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Antifungal susceptibility testing in teaching hospitals
Manjunath P Pai1, Susan L Pendland
1College of Pharmacy, University of New Mexico, Albuquerque, NM, USA.
The Annals of Pharmacotherapy
|January 29, 2003
Summary
Antifungal susceptibility testing (AST) practices were assessed in teaching hospitals. On-site AST yielded faster results for Candida bloodstream isolates compared to off-site testing.
Area of Science:
- Clinical Microbiology
- Infectious Diseases
- Healthcare Management
Background:
- Antifungal susceptibility testing (AST) assessments have not been updated since the NCCLS M27-A document.
- Current AST practices in teaching hospitals remain largely uncharacterized.
Purpose of the Study:
- To determine the current antifungal susceptibility testing (AST) practices in teaching hospitals across the United States.
- To evaluate the timeliness of AST results based on testing location (on-site vs. off-site).
Main Methods:
- A national survey using questionnaires was distributed to 386 microbiology departments in randomly selected teaching hospitals.
- Data on Candida isolate numbers and AST performance were collected and analyzed.
- Response rates and hospital characteristics (bed size, inpatient days) were documented.
Main Results:
- A 44.3% response rate was achieved, with 171 institutions participating.
- Approximately 1% of over 137,000 Candida isolates underwent AST, primarily from blood specimens.
- AST was performed by 67.2% of hospitals; on-site testing (27 institutions) resulted in significantly faster turnaround times (3 days) compared to off-site testing (7-10 days).
Conclusions:
- A substantial volume of Candida bloodstream isolates is subjected to AST annually.
- On-site AST significantly reduces the time to obtain crucial results, potentially improving patient management.
- Standardized AST protocols, like NCCLS methodology (80% broth microdilution), are widely adopted for on-site testing.