UPDATE ON CLINICAL ANTIFUNGAL SUSCEPTIBILITY TESTING FOR CANDIDA SPECIES

With the emergence of fungi as important nosocomial pathogens, increas ing reports of antifungal resistance, and expanding drug therapy optio ns, the need for clinically relevant antifungal susceptibility testing is evident. Over the last decade, the National Committee for Clinical Laboratory Standards (NCCLS) worked to standardize procedures for in vitro susceptibility testing of Candida species against fluconazole, i traconazole, 5-fluorocytosine, and amphotericin B. With the establishm ent of a reproducible methodology, correlation of antifungal susceptib ility in vitro with clinical outcome is a priority. The NCCLS proposed susceptibility breakpoints for the three agents against Candida speci es, with breakpoints for amphotericin B forthcoming. These breakpoints could provide useful guidance in some clinical situations involving a zole or S-fluorocytosine therapy; however, routine susceptibility test ing of fungal isolates should be discouraged.