Cited by 82Antifungal resistance and susceptibilityFungal Plant Pathogen ControlFungal and yeast genetics research

Molecular mechanisms of acquired antifungal drug resistance in principal fungal pathogens and EUCAST guidance for their laboratory detection and clinical implications

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Rogers, Thomas R, Verweij, Paul E, Castanheira, Mariana, Dannaoui, Eric, White, P Lewis, Arendrup, Maiken Cavling, Subcommittee on Antifungal Susceptibility Testing (AFST) of the ESCMID European Committee for Antimicrobial Susceptibility Testing (EUCAST), Arendrup, M C +18 more·2022·Journal of Antimicrobial Chemotherapy

Abstract

The increasing incidence and changing epidemiology of invasive fungal infections continue to present many challenges to their effective management. The repertoire of antifungal drugs available for treatment is still limited although there are new antifungals on the horizon. Successful treatment of invasive mycoses is dependent on a mix of pathogen-, host- and antifungal drug-related factors. Laboratories need to be adept at detection of fungal pathogens in clinical samples in order to effectively guide treatment by identifying isolates with acquired drug resistance. While there are international guidelines on how to conduct in vitro antifungal susceptibility testing, these are not performed as widely as for bacterial pathogens. Furthermore, fungi generally are recovered in cultures more slowly than bacteria, and often cannot be cultured in the laboratory. Therefore, non-culture-based methods, including molecular tests, to detect fungi in clinical specimens are increasingly important in patient management and are becoming more reliable as technology improves. Molecular methods can also be used for detection of target gene mutations or other mechanisms that predict antifungal drug resistance. This review addresses acquired antifungal drug resistance in the principal human fungal pathogens and describes known resistance mechanisms and what in-house and commercial tools are available for their detection. It is emphasized that this approach should be complementary to culture-based susceptibility testing, given the range of mutations, resistance mechanisms and target genes that may be present in clinical isolates, but may not be included in current molecular assays.

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  1. [167]WHO. Guidelines on the diagnosis, prevention and management of cryptococcal disease in HIV-infected adults, adolescents and children: supplement to the 2016 consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection. Geneva: WHO 2018. https://apps.who.int/iris/handle/10665/260399. 30285342
  2. [226]CLSI. Reference Method for Broth Dilution Antifungal Susceptibility Testing of Filamentous Fungi; Approved Standard—Second Edition: M38-A2. 2008.
  3. [257]Ahn A, Chang J, Sung H et al Case of pneumonia caused by Pneumocystis jirovecii resistant to SXT in the absence of previous drug exposure. Lab Med Online 2016; 6: 250– 4.

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Authors
Rogers, T. R., Verweij, P. E., Castanheira, M., Dannaoui, E., White, P. L., Arendrup, M. C., Subcommittee on Antifungal Susceptibility Testing (AFST) of the ESCMID European Committee for Antimicrobial Susceptibility Testing (EUCAST), Arendrup, M. C., Arikan-Akdagli, S., Barchiesi, F., Buil, J., Castanheira, M., Chryssanthou, E., Friberg, N., Guinea, J., Hamal, P., Hilmarsdottir, I., Klimko, N., Kurzai, O., Lagrou, K., Lass-Flörl, C., Matos, T., Meletiadis, J., Moore, C., Muehlethaler, K., & Rogers, T. R.
Affiliations
  • Department of Clinical Microbiology, Trinity College Dublin, St James’s Hospital Campus , Dublin 8 , Ireland
  • Radboud University Nijmegen (NL)
  • JMI Laboratories, North Liberty , IA , USA
  • Unité de parasitologie-mycologie, service de microbiologie, hôpital européen Georges-Pompidou, AP-HP , Paris , France
  • University Hospital of Wales (GB)
  • Unit of Mycology , Statens Serum Institut, Copenhagen , Denmark
  • Statens Serum Institut (DK)
  • Université Paris Cité (FR)
Venue
Journal of Antimicrobial Chemotherapy
Published
2022-06-15
Volume
77
Issue
8
Pages
2053-2073
ISSN
  • 0305-7453 (ISSN-L)
  • 1460-2091
OpenAlex
W4282963864
Cited by
82
References
269
Citations by year
2026: 14 · 2025: 23 · 2024: 20 · 2023: 21 · 2022: 4
FWCI
2.61
Type
journal article
Language
en
Open access
Locations
  • Journal of Antimicrobial Chemotherapy (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • Research at the University of Copenhagen (University of Copenhagen) (publishedVersion, cc-by-nc)
  • Lirias (submittedVersion, cc-by-nc)
  • HAL (submittedVersion, other-oa)
  • Radboud Repository (Radboud University) (submittedVersion)
  • Radboud Repository (Radboud University) (submittedVersion, other-oa)
Funders
  • Pfizer
  • Bayer
  • GlaxoSmithKline
  • Novartis
  • Gilead Sciences
  • Beth Israel Deaconess Medical Center
  • University of Southern California
  • Wayne State University
  • Tufts Medical Center
  • F. Hoffmann-La Roche
  • Medpace
  • Harvard University
  • University of Texas Southwestern Medical Center
  • University of North Texas
  • Cidara Therapeutics
  • GenePOC
  • Medicines Company
  • Melinta Therapeutics
  • Amplyx
  • Boston Pharmaceuticals
  • Achaogen
  • Entasis Therapeutics
  • Albany College of Pharmacy and Health Sciences
  • Nabriva Therapeutics
  • Insmed
  • National University of Singapore
  • European Society of Clinical Microbiology and Infectious Diseases
  • University of Queensland
  • Meiji Seika Pharma
  • North Bristol NHS Trust
  • Astellas Pharma
  • Shionogi
  • Radboud Universitair Medisch Centrum
  • Astellas Foundation for Research on Metabolic Disorders
  • Basilea Pharmaceutica
  • Pfizer Healthcare Ireland
  • Wockhardt
  • Idorsia Pharmaceuticals
  • Dr. Falk Pharma
  • TenNor Therapeutics
  • Roivant Sciences
  • National Institutes of Health
  • U.S. Food and Drug Administration
  • Allergan
  • Medical Center, University of Rochester
Topics
  • Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
  • Life Sciences › Agricultural and Biological Sciences › Ecology, Evolution, Behavior and Systematics › Fungal Plant Pathogen Control
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Fungal and yeast genetics research
Keywords
invasive fungal infections, antifungal susceptibility testing, EUCAST guidelines, resistance mechanisms, clinical isolates, antifungal agents
MeSH terms
Invasive Fungal Infections, Antifungal Agents, Fungi, Humans, Laboratories, Microbial Sensitivity Tests, Drug Resistance, Fungal

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