Abstract：
Introduction. The increasing prevalence and growing resistance of fungi present a significant peril to public health. There are only four classes of antifungal medicines available today, and few candidates are in clinical trials.Hypothesis/Gap Statement. Rapid and sensitive diagnostic techniques are lacking for most fungal pathogens, and those that do exist are expensive or hard to obtain.Aim. This study aimed to evaluate the feasibility of a novel automated antifungal susceptibility testing system, Fungus AST, in comparison to the broth microdilution method (BMD) recommended by the Clinical and Laboratory Standards Institute (CLSI).Methodology. A total of 101 clinical Candida spp. isolates were collected from the Zengcheng Branch of Nanfang Hospital and subjected to antifungal susceptibility testing. Antifungal susceptibility was assessed using the Fungus AST method and the BMD.Results. In this study, we introduce a novel automated antifungal susceptibility testing system, Fungus AST, which detects the turbidity and/or colour intensity of microdilution wells using a four-wavelength detection technology in real time and is designed to match the growth characteristics of strains over time. Based on our analysis, all reportable ranges of Fungus AST were suitable for clinical fungal isolates in PR China. Within ±twofold dilutions, reproducibility was 100 %. Considering the BMD as a referenced method, ten antifungal agents (anidulafungin, caspofungin, micafungin, fluconazole, voriconazole, posaconazole, itraconazole, amphotericin B, 5-flucytosine and nystatin) showed an essential agreement of >95 %. The category agreement of five antifungal agents (anidulafungin, caspofungin, micafungin, fluconazole and voriconazole) was excellent at >90 %. One Candida albicans isolate and voriconazole showed a major error (ME) (1.7 %), and no other ME or very ME agents were found.Conclusion. Given the above, it can be argued that the utilization of Fungus AST is a discretionary automated approach. More improvements are needed in Fungus AST compared to the BMD system for a wider range of clinical isolates, including different types of fungi.
摘要：
Introduction.真菌的流行和抗性的增加对公共卫生构成了重大危险。今天只有四类抗真菌药物可用，很少有候选人在临床试验中。假设/差距声明。大多数真菌病原体缺乏快速和灵敏的诊断技术，那些确实存在的东西很昂贵或很难获得。瞄准.本研究旨在评估一种新型自动化抗真菌药敏检测系统的可行性。真菌AST,与临床和实验室标准研究所（CLSI）推荐的肉汤微量稀释法（BMD）相比。方法论。共101例临床念珠菌。从南方医院增城分院收集并进行抗真菌药敏试验。使用真菌AST方法和BMD评估抗真菌敏感性。结果。在这项研究中,我们介绍了一种新型的自动化抗真菌药敏测试系统，真菌AST,它使用四波长检测技术实时检测微量稀释孔的浊度和/或颜色强度，旨在匹配菌株随时间的生长特性。根据我们的分析,真菌AST的所有可报告范围均适用于PR中国的临床真菌分离株。在±两倍稀释内，重现性为100%。考虑到BMD作为一种参考方法，十种抗真菌剂（阿尼杜拉芬净，卡波芬金,米卡芬净,氟康唑,伏立康唑,泊沙康唑,伊曲康唑,两性霉素B,5-氟胞嘧啶和制霉菌素）显示出>95％的基本一致性。五种抗真菌药物的类别协议(anidulafungin，卡波芬金,米卡芬净,氟康唑和伏立康唑)在>90%时表现优异。一个白色念珠菌分离物和伏立康唑显示主要错误（ME）（1.7％），没有发现其他我或非常我的特工。结论。鉴于上述情况，可以说，真菌AST的利用是一种随意选择的自动化方法。对于更广泛的临床分离株，与BMD系统相比，真菌AST需要更多的改进，包括不同类型的真菌。
