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Antifungal susceptibility testing and resistance 

Antifungal susceptibility testing and resistance
Chapter:
Antifungal susceptibility testing and resistance
Author(s):

Elizabeth M. Johnson

DOI:
10.1093/med/9780198755388.003.0047
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date: 24 February 2021

The availability of choice of systemically active antifungal agents and the proliferation in the number of fungal species implicated in invasive disease have meant that clinicians are increasingly looking for guidance from clinical laboratory results to help select the most appropriate agent. There are now well-established and predictable patterns of innate in vitro resistance to one or more antifungal agents associated with many yeast and mould species. This chapter provides definitions for the most frequently used terminology and outlines some of the issues surrounding antifungal susceptibility testing with yeast and mould isolates. Reference methods published by the Clinical Laboratory Standards Institute (CLSI) and the European Committee on Antimicrobial Susceptibility Testing (EUCAST) are discussed. Both innate and emergent antifungal drug resistance are increasingly recognized as limiting factors in the selection of antifungal agents, and the epidemiology and mechanisms of resistance are described for each of the major classes of antifungal agent.

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