The rapid rise in increasingly resistant bacteria has become a major threat to public health. Antimicrobial susceptibility testing (AST) is crucial in guiding appropriate therapeutic decisions and infection prevention practices for patient care. However, conventional culture-based AST methods are time-consuming and labor-intensive. Therefore, rapid AST approaches exist to address the delayed gap in time to actionable results. There are two main types of rapid AST technologies— phenotypic and genotypic approaches. In this review, we provide a summary of all commercially available rapid AST platforms for use in clinical microbiology laboratories. We describe the technologies utilized, performance characteristics, acceptable specimen types, types of resistance detected, turnaround times, limitations, and clinical outcomes driven by these rapid tests. We also discuss crucial factors to consider for the implementation of rapid AST technologies in a clinical laboratory and what the future of rapid AST holds.

Invasive fungal infections (IFI) are a significant cause of morbidity and mortality in hematologic malignancy patients and hematopoietic cell transplant (HCT) recipients. Mold cholecystitis has rarely been described. We present a case of disseminated Lomentospora prolificans , that had recrudescence of symptoms with acute cholecystitis. Treatment included a temporary cholecystostomy and administration of the novel antifungal fosmanogepix. At 6 weeks post-HCT, the patient underwent cholecystectomy and completed a course of fosmanogepix, leading to resolution of her infection. Here we review the published literature on non- Candida fungal cholecystitis, underlying risk factors and treatment.