Antifungal susceptibility testing: a primer for clinicians

Area of Science:

• Medical Microbiology
• Clinical Mycology
• Infectious Diseases

Background:

• Antifungal susceptibility testing (AST) is less common than antibacterial AST.
• Current antifungal resistance detection methods are novel, requiring specialized supplies and lacking standardized breakpoints for molds.
• Yeast breakpoints exist but require continuous updates based on surveillance data.

Purpose of the Study:

• To describe common antifungal susceptibility tests in clinical microbiology.
• To review the literature on the impact of antifungal drug selection, resistance mechanisms, and pharmacodynamics on patient outcomes.
• To highlight the importance of understanding AST methods for appropriate antifungal use.

Main Methods:

• Discussion of conventional and modern antifungal susceptibility testing methods.
• Review of literature concerning factors influencing antifungal treatment efficacy.
• Explanation of qualitative, quantitative, and automated testing systems.

Main Results:

• Antifungal susceptibility testing methods are evolving and require further research for clinical application.
• Nuances in current testing can lead to misinterpretation and suboptimal antifungal choices.
• Clinician understanding of AST is key to improving patient care and outcomes.

Conclusions:

• Reliable and reproducible antifungal susceptibility testing methods are needed.
• Further research is essential to integrate AST into patient care for positive clinical outcomes.
• Educating clinicians on AST nuances can enhance antifungal stewardship and patient management.