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Fungal susceptibility testing: where are we now?
1University of Texas Health Science Center at San Antonio, San Antonio, TX 78229-3900, USA. patterson@uthscsa.edu
Summary
Antifungal susceptibility testing is crucial for managing invasive fungal infections in immunocompromised patients. Judicious use of these tests aids clinicians in selecting appropriate antifungal agents and improves patient outcomes.
Area of Science:
- Medical Mycology
- Infectious Diseases
- Clinical Microbiology
Background:
- Invasive fungal infections (IFIs) are increasing in immunocompromised patients.
- Emerging antifungal resistance necessitates reliable diagnostic methods.
- Established standards exist for antifungal susceptibility testing (AST) of yeasts and moulds.
Purpose of the Study:
- To review the clinical relevance and utility of antifungal susceptibility testing.
- To evaluate the role of AST in guiding the management of IFIs.
- To discuss species-level identification of yeasts for predicting antifungal susceptibility.
Main Methods:
- Literature review of clinical data supporting the use of antifungal susceptibility testing.
- Evaluation of strategies for predicting antifungal susceptibility, including species identification.
- Assessment of the role of the mycology laboratory in managing IFIs.
Main Results:
- Clinical data, particularly for yeasts, support the judicious use of antifungal susceptibility testing.
- Species identification can aid in predicting antifungal susceptibility.
- Not all fungal isolates require susceptibility testing; strategic application is key.
Conclusions:
- Antifungal susceptibility testing is a valuable tool when used judiciously in managing IFIs.
- Mycology laboratories play a vital role in assisting clinicians through AST and species identification.
- The strategic use of these tests, rather than routine application, optimizes patient care.