Fungal pathogens represent a significant threat to public health, particularly for immunocompromised individuals. The World Health Organization (WHO)’s 2022 fungal priority pathogens list of the 19 fungi representing the greatest threat to public health highlights the growing need for research and development to strengthen the global response to fungal infection and antifungal resistance.
According to the WHO, climate change and international travel are causing the spread of fungal diseases across the globe. In January 2024, The Lancet published estimates suggesting an annual incidence of 6.5 million invasive fungal infections and 3.8 million deaths, of which approximately 2.5 million were directly attributable. As fungi like Candida – Candida auris in particular – that cause common infections become increasingly resistant to drugs, the prevalence of more invasive strains with no effective treatment is also growing among the general population, posing severe risks to patients and placing a substantial financial burden on public health systems.
Accurate testing in the routine laboratory
The need for standardised, routine antifungal susceptibility testing (AFST) to the latest international standards is clear. Rapidly identifying the most effective antifungal therapy for a specific pathogen not only ensures that individuals receive the most effective treatment, but also reduces the need for multiple therapy attempts, improves patient outcomes and minimises the potential for drug resistance to develop.
Testing based on the EUCAST reference method
The European Committee on Antimicrobial Susceptibility Testing (EUCAST) publishes standards for AFST and interpretation criteria for use in a routine laboratory. The MICRONAUT-AM solution from Bruker for reliable antifungal susceptibility testing of Candida spp. and Cryptococcus neoformans is based on the EUCAST reference method of broth microdilution methodology delivering proven accurate minimum inhibitory concentrations (MIC) and using up-to-date EUCAST clinical breakpoints for MIC interpretation.
The system offers a user-friendly workflow with at-a-glance visual or photometric results for up to nine different antifungal agents in a single run, including amphotericin B, fluconazole, itraconazole and micafungin.
AFST of Candida auris
C. auris is a multi-drug resistant species that has emerged recently as a potentially high-level threat, because of its resistance to many first-line antifungal agents and its ability to cause severe outbreaks in hospital settings. MICRONAUT-AM has been proven to deliver reliable and accurate results for amphotericin B treatment of C. auris, whereas some other commercial antifungal tests were subject of a recent warning from EUCAST concerning overestimation of resistance in C. auris.
As the threat of fungal infection to public health continues to grow, so too does the need for reliable antifungal susceptibility testing in the routine laboratory. Bruker is at the forefront of the fight against fungal infection and drug resistance, enabling accurate antifungal resistance detection to inform treatment decisions that have a positive impact on patient care, while helping prevent the spread of further drug resistance.
