Antifungal Susceptibility Testing Methodologies
Summary
Antifungal susceptibility testing (AFST) underpins infectious disease management by guiding clinical decisions, informing public health surveillance and accelerating therapeutic development. Reference methods—principally broth microdilution protocols endorsed by international standards bodies—determine minimum inhibitory concentrations (MICs) and minimum fungicidal concentrations (MFCs) for yeast and mould pathogens. Complementary approaches such as gradient diffusion (Etest) and disk diffusion assays provide rapid, cost-effective estimates of MIC values, while automated systems deliver standardised, high-throughput workflows. Recent innovations include miniaturised plate formats, digital image analysis and integration with informatics platforms to enhance reproducibility and data comparability. Harmonisation of media, inoculum density and endpoint criteria remains essential to ensure global consistency, reliable susceptibility categorisation and effective stewardship of existing and novel antifungal agents.
Research from Nature Portfolio
Recent studies have optimised broth microdilution testing by extending standard protocols to high-density 384-well formats, achieving uniform growth conditions and minimal variability across ten clinically authorised antifungal agents. This enhanced configuration retains established endpoint definitions while screening a broader array of compounds, thereby streamlining early-stage drug discovery and enabling comprehensive resistance monitoring in diverse fungal species.
Antifungal Susceptibility Testing Methodologies publication trend
The graph below shows the total number of articles in antifungal susceptibility testing methodologies across all publications each year (not limited to Nature Index journals).
Technical terms
Minimum inhibitory concentration (MIC): The lowest drug concentration that visibly prevents fungal growth under standard conditions.
Minimum fungicidal concentration (MFC): The lowest concentration that kills a defined proportion of the inoculum, typically ≥99.9 %.
Broth microdilution: A quantitative method in which serial dilutions of an antifungal are prepared in liquid medium and inoculated to establish MICs.
Etest: A strip-based gradient diffusion technique on agar that produces an elliptical inhibition zone intersecting the strip to indicate MIC.
Disk diffusion: A qualitative or semi-quantitative assay where drug-impregnated disks on agar yield inhibition zones whose diameters infer susceptibility.
References
- Standardisation of high throughput microdilution antifungal susceptibility testing for Candida albicans and Cryptococcus neoformans. Scientific Reports (2024).
- Design, Synthesis, and Antifungal Activity of 3‑Substituted-2(5H)‑Oxaboroles. ACS Medicinal Chemistry Letters (2024).
- Antifungal susceptibility of yeasts by Etest. Comparison of 3 media.. Revista Medica de Chile (2003).
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