Antifungal susceptibility testing practices at acute care hospitals enrolled in the National Healthcare Safety Network, United States, 2011–2015.
Open accessAbstract
We assessed availability of antifungal susceptibility testing (AFST) at nearly 4000 acute care hospitals enrolled in the National Healthcare Safety Network. In 2015, 95% offered any AFST, 28% offered AFST at their own laboratory or at an affiliated medical center, and 33% offered reflexive AFST. Availability of AFST improved from 2011 to 2015, but substantial gaps exist in the availability of AFST.
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Availability of species-level identification and AFST, especially AFST, is limited in clinical laboratories.
“However, availability of both types of testing, especially AFST, is limited in clinical laboratories (62).”
From Population-Based Active Surveillance for Culture-Confirmed Candidemia — Four Sites, United States, 2012–2016 (2019) · cites this paper as [62]
The Results and Discussion report limited access to AFST at a hospital’s own laboratory or an affiliated medical center, and limited reflexive AFST. They also report that 95.5% of surveyed hospitals offered AFST through some route, so the limitation concerns local and reflexive access rather than AFST availability overall. The paper does not establish that species-level identification is limited. (LLM, conf=0.88)
Experimental — accuracy not yet measuredA recent analysis using National Healthcare Safety Network data found that reflexive AFST is lacking in approximately two-thirds of acute care hospitals.
“A recent analysis using National Healthcare Safety Network data found that reflexive AFST is lacking in approximately two-thirds of acute care hospitals [14].”
From Treatment practices for adults with candidemia at 9 active surveillance sites—United States, 2017–2018. (2021) · cites this paper as [14]
The frequency of AFST performance and use in clinical decision-making might vary based on cost, lack of trained personnel, and reliance on off-site testing, which can delay results (about 3 days on-site vs 7 days off-site).
“Although the capacity of laboratories in the United States to perform AFST has increased in recent years, the frequency of AFST performance and use in clinical decision-making might vary based on several factors, including cost, a lack of personnel trained in mycology, and reliance on off-site testing, which can substantially delay results (from ~3 days with on-site testing versus ~7 days for off”
From Treatment practices for adults with candidemia at 9 active surveillance sites—United States, 2017–2018. (2021) · cites this paper as [14]
Because it generally takes at least 2-4 days after blood culture collection to detect and identify Candida species, and because access to AFST may be limited or delayed, clinicians usually select initial antifungal treatment based on local species epidemiology, antifungal resistance patterns, and individual patient factors.
“Because it generally takes at least 2–4 days after blood culture collection to detect and identify Candida species, and because access to AFST may be limited or delayed, clinicians usually select initial antifungal treatment based on local species epidemiology, antifungal resistance patterns, and individual patient factors [13–16].”
From Treatment practices for adults with candidemia at 9 active surveillance sites—United States, 2017–2018. (2021) · cites this paper as [14]
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Cites
Pappas, P. G., Kauffman, C. A., Andes, D. R., Clancy, C. J., Marr, K. A., Ostrosky-Zeichner, L., Reboli, A. C., Schuster, M. G., Vazquez, J. A., Walsh, T. J., et al. (2016) · Clinical Infectious Diseases · doi:10.1093/cid/civ933 · Cited by 4,200 · see citing works
Multistate point-prevalence survey of health care-associated infections
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Self-citationPappas, P. G., Kauffman, C. A., Andes, D. R., Clancy, C. J., Marr, K. A., Ostrosky-Zeichner, L., Reboli, A. C., Schuster, M. G., Vazquez, J. A., Walsh, T. J., et al. (2016) · Clinical Infectious Diseases · doi:10.1093/cid/civ1194 · Cited by 1,298 · see citing works
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Self-citationWiederhold, N. P., Gil, V. G., Gutierrez, F., Lindner, J. R., Bataineh, M. T. A., McCarthy, D. I., Sanders, C. J., Fan, H., Fothergill, A. W., & Sutton, D. A. (2015) · Journal of Clinical Microbiology · doi:10.1128/jcm.02478-15 · Cited by 168 · see citing works
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Self-citationShah, D. N., Yau, R., Weston, J., Lasco, T. M., Salazar, M., Palmer, H. R., & Garey, K. W. (2011) · Journal of Antimicrobial Chemotherapy · doi:10.1093/jac/dkr244 · Cited by 75 · see citing works
Antifungal susceptibility testing in teaching hospitals
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Toda, M., Williams, S. R., Berkow, E. L., Farley, M. M., Harrison, L. H., Bonner, L., Marceaux, K. M., Hollick, R., Zhang, A. Y., Schaffner, W., et al. (2019) · MMWR Surveillance Summaries · doi:10.15585/mmwr.ss6808a1 · Cited by 198 · see citing works
“However, availability of both types of testing, especially AFST, is limited in clinical laboratories (62).”
BackgroundSelf-citationGold, J. A. W., Seagle, E. E., Nadle, J., Barter, D. M., Czaja, C. A., Johnston, H., Farley, M. M., Thomas, S., Harrison, L. H., Fischer, J., et al. (2021) · Clinical Infectious Diseases · doi:10.1093/cid/ciab512 · Cited by 20 · see citing works
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- Authors
- Vallabhaneni, S., Sapiano, M., Weiner, L. M., Lockhart, S. R., & Magill, S.
- Affiliations
- Mycotic Diseases Branch and
- Centers for Disease Control and Prevention (US)
- Corresponding author
- Vallabhaneni, Snigdha
- Venue
- Open Forum Infectious Diseases
- Publisher
- Oxford University Press (OUP)
- Published
- 2017
- Volume
- 4
- Issue
- 4
- Pages
- ofx175-ofx175
- ISSN
- 2328-8957 (ISSN-L)
- PMC
- PMC5632525
- OpenAlex
- W2569696447
- Cited by
- 14
- References
- 11
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 1 · 2023: 1 · 2021: 2 · 2020: 1 · 2019: 3 · 2018: 2
- FWCI
- 1.26
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- public-domain
- Locations
- Open Forum Infectious Diseases (publishedVersion, public-domain)
- Europe PMC (PubMed Central) (publishedVersion, public-domain)
- PubMed Central (publishedVersion, public-domain)
- PubMed (publishedVersion)
- Funders
- Centers for Disease Control and Prevention
- Topics
- Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
- Life Sciences › Immunology and Microbiology › Applied Microbiology and Biotechnology › Antibiotic Use and Resistance
- Health Sciences › Medicine › Infectious Diseases › Infection Control in Healthcare
- Keywords
- antifungal susceptibility testing, acute care hospitals, National Healthcare Safety Network, reflex testing, healthcare-associated fungal infections
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