Wiederhold Nathan P
Fungus Testing Laboratory, Department of Pathology and Laboratory Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA.
Open Forum Infect Dis. 2021 Sep 9;8(11):ofab444. doi: 10.1093/ofid/ofab444. eCollection 2021 Nov.
Clinicians treating patients with fungal infections may turn to susceptibility testing to obtain information regarding the activity of different antifungals against a specific fungus that has been cultured. These results may then be used to make decisions regarding a patient's therapy. However, for many fungal species that are capable of causing invasive infections, clinical breakpoints have not been established. Thus, interpretations of susceptible or resistant cannot be provided by clinical laboratories, and this is especially true for many molds capable of causing severe mycoses. The purpose of this review is to provide an overview of susceptibility testing for clinicians, including the methods used to perform these assays, their limitations, how clinical breakpoints are established, and how the results may be put into context in the absence of interpretive criteria. Examples of when susceptibility testing is not warranted are also provided.
治疗真菌感染患者的临床医生可能会借助药敏试验来获取有关不同抗真菌药物对已培养出的特定真菌活性的信息。这些结果随后可用于指导患者的治疗决策。然而,对于许多能够引起侵袭性感染的真菌种类,尚未确立临床断点。因此,临床实验室无法提供敏感或耐药的解读,对于许多能够引起严重真菌病的霉菌来说尤其如此。本综述的目的是为临床医生提供药敏试验的概述,包括进行这些检测的方法、其局限性、临床断点是如何确立的,以及在缺乏解读标准的情况下如何将结果应用于实际情况。还提供了不适合进行药敏试验的实例。