Antifungal Susceptibility Testing 2022

Dear Colleagues,

For many years, only one compound was available to treat serious fungal infections. Fortunately, in the last few decades, several other drugs and families have been licensed and a number of other antifungal drugs are currently under different stages of clinical development. Therefore, nowadays, there are several therapeutic options to treat fungal infections. Additionally, a number of fungal pathogenic species (with different susceptibility profiles) and antifungal resistance are emerging worldwide, threatening the outcomes of patients infected with resistant isolates and becoming a public health threat. Resistance is emerging in Candida and Aspergillus and in azoles and echinocandins but it is present in many other fungal species, such as the species of Scedosporium, Fusarium, Lomentospora or the order mucorales. Antifungal resistance surveillance is being recommended to monitor resistance emergence and WHO is formally requesting the inclusion of Candida in the GLASS (Global Antimicrobial Surveillance) program. Detection of antifungal resistance and susceptibility profiles of fungal pathogens are essential to manage patients affected with fungal infections. Two organizations, the European EUCAST and the American CLSI, have intensively worked towards standardized methods for antifungal susceptibility testing and have developed interpretative breakpoints to define antifungal resistance. However, other commercial methods have been developed, providing comparable results that are increasingly used in the clinical setting. Therefore, antifungal susceptibility tests have now become essential tools to detect resistance, to guide treatment and to study epidemiology in different settings.

Dr. Ana Alastruey-Izquierdo
Guest Editor

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