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Can We Improve Antifungal Susceptibility Testing?
Systemic antifungal agents are increasingly used for prevention or treatment of invasive fungal infections, whose prognosis remains poor. At the same time, emergence of resistant or even multi-resistant strains is of concern as the antifungal arsenal is limited. Antifungal susceptibility testing (AF...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Frontiers Media S.A.
2021
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8461061/ https://www.ncbi.nlm.nih.gov/pubmed/34568095 http://dx.doi.org/10.3389/fcimb.2021.720609 |
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author | Durand, Charlotte Maubon, Danièle Cornet, Muriel Wang, Yan Aldebert, Delphine Garnaud, Cécile |
author_facet | Durand, Charlotte Maubon, Danièle Cornet, Muriel Wang, Yan Aldebert, Delphine Garnaud, Cécile |
author_sort | Durand, Charlotte |
collection | PubMed |
description | Systemic antifungal agents are increasingly used for prevention or treatment of invasive fungal infections, whose prognosis remains poor. At the same time, emergence of resistant or even multi-resistant strains is of concern as the antifungal arsenal is limited. Antifungal susceptibility testing (AFST) is therefore of key importance for patient management and antifungal stewardship. Current AFST methods, including reference and commercial types, are based on growth inhibition in the presence of an antifungal, in liquid or solid media. They usually enable Minimal Inhibitory Concentrations (MIC) to be determined with direct clinical application. However, they are limited by a high turnaround time (TAT). Several innovative methods are currently under development to improve AFST. Techniques based on MALDI-TOF are promising with short TAT, but still need extensive clinical validation. Flow cytometry and computed imaging techniques detecting cellular responses to antifungal stress other than growth inhibition are also of interest. Finally, molecular detection of mutations associated with antifungal resistance is an intriguing alternative to standard AFST, already used in routine microbiology labs for detection of azole resistance in Aspergillus and even directly from samples. It is still restricted to known mutations. The development of Next Generation Sequencing (NGS) and whole-genome approaches may overcome this limitation in the near future. While promising approaches are under development, they are not perfect and the ideal AFST technique (user-friendly, reproducible, low-cost, fast and accurate) still needs to be set up routinely in clinical laboratories. |
format | Online Article Text |
id | pubmed-8461061 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-84610612021-09-25 Can We Improve Antifungal Susceptibility Testing? Durand, Charlotte Maubon, Danièle Cornet, Muriel Wang, Yan Aldebert, Delphine Garnaud, Cécile Front Cell Infect Microbiol Cellular and Infection Microbiology Systemic antifungal agents are increasingly used for prevention or treatment of invasive fungal infections, whose prognosis remains poor. At the same time, emergence of resistant or even multi-resistant strains is of concern as the antifungal arsenal is limited. Antifungal susceptibility testing (AFST) is therefore of key importance for patient management and antifungal stewardship. Current AFST methods, including reference and commercial types, are based on growth inhibition in the presence of an antifungal, in liquid or solid media. They usually enable Minimal Inhibitory Concentrations (MIC) to be determined with direct clinical application. However, they are limited by a high turnaround time (TAT). Several innovative methods are currently under development to improve AFST. Techniques based on MALDI-TOF are promising with short TAT, but still need extensive clinical validation. Flow cytometry and computed imaging techniques detecting cellular responses to antifungal stress other than growth inhibition are also of interest. Finally, molecular detection of mutations associated with antifungal resistance is an intriguing alternative to standard AFST, already used in routine microbiology labs for detection of azole resistance in Aspergillus and even directly from samples. It is still restricted to known mutations. The development of Next Generation Sequencing (NGS) and whole-genome approaches may overcome this limitation in the near future. While promising approaches are under development, they are not perfect and the ideal AFST technique (user-friendly, reproducible, low-cost, fast and accurate) still needs to be set up routinely in clinical laboratories. Frontiers Media S.A. 2021-09-10 /pmc/articles/PMC8461061/ /pubmed/34568095 http://dx.doi.org/10.3389/fcimb.2021.720609 Text en Copyright © 2021 Durand, Maubon, Cornet, Wang, Aldebert and Garnaud https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Cellular and Infection Microbiology Durand, Charlotte Maubon, Danièle Cornet, Muriel Wang, Yan Aldebert, Delphine Garnaud, Cécile Can We Improve Antifungal Susceptibility Testing? |
title | Can We Improve Antifungal Susceptibility Testing? |
title_full | Can We Improve Antifungal Susceptibility Testing? |
title_fullStr | Can We Improve Antifungal Susceptibility Testing? |
title_full_unstemmed | Can We Improve Antifungal Susceptibility Testing? |
title_short | Can We Improve Antifungal Susceptibility Testing? |
title_sort | can we improve antifungal susceptibility testing? |
topic | Cellular and Infection Microbiology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8461061/ https://www.ncbi.nlm.nih.gov/pubmed/34568095 http://dx.doi.org/10.3389/fcimb.2021.720609 |
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