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Updated: Jan 7, 2026
Whole Genome Sequencing of Candida glabrata for Detection of Markers of Antifungal Drug Resistance
Published on: December 28, 2017
When Should Clinical Mycology Laboratories Perform Antifungal Susceptibility Testing? Revisiting Practice Through the
Cornelia Lass-Flörl1, Sevtap Arikan-Akdagli2
1Institute of Hygiene and Medical Microbiology, ECMM Excellence Center of Medical Mycology, Medical University of Innsbruck, Innsbruck, Austria. cornelia.lass-floerl@i-med.ac.at.
Background:
Antifungal susceptibility testing (AFST) guides therapy for invasive and refractory fungal infections, but routine testing of species with predictable, species-level (intrinsic) resistance can waste laboratory resources.
Methods:
Narrative synthesis of guideline documents and recent literature to define intrinsic resistance, summarize major fungal examples, and propose a selective AFST framework.
Results:
Key taxa show intrinsic non-susceptibility (e.g., Pichia kudriavzevii to fluconazole; Mucorales to short-tailed azoles; Cryptococcus spp. to echinocandins). Terminology differences between EUCAST and CLSI are noted. Recommended AFST is targeted to invasive/rare pathogens, treatment failure, surveillance, outbreak investigation, and evaluation of novel agents.
Conclusion:
A selective AFST strategy, reserving routine testing for species with variable or emergent resistance, enhances laboratory efficiency and antifungal stewardship while ensuring appropriate clinical therapy.
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