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Chapter 8.10 : Antifungal Susceptibility Testing
Category: Clinical Microbiology
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Until recently, antifungal susceptibility testing (AFST) has lagged behind its antibacterial counterpart. A number of important achievements helped propel the antifungal susceptibility field. These achievements include publication of the approved reference method for broth dilution AFST of yeast, CLSI document M27-A3 ( 1 , 2 ); publication of interpretive breakpoints using this method ( 3 ); the recommended use of AFST during selection of therapy of patients with candidemia and hematogenously disseminated candidiasis as outlined by the published guidelines for the treatment of candidiasis ( 4 ); publication of a reference method for broth dilution AFST of conidium-forming filamentous fungi, CLSI document M38-A2 ( 5 ); and recent development and publication of AFST methods for dermatophytes ( 6 ). The procedures described below are based on CLSI documents M27-A3, M27-S4, and M38-A2.
Dilution procedure for water-soluble drugs
Dilution procedure for water-insoluble drugs
Recommended 24- and 48-h MIC limits for two QC strains for broth microdilution ( 2 )
Dilution procedure for water-insoluble drugs used in broth microdilution susceptibility tests for nondermatophyte filamentous moulds
Dilution procedure for water-insoluble drugs used in broth dilution susceptibility tests for dermatophyte isolates
Dilution procedure for water-soluble drugs used in broth dilution susceptibility tests of dermatophyte and nondermatophyte filamentous moulds
Interpretive guidelines for in vitro susceptibility testing of Candida spp. and selected azoles after 24-h incubation a
Recommended quality control zone diameter (mm) ranges for testing yeast isolates a
Recommended QC zone diameter (mm) ranges for testing filamentous fungi a
Zone diameter interpretive standards and corresponding MIC breakpoints for select antifungal agents against Candida spp. a