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Test ID: MMLYP    
Antimicrobial Susceptibility Panel, Yeast

Useful For Suggests clinical disorders or settings where the test may be helpful

Determining in vitro quantitative antifungal susceptibility (minimum inhibitory concentration) of non-fastidious yeast

 

Testing may be warranted to aid in the management of certain circumstances, such as:

-Refractory oropharyngeal infections due to Candida species in patients who appear to be experiencing therapeutic failure with standard agents at standard doses

-Invasive infections due to Candida species when the utility of azole antifungal agents is uncertain (eg, when the infection is due to a non-Candida albicans organism)

Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test

Candida species are the fourth leading cause of nosocomial infections and are also frequent causes of community-acquired infections.

 

Antifungal susceptibility testing may aid in the management of patients with invasive infections due to Candida species or patients who appear to be experiencing therapeutic failure.

 

The Clinical Laboratory Standards Institute has approved the use of a broth microdilution method for determining the susceptibility of Candida species.

Reference Values Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.

Results reported in mcg/mL

Interpretation Provides information to assist in interpretation of the test results

The minimum inhibitory concentration (MIC) is recorded as the lowest concentration of antifungal agent producing complete inhibition of growth. Interpretive breakpoints are available for Candida albicans, Candida glabrata, Candida guilliermondii, Candida krusei, Candida parapsilosis, and Candida tropicalis for limited drugs (see tables below); the clinical relevance of testing any other organism-drug combination remains uncertain.

Agent

MIC Ranges on Yeast Plate

(mcg/mL)

Candida albicans Interpretations (mcg/mL)

Susceptible

Dose Dependent Susceptible

Intermediate

Resistant

Amphotericin

0.12-8

-

-

-

-

Anidulafungin

0.015-8

< or =0.25

-

0.5

> or =1

Fluconazole

0.125-256

< or =2

4

-

> or =8

Itraconazole

0.015-16

-

-

-

-

Micafungin

0.008-8

< or =0.25

-

0.5

> or =1

5-Flucytosine

0.06-64

-

-

-

-

Voriconazole

0.008-8

< or =0.12

0.25-0.5

-

> or =1

Caspofungin

0.008-8

< or =0.25

-

0.5

> or =1

Posaconazole

0.008-8

-

-

-

-

 

Agent

MIC Ranges on Yeast Plate

(mcg/mL)

Candida glabrata Interpretations (mcg/mL)

Susceptible

Dose Dependent Susceptible

Intermediate

Resistant

Amphotericin

0.12-8

-

-

-

-

Anidulafungin

0.015-8

< or =0.12

-

0.25

> or =0.5

Fluconazole

0.125-256

-

< or =32

-

> or =64

Itraconazole

0.015-16

-

-

-

-

Micafungin

0.008-8

< or =0.06

-

0.12

> or =0.25

5-Flucytosine

0.06-64

-

-

-

-

Voriconazole

0.008-8

-

-

 

-

Caspofungin

0.008-8

< or =0.12

-

0.25

> or =1

Posaconazole

0.008-8

-

-

-

-

 

Agent

MIC Ranges on Yeast Plate

(mcg/mL)

Candida guilliermondii Interpretations (mcg/mL)

Susceptible

Dose Dependent Susceptible

Intermediate

Resistant

Amphotericin

0.12-8

-

-

-

-

Anidulafungin

0.015-8

< or =2

-

4

> or =8

Fluconazole

0.125-256

-

-

-

-

Itraconazole

0.015-16

-

-

-

-

Micafungin

0.008-8

< or =2

-

4

> or =8

5-Flucytosine

0.06-64

-

-

-

-

Voriconazole

0.008-8

-

-

-

-

Caspofungin

0.008-8

< or =2

-

4

> or =8

Posaconazole

0.008-8

-

-

-

-

 

 

 

 

 

 

Agent

MIC Ranges on Yeast Plate

(mcg/mL)

Candida krusei Interpretations (mcg/mL)

Susceptible

Dose Dependent Susceptible

Intermediate

Resistant

Amphotericin

0.12-8

-

-

-

-

Anidulafungin

0.015-8

< or =0.25

-

0.5

> or =1

Fluconazole

0.125-256

-

-

-

-

Itraconazole

0.015-16

 

-

-

-

Micafungin

0.008-8

< or =0.25

-

0.5

> or =1

5-Flucytosine

0.06-64

-

-

-

-

Voriconazole

0.008-8

< or =0.5

1

-

> or =2

Caspofungin

0.008-8

< or =0.25

-

0.5

> or =1

Posaconazole

0.008-8

-

-

-

-

 

Agent

MIC Ranges on Yeast Plate

(mcg/mL)

Candida parapsilosis Interpretations (mcg/mL)

Susceptible

Dose Dependent Susceptible

Intermediate

Resistant

Amphotericin

0.12-8

-

-

-

-

Anidulafungin

0.015-8

< or =2

-

4

> or =8

Fluconazole

0.125-256

< or =2

4

-

> or =8

Itraconazole

0.015-16

-

-

-

-

Micafungin

0.008-8

< or =2

-

4

> or =8

5-Flucytosine

0.06-64

-

-

-

-

Voriconazole

0.008-8

< or =0.12

0.25-0.5

-

> or =1

Caspofungin

0.008-8

< or =2

-

4

> or =8

Posaconazole

0.008-8

-

-

-

-

 

Agent

MIC Ranges on Yeast Plate

(mcg/mL)

Candida tropicalis Interpretations (mcg/mL)

Susceptible

Dose Dependent Susceptible

Intermediate

Resistant

Amphotericin

0.12-8

-

-

-

-

Anidulafungin

0.015-8

< or =0.25

-

0.5

> or =1

Fluconazole

0.125-256

< or =2

4

-

> or =8

Itraconazole

0.015-16

-

-

-

-

Micafungin

0.008-8

< or =0.25

-

0.5

> or =1

5-Flucytosine

0.06-64

-

-

-

-

Voriconazole

0.008-8

< or =0.12

0.25-0.5

-

> or =1

Caspofungin

0.008-8

< or =0.25

-

0.5

> or =1

Posaconazole

0.008-8

-

-

-

-

 

Please note that Candida krusei is intrinsically resistant to fluconazole regardless of in vitro MIC result.

Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances

The assay is intended for Candida species and is not fully validated for use with Cryptococcus species, or other rapidly growing yeast. The assay cannot be used for minimum inhibitory concentration determinations for the dimorphic yeast of filamentous fungi.

Clinical Reference Provides recommendations for further in-depth reading of a clinical nature

Pappas PG, Rex JH, Sobel JD, et al: Guidelines for treatment of Candidiasis. Clin Infect Dis 2004;38:161-189

Special Instructions and Forms Describes specimen collection and preparation information, test algorithms, and other information pertinent to test. Also includes pertinent information and consent forms to be used when requesting a particular test