Testing of micromycets' susceptibility to antifungals in vitro in immunosuppressed patients - expert recommendations with the support of CELL and SLM CLS JEP
Abstract
A significant increase in the frequency of systemic fungal infections in patients with serious diseases was observed in the last twenty years. Thus a number of new antifungal agents were developed, but micromycets' resistance was also gradually growing in the population.
Based on the need for an early and objective detection of this resistance the importance of determination of susceptibility to antifungal agents in vitro, including the need for unificatin of methodologies, was increasing.In this article the development and basic features of current standardized procedures are summarized and the significance of derived commercial products for diagnostic practice is assessed. In further parts of the article current approaches to the interpretation of results are discussed and the importance of clinical breakpoints is commented.
The circumstances under which it is advisable to perform suscceptibility testint are mentioned and knowledge, limiting our options in terms of properties of individual groups of antifungals and micromycets species, is listed. In conclusion, recommendations for the use of methods for detecting resistance of yeasts an filamentous fungi in isolates obtained from immunocompromised patients, through summarizatin of the most important concepts, are developed.