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Susceptibility testing should be performed when clinically indicated. The antifungal profiles that are available in the literature are a good guideline to predict antifungal efficacy for the commoon Candida species. Note that the CLSI standard does not apply to non-Candida yeast genera.
It is useful, if possible, to determine the antifungal profiles for various species isolated at your institution, which can then form a general basis for when to do isolate specific testing. For example, if you find that all C. albicans isolates are susceptible during the study to fluconazole, then the likelihood that a C. albicans isolated from a patient subsequent to your study will be resistant is very low. If, however, the patient is treated with fluconazole and subsequent cultures are positive for C. albicans, then susceptibility testing may be warranted.
Institutions may decide to perform susceptibility testing for all Candida isolates from ICUs because of concern for greater resistance due to higher usage of antifungals in those units.
If you want more specific guidance, feel free to contact me directly or through AskIt.
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