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Fungal Drug Resistance Assays

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Antimicrobial Drug Resistance

Abstract

The increase in opportunistic mycosis as well as the emergence of antifungal resistance and the development of novel antifungal drugs necessitated the development of standard phenotypic drug resistance assays for fungi. Microdilution methods for testing yeasts (CLSI M27-A3 and EUCAST E.Def 7.2 assay) and filamentous fungi (CLSI M38-A2 and EUCAST E.Def 9.2 assay) are available. Disk diffusion assays for testing Candida (CLSI M44-A2) and nondermatophytic molds (CLSI M51-A) have also been standardized. Despite their availability and increasing knowledge of epidemiological cutoff values, these assays still have limitations. Most notably, clinical MIC breakpoints are as yet undetermined for some important drug–genus combinations. In an effort to standardize methodologies that might solve these problems as well as approaches that would support assay automation, techniques based on gradient strip method, colorimetric microdilution, agar dilution, flow cytometry, sterol quantitation, and isothermal microcalorimetry are also being studied. MALDI-TOF MS and genotypic assays are other approaches currently explored for detection of antifungal resistance.

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Authors and Affiliations

  1. Professor of Microbiology and Clinical Microbiology, Hacettepe University Medical School, Ankara, Turkey

    Sevtap Arikan-Akdagli M.D.

  2. Mycology Laboratory, Hacettepe University Medical School, Ankara, Turkey

    Sevtap Arikan-Akdagli M.D.

  3. AstraZeneca Infection Business Unit, Waltham, MA, USA

    John H. Rex M.D.

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  1. Sevtap Arikan-Akdagli M.D.
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  2. John H. Rex M.D.
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Correspondence to Sevtap Arikan-Akdagli M.D. .

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  1. Treiber Therapeutics, Cambridge, Massachusetts, USA

    Douglas L. Mayers

  2. Wayne State University School of Medicine, Detroit Medical Center, Detroit, Michigan, USA

    Jack D. Sobel

  3. Canada Research Chair in Antimicrobial Resistance, Centre de recherche en Infectiologie, University of Laval, Quebec City, Canada

    Marc Ouellette

  4. Division of Infectious Diseases, University of Michigan Medical School, Ann Arbor, Michigan, USA

    Keith S. Kaye

  5. Infection Control and Prevention Unit of Infectious Diseases, Assaf Harofeh Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel

    Dror Marchaim

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Arikan-Akdagli, S., Rex, J.H. (2017). Fungal Drug Resistance Assays. In: Mayers, D., Sobel, J., Ouellette, M., Kaye, K., Marchaim, D. (eds) Antimicrobial Drug Resistance. Springer, Cham. https://doi.org/10.1007/978-3-319-47266-9_34

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