Antifungal Susceptibility Testing of Filamentous Fungi |
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Authors: | Ana Espinel-Ingroff Emilia Cantón Javier Pemán |
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Affiliation: | 1. 3804 Dover Rd., Richmond, VA, 23221, USA 2. Hospital Universitario y Polit??cnico La Fe, Valencia, Spain 3. Servicio de Microbiologia, Hospital Universitario La Fe, 46009, Valencia, Spain
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Abstract: | Methods developed for testing filamentous fungi (molds) include standardized broth microdilution (Clinical and Laboratory Standards Institute [CLSI] and European Committee for Antimicrobial Susceptibility Testing [AFST-EUCAST]) methods and disk diffusion (CLSI) methods. Quality control limits also are available from CLSI for MIC (minimal inhibitory concentration), MEC (minimal effective concentration), and zone diameters. Although clinical breakpoints based on correlations of in vitro results with clinical outcome have not been established, epidemiologic cutoff values have been defined for six Aspergillus species and the triazoles, caspofungin, and amphotericin B. The link between resistance molecular mechanisms, elevated MICs, and clinical treatment failure has also been documented, especially for Aspergillus and the triazoles. Other insights into the potential clinical value of high MICs have also been reported. Various commercial methods (e.g., YeastOne, Etest, and Neo-Sensitabs) have been evaluated in comparison with reference methods. This review summarizes and discusses these developments. |
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