Introduction

Invasive fungal diseases (IFDs) have received attention as an emerging public health threat, are difficult to diagnose and to treat, and are associated with substantial morbidity and mortality. The standard of care in IFD management requires an early and targeted antifungal treatment, hence covers – amongst others – species identification and antifungal susceptibility testing (AFST).

Areas covered

This review gives an overview of methods currently applied in AFST and highlights promising new tools for shortening the turnaround time focusing on Candida species.

Expert opinion

The performance of the broth microdilution reference methods for AFST is not suitable for daily laboratory practice as they are too labor-intensive and time-consuming. Other conventional approaches such as disk diffusion assays, epsilometer tests, colorimetric or automated approaches are easier in handling, and in part, show good correlations with the reference methods. Promising results for shortening the turnaround time in providing MIC data or resistance detection include matrix-assisted laser desorption/ionization-time of flight mass spectrometer (MALDI-TOF MS) assisted AFST, molecular-based techniques and modified conventional approaches applying direct inoculation methods. These underlying AFST concepts are promising but in part completely different, have their own advantages and disadvantages, and need further clinical validation.

中文翻译：

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念珠菌属物种的抗真菌药敏试验：缩短周转时间的当前方法和有希望的新工具。

介绍

侵袭性真菌病（IFD）已作为一种新兴的公共卫生威胁而受到关注，难以诊断和治疗，并与大量发病率和死亡率相关。IFD管理中的护理标准要求及早和有针对性的抗真菌治疗，因此除其他事项外，还包括物种识别和抗真菌药敏测试（AFST）。

覆盖区域

这篇综述概述了AFST中目前使用的方法，并着重介绍了有希望的新工具，可以缩短针对念珠菌物种的周转时间。

专家意见

AFST的肉汤微量稀释参考方法的性能不适合日常实验室操作，因为它们劳动强度大且费时。其他常规方法（例如磁盘扩散测定，电涡度计测试，比色法或自动方法）更易于处理，并且部分显示出与参考方法的良好相关性。缩短提供MIC数据或电阻检测的周转时间的有希望的结果包括：基质辅助激光解吸/电离飞行时间质谱仪（MALDI-TOF MS）辅助的AFST，基于分子的技术以及采用直接接种方法的改良常规方法。这些潜在的AFST概念很有希望，但部分完全不同，各有优缺点，需要进一步的临床验证。