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Abstract
Although not as ubiquitous as antibacterial susceptibility testing, antifungal susceptibility testing (AFST) is a tool of increasing importance in clinical microbiology laboratories. The goal of AFST is to reliably produce MIC values that may be used to guide patient therapy, inform epidemiological studies, and track rates of antifungal drug resistance. There are three methods that have been standardized by standards development organizations: broth dilution, disk diffusion, and azole agar screening for Aspergillus Other commonly used methods include gradient diffusion and the use of rapid automated instruments. Novel methodologies for susceptibility testing are in development. It is important for laboratories to consider not only the method of testing but also the interpretation (or lack thereof) of in vitro data.
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Posteraro B, Sanguinetti M. The future of fungal susceptibility testing. Future Microbiol 2014; 9:947-67. [DOI: 10.2217/fmb.14.55] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
ABSTRACT The antifungal treatment failures and the emergence of resistant fungal strains have stimulated the need for reproducible and clinically relevant antifungal susceptibility testing (AFST). While the standard reference methods are not intended for routine use, commercial methods are widely used for performing AFST. However, to accelerate AFST and to improve the detection of antifungal resistance, which is the most challenging goal of AFST, novel assays have been developed. Following brief drug exposures of fungal cells, the new antifungal susceptibility end points seem to provide a reliable means of identifying fungal isolates, which harbor mutations that have been associated with antifungal resistance. This article summarizes the recent progress in AFST that is destined to enhance its clinical utility in the near future.
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Affiliation(s)
- Brunella Posteraro
- Institute of Public Health, Section of Hygiene, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, Rome, Italy
| | - Maurizio Sanguinetti
- Institute of Microbiology, Università Cattolica del Sacro Cuore, Largo F. Vito 1, 00168 Rome, Italy
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Chadwick SG, Schuyler JA, Vermitsky JP, Adelson ME, Mordechai E, Gygax SE. X-Plate Technology: a new method for detecting fluconazole resistance in Candida species. J Med Microbiol 2013; 62:720-726. [DOI: 10.1099/jmm.0.054445-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Candida species are responsible for many opportunistic fungal infections. Fluconazole is a well-tolerated antifungal drug, commonly used in the treatment of candidiasis. However, with fluconazole resistance ever increasing, rapid detection and antifungal susceptibility testing of Candida is imperative for proper patient treatment. This paper reports a cost-effective, simple and rapid chromogenic agar dilution method for simultaneous Candida species identification and fluconazole susceptibility testing. The results obtained by X-Plate Technology were in absolute concordance with standard microbroth dilution assays. Analysis of 1383 clinical patient samples with suspected vulvovaginal candidiasis revealed that this technology was able to detect and speciate the Candida isolate and determine the fluconazole susceptibility. The prevalence and susceptibility profiles of the clinical isolates using this method were highly similar to published reports using the microbroth dilution method.
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Affiliation(s)
- Sean G. Chadwick
- Femeris Women’s Health Research Center, Medical Diagnostic Laboratories, LLC, A Member of Genesis Biotechnology Group, 2439 Kuser Road, Hamilton, NJ 08690, USA
| | - Jessica A. Schuyler
- Femeris Women’s Health Research Center, Medical Diagnostic Laboratories, LLC, A Member of Genesis Biotechnology Group, 2439 Kuser Road, Hamilton, NJ 08690, USA
| | - John-Paul Vermitsky
- Femeris Women’s Health Research Center, Medical Diagnostic Laboratories, LLC, A Member of Genesis Biotechnology Group, 2439 Kuser Road, Hamilton, NJ 08690, USA
| | - Martin E. Adelson
- Femeris Women’s Health Research Center, Medical Diagnostic Laboratories, LLC, A Member of Genesis Biotechnology Group, 2439 Kuser Road, Hamilton, NJ 08690, USA
| | - Eli Mordechai
- Femeris Women’s Health Research Center, Medical Diagnostic Laboratories, LLC, A Member of Genesis Biotechnology Group, 2439 Kuser Road, Hamilton, NJ 08690, USA
| | - Scott E. Gygax
- Femeris Women’s Health Research Center, Medical Diagnostic Laboratories, LLC, A Member of Genesis Biotechnology Group, 2439 Kuser Road, Hamilton, NJ 08690, USA
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