Test ID: MMLYP
Antimicrobial Susceptibility Panel, Yeast
NY State Approved 
Indicates the status of NY State approval and if the test is orderable for NY State clients.
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)
Additional Tests Lists test(s) that are always performed, at an additional charge, with the initial test(s)
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| SYP | Susceptibility Yeast Panel | No, (Bill Only) | Yes |
Testing Algorithm Delineates situation(s) when tests are added to the initial order. This includes reflex and additional tests.
When this test is ordered, Susceptibility Yeast Panel will be performed and charged.
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
Method Name A short description of the method used to perform the test
Minimum Inhibitory Concentration (MIC)
Antifungals included in the assay are: amphotericin B, anidulafungin, caspofungin fluconazole, 5-flucytosine, itraconazole, micafungin, posaconazole, and voriconazole.
Reporting Name A shorter/abbreviated version of the Published Name for a test; an abbreviated test name
Aliases Lists additional common names for a test, as an aid in searching
Amphotericin B (Abelcet)
Ancobon (5-Flucytosine)
Anidulafungin (ERAXIS)
CANCIDAS (Caspofungin)
Caspofungin (CANCIDAS)
Diflucan (Fluconazole)
ERAXIS (Anidulafungin)
Fluconazole (Diflucan)
Flucytosine (Ancobon)
Itraconazole (Sporanox)
Micafungin (Mycamine)
NOXAFIL (Posaconazole)
Posaconazole (NOXAFIL)
Sporanox (Itraconazole)
Susceptibility Panel, Yeast
Susceptibility Testing
Vfend (Voriconazole)
Voriconazole (Vfend)
Yeast Susceptibility Panel
Specimen Type Describes the specimen type needed for testing
Specimen Required Defines the optimal specimen. This field describes the type of specimen required to perform the test and the preferred volume to complete testing. The volume allows automated processing, fastest throughput and, when indicated, repeat or reflex testing.
Specimen Type: Organism
Container/Tube: Sabouraud's dextrose agar slant
Specimen Volume: Infecting yeast isolate
Collection Instructions:
1. Organism must be in pure culture, actively growing.
2. Place specimen in a large infectious container (Supply T146) and label as an etiologic agent.
Additional Information:
1. Specimen source and suspected organism identification are required.
2. See Infectious Specimen Shipping Guide in Special Instructions.
Forms: If not ordering electronically, submit a Microbiology Request Form (Supply T244) with the specimen.
Specimen Minimum Volume Defines the amount of specimen required to perform an assay once, including instrument and container dead space. Submitting the minimum specimen volume makes it impossible to repeat the test or perform confirmatory or perform reflex testing. In some situations, a minimum specimen volume may result in a QNS (quantity not sufficient) result, requiring a second specimen to be collected.
Reject Due To Identifies specimen types and conditions that may cause the specimen to be rejected
| Hemolysis | NA |
| Lipemia | NA |
| Icterus | NA |
| Other | Agar plate |
Specimen Stability Information Provides a description of the temperatures required to transport a specimen to the laboratory. Alternate acceptable temperature(s) are also included.
| Specimen Type | Temperature | Time |
|---|---|---|
| Varies | Ambient (preferred) | |
| Refrigerated | ||
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
Method Description Describes how the test is performed and provides a method-specific reference
Yeast susceptibility is determined by colorimetric microdilution broth method using TREK Sensititre YeastOne Y09 Susceptibility Plate. Each plate is setup with appropriate dilutions of antifungal agents and a colorimetric indicator. After inoculation with a standardized suspension of organism in inoculum medium and incubation at 35 degrees C for 24 to 48 hours; the minimum inhibitory concentrations for the test organism are determined by observing the lowest antifungal concentration showing inhibition of growth (as evidenced by no color change of the test medium). (Clinical and Laboratory Standards Institute 2012. Reference Method for Broth Dilution Antifungal Susceptibility Testing of Yeasts: Fourth informational supplement (M27-S4).CLSI, Wayne, PA
Day(s) and Time(s) Test Performed Outlines the days and times the test is performed. This field reflects the day and time the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time required before the test is performed. Some tests are listed as continuously performed, which means assays are performed several times during the day.
Monday through Saturday; Varies
Analytic Time Defines the amount of time it takes the laboratory to setup and perform the test. This is defined in number of days. The shortest interval of time expressed is "same day/1 day," which means the results may be available the same day that the sample is received in the testing laboratory. One day means results are available 1 day after the sample is received in the laboratory.
Maximum Laboratory Time Defines the maximum time from specimen receipt at Mayo Medical Laboratories until the release of the test result
Specimen Retention Time Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded
Performing Laboratory Location The location of the laboratory that performs the test
Test Classification Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer's instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR), Investigation Use Only (IUO) product, or a Research Use Only (RUO) product.
CPT Code Information Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Medical Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.
87186
LOINC® Code Information Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the result codes returned for this test or profile.
| Result ID | Reporting Name | LOINC Code |
|---|---|---|
| MMLYP | Susceptibility Panel, Yeast | In Process |
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