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Related Experiment Videos

Issues in antifungal susceptibility testing.

Elizabeth M Johnson1

  • 1Mycology Reference Laboratory, Health Protection Agency, Myrtle Road, Kingsdown, Bristol BS2 8EL, UK. elizabeth.johnson@ubht.nhs.uk

The Journal of Antimicrobial Chemotherapy
|February 15, 2008
PubMed
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Accurate antifungal susceptibility testing is crucial for guiding clinical treatment choices. Standardized methods now enable reliable testing, epidemiological analysis, and prediction of antifungal resistance trends.

Area of Science:

  • Medical Mycology
  • Clinical Microbiology
  • Pharmacology

Background:

  • Increasing availability of systemic antifungal agents necessitates reliable susceptibility testing.
  • Standardized methods for yeast and mould isolates ensure reproducible results.
  • Early focus was on inter-laboratory reproducibility, now methods allow epidemiological analysis.

Purpose of the Study:

  • To inform clinical choice of antifungal agents.
  • To establish breakpoints for antifungal agents using clinical outcome data.
  • To define the spectrum of activity for available antifungal agents.

Main Methods:

  • Development of standardized antifungal susceptibility testing (AST) methods.
  • Analysis of intra- and inter-laboratory reproducibility.

Related Experiment Videos

  • Pharmacokinetic/pharmacodynamic (PK/PD) analyses and resistance mechanism identification.
  • In vitro-in vivo correlation studies for clinical efficacy.

    • Main Results:

    • Standardized AST methods provide comparable results across laboratories.
    • Epidemiological analyses and trend monitoring of antifungal resistance are now feasible.
    • Breakpoint data established for some systemic agents against yeast isolates.
    • Intrinsic resistance is predictable via species identification; emergent resistance during treatment is rare.

    Conclusions:

    • Standardized antifungal susceptibility testing is vital for clinical decision-making.
    • AST aids in understanding antifungal spectrum and resistance patterns.
    • Predicting and monitoring antifungal drug resistance is essential for effective therapy.