, and compared them to the agar dilution reference method. Essential and categorical agreements were 93.6% and 95%, respectively, for the 10(6) CFU/ml alternative inoculum, and they were 67.6% and 78.2%, respectively, for the standard inoculum (10(8) CFU/ml). The use of the 10(6) CFU/ml inoculum improves the agreement values and inhibition zone readings.