Alastruey-Izquierdo Ana, Melhem Marcia S C, Bonfietti Lucas X, Rodriguez-Tudela Juan L
National Centre for Microbiology, Instituto de Salud Carlos III, Majadahonda, España.
Instituto Adolfo Lutz, Sao Paulo, SP, Brasil.
Rev Inst Med Trop Sao Paulo. 2015 Sep;57 Suppl 19(Suppl 19):57-64. doi: 10.1590/S0036-46652015000700011.
During recent decades, antifungal susceptibility testing has become standardized and nowadays has the same role of the antibacterial susceptibility testing in microbiology laboratories. American and European standards have been developed, as well as equivalent commercial systems which are more appropriate for clinical laboratories. The detection of resistant strains by means of these systems has allowed the study and understanding of the molecular basis and the mechanisms of resistance of fungal species to antifungal agents. In addition, many studies on the correlation of in vitro results with the outcome of patients have been performed, reaching the conclusion that infections caused by resistant strains have worse outcome than those caused by susceptible fungal isolates. These studies have allowed the development of interpretative breakpoints for Candida spp. and Aspergillus spp., the most frequent agents of fungal infections in the world. In summary, antifungal susceptibility tests have become essential tools to guide the treatment of fungal diseases, to know the local and global disease epidemiology, and to identify resistance to antifungals.
在最近几十年里，抗真菌药敏试验已实现标准化，如今在微生物实验室中发挥着与抗菌药敏试验相同的作用。美国和欧洲的标准已经制定出来，还有一些更适合临床实验室的等效商业系统。通过这些系统检测耐药菌株，有助于研究和理解真菌物种对抗真菌药物耐药的分子基础和机制。此外，已经开展了许多关于体外试验结果与患者预后相关性的研究，得出的结论是，耐药菌株引起的感染比敏感真菌分离株引起的感染预后更差。这些研究推动了念珠菌属和曲霉属（全球最常见的真菌感染病原体）解释性折点的制定。总之，抗真菌药敏试验已成为指导真菌疾病治疗、了解局部和全球疾病流行病学以及鉴定抗真菌药物耐药性的重要工具。
