When Should Clinical Mycology Laboratories Perform Antifungal Susceptibility Testing? Revisiting Practice Through the Lens of Intrinsic Resistance
Mycopathologia, cilt.191, sa.1, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 191 Sayı: 1
- Basım Tarihi: 2026
- Doi Numarası: 10.1007/s11046-025-01033-6
- Dergi Adı: Mycopathologia
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, BIOSIS, Environment Index
- Anahtar Kelimeler: Acquired resistance, Fungi, Intrinsic resistance, Natural resistance, Resistance
- Hacettepe Üniversitesi Adresli: Evet
Özet
Background: Antifungal susceptibility testing (AFST) guides therapy for invasive and refractory fungal infections, but routine testing of species with predictable, species-level (intrinsic) resistance can waste laboratory resources. Methods: Narrative synthesis of guideline documents and recent literature to define intrinsic resistance, summarize major fungal examples, and propose a selective AFST framework. Results: Key taxa show intrinsic non-susceptibility (e.g., Pichia kudriavzevii to fluconazole; Mucorales to short-tailed azoles; Cryptococcus spp. to echinocandins). Terminology differences between EUCAST and CLSI are noted. Recommended AFST is targeted to invasive/rare pathogens, treatment failure, surveillance, outbreak investigation, and evaluation of novel agents. Conclusion: A selective AFST strategy, reserving routine testing for species with variable or emergent resistance, enhances laboratory efficiency and antifungal stewardship while ensuring appropriate clinical therapy.