scholarly journals Luliconazole, a New Antifungal, vs Amphotericin B, Voriconazole, Posaconazole and Caspofungin against Clinical and EnvironmentalAspergillusNigri Complex

2019 ◽  
Author(s):  
Sahar Hivary ◽  
Mahnaz Fatahinia ◽  
Marzieh Halvaeezadeh ◽  
Ali Zarei Mahmoudabadi
Keyword(s):  
Amphotericin B ◽  
Gold Standard ◽  
Antifungal Susceptibility ◽  
Environmental Isolates ◽  
Clinical Strains ◽  
Molecular Tests ◽  
Black Aspergilli ◽  
Antifungal Susceptibility Test ◽  
The Common

ABSTRACTBlack Aspergilli are,the most causes of aspergillosis andAspergillus niger and A. tubingensis are two more frequently isolates. Although, amphotericin B was a gold standard for the treatment of invasive fungal infection for several decades, it replaced by several new antifungals. Furthermore, a novel antifungal, luliconazole, appears to offer the potential for improved therapy for aspergillosis. The aim of the present study was to compare the effect of a novel antifungal agent, luliconazole, with classical antifungalagainst clinical and environmental strains of black Aspergilli. Sixty seven strains of black Aspergilli were identified using morphological and molecular tests (β-Tubulin gene). Antifungal susceptibility test was applied according to CLSI M38 A2. The results were reported as MIC range, MIC50, MIC90and MICGM. In the present study,A. nigerwas the common isolate followed by,A. tubingensisand 54.1% (clinical) and 30% (environmental) of isolates were resistant to caspofungin. The highest resistant rate was found in amphotericin B for both clinical (86.5%) and environmental (96.7%) strains. Clinical strains ofAspergilluswere more sensitive to voriconazole (86.7%) than environmental strains (70.3%). On the other hand, 83.8% of clinical and 70% of environmental isolates were resistant to posaconazole, respectively. It is found that the lowest MIC range, MIC50, MIC90, and MICGMwas attributed to luliconazole in clinical strains. In conclusion, luliconazole vs. routine antifungal is a potent antifungal forA. nigercomplexin vitro. The MIC range, MIC50, MIC90and MICGMof luliconazole against black Aspergilli were the lowest among the representative tested antifungals.

The potency of luliconazole against clinical and environmental Aspergillus nigri complex

2020 ◽  
Author(s):  
Sahar Hivary ◽  
Mahnaz Fatahinia ◽  
Marzieh Halvaeezadeh ◽  
Ali Zarei Mahmoudabadi
Keyword(s):  
Aspergillus Niger ◽  
Amphotericin B ◽  
Antifungal Susceptibility ◽  
Vitro Activity ◽  
Molecular Technique ◽  
In Vitro Activity ◽  
Environmental Isolates ◽  
Minimum Effective Concentration ◽  
Clinical Strains

Background and Objectives: Black Aspergillus strains including, Aspergillus niger and A. tubingensis, are the most cause of otomycosis with worldwide distribution. Although, amphotericin B was a Gold standard for the treatment of invasive fungal infection for several decades, it gradually replaced by fluconazole and /or voriconazole. Moreover, luliconazole, appears to offer the best potential for in vitro activity against black Aspergillus strains. The aim of the present study was to compare the in vitro activity luliconazole, with commonly used antifungals against clinical and environmental strains of black Aspergillus. Materials and Methods: Sixty seven (37 clinical and 30 environmental) strains of black Aspergillus were identified using morphological and molecular technique (β-Tubulin gene). In addition, antifungal susceptibility test was applied according to CLSI M38 A2. The results were reported as minimum inhibitory concentration (MIC) or minimum effective concentration (MEC) range, MIC50 or MEC50, MIC90 or MEC90 and MIC geometric (GM) or MECGM. Results: Aspergillus niger was the common isolate followed by, A. tubingensis in both clinical and environmental strains. The lowest MIC range, MIC50, MIC90, and MICGM was attributed to luliconazole in clinical strains. The highest resistant rate was found in amphotericin B for both clinical (86.5%) and environmental (96.7%) strains whereas 54.1% of clinical and 30% of environmental isolates were resistant to caspofungin. Clinical strains of Aspergillus were more sensitive to voriconazole (86.7%) than environmental strains (70.3%). On the other hand, 83.8% of clinical and 70% of environmental isolates were resistant to posaconazole. Conclusion: Luliconazole versus amphotericin B, voriconazole, posaconazole and caspofungin is a potent antifungal for Aspergillus Nigri complex. The in vitro extremely antifungal efficacy against black Aspergillus strains of luliconazole, is different from those of other used antifungals.

scholarly journals Relationship between the Antifungal Susceptibility Profile and the Production of Virulence-Related Hydrolytic Enzymes in Brazilian Clinical Strains ofCandida glabrata

2017 ◽  
Vol 2017 ◽  
pp. 1-10 ◽  
Author(s):  
Maria Helena Galdino Figueiredo-Carvalho ◽  
Lívia de Souza Ramos ◽  
Leonardo Silva Barbedo ◽  
Jean Carlos Almeida de Oliveira ◽  
André Luis Souza dos Santos ◽  
...  
Keyword(s):  
Amphotericin B ◽  
Antifungal Susceptibility ◽  
Hydrolytic Enzymes ◽  
Antifungal Drug ◽  
Clinical Strains ◽  
Antifungal Drug Resistance ◽  
Opportunistic Fungal Pathogen ◽  
Esterase Production ◽  
In Vitro Antifungal Susceptibility

Candida glabratais a facultative intracellular opportunistic fungal pathogen in human infections. Several virulence-associated attributes are involved in its pathogenesis, host-pathogen interactions, modulation of host immune defenses, and regulation of antifungal drug resistance. This study evaluated the in vitro antifungal susceptibility profile to five antifungal agents, the production of seven hydrolytic enzymes related to virulence, and the relationship between these phenotypes in 91 clinical strains ofC. glabrata. AllC. glabratastrains were susceptible to flucytosine. However, some of these strains showed resistance to amphotericin B (9.9%), fluconazole (15.4%), itraconazole (5.5%), or micafungin (15.4%). Overall,C. glabratastrains were good producers of catalase, aspartic protease, esterase, phytase, and hemolysin. However, caseinase and phospholipase in vitro activities were not detected. Statistically significant correlations were identified between micafungin minimum inhibitory concentration (MIC) and esterase production, between fluconazole and micafungin MIC and hemolytic activity, and between amphotericin B MIC and phytase production. These results contribute to clarify some of theC. glabratamechanisms of pathogenicity. Moreover, the association between some virulence attributes and the regulation of antifungal resistance encourage the development of new therapeutic strategies involving virulence mechanisms as potential targets for effective antifungal drug development for the treatment ofC. glabratainfections.

scholarly journals Molecular Identification, Antifungal Susceptibility Profile, and Biofilm Formation of Clinical and Environmental Rhodotorula Species Isolates

2012 ◽  
Vol 57 (1) ◽  
pp. 382-389 ◽  
Author(s):  
Jorge Meneses Nunes ◽  
Fernando César Bizerra ◽  
Renata Carmona e Ferreira ◽  
Arnaldo Lopes Colombo
Keyword(s):  
Amphotericin B ◽  
Biofilm Formation ◽  
Fungal Pathogens ◽  
Antifungal Susceptibility ◽  
Nitrate Assimilation ◽  
Clinical Isolates ◽  
Its Sequencing ◽  
Environmental Isolates ◽  
Content Type

ABSTRACTRhodotorulaspecies are emergent fungal pathogens capable of causing invasive infections, primarily fungemia. They are particularly problematic in immunosuppressed patients when using a central venous catheter. In this study, we evaluated the species distribution of 51 clinical and 8 environmentalRhodotorulaspecies isolates using the ID32C system and internal transcribed spacer (ITS) sequencing. Antifungal susceptibility testing and biofilm formation capability using a crystal violet staining assay were performed. Using ITS sequencing as the gold standard, the clinical isolates were identified as follows: 44R. mucilaginosaisolates, 2R. glutinisisolates, 2R. minutaisolates, 2R. dairenensisisolates, and 1Rhodosporidium fluvialeisolate. The environmental isolates included 7R. mucilaginosaisolates and 1R. slooffiaeisolate. Using the ID32C system, along with a nitrate assimilation test, only 90.3% of the isolates tested were correctly identified. In the biofilm formation assay,R. mucilaginosaandR. minutaexhibited greater biofilm formation ability compared to the otherRhodotorulaspecies; the clinical isolates ofR. mucilaginosashowed greater biofilm formation compared to the environmental isolates (P= 0.04). Amphotericin B showed goodin vitroactivity (MIC ≤ 1 μg/ml) against planktonic cells, whereas voriconazole and posaconazole showed poor activity (MIC50/MIC90, 2/4 μg/ml). Caspofungin and fluconazole MICs were consistently high for all isolates tested (≥64 μg/ml and ≥ 4 μg/ml, respectively). In this study, we emphasized the importance of molecular methods to correctly identifyRhodotorulaspecies isolates and non-R. mucilaginosaspecies in particular. The antifungal susceptibility profile reinforces amphotericin B as the antifungal drug of choice for the treatment ofRhodotorulainfections. To our knowledge, this is the first study evaluating putative differences in the ability of biofilm formation among differentRhodotorulaspecies.

scholarly journals Isolation of Candida africana in oral candidiasis: First report among cancer patients in Iran

2020 ◽  
Author(s):  
Ensieh Lotfali ◽  
Masoud Mardani ◽  
Sara Abolghasemi ◽  
David Darvishnia ◽  
Mohammad Mahdi Rabiei ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Amphotericin B ◽  
Oral Candidiasis ◽  
Antifungal Susceptibility ◽  
Empirical Therapy ◽  
Antifungal Prophylaxis ◽  
In Vitro Susceptibility ◽  
Molecular Tests ◽  
In Vitro Antifungal Susceptibility

Background and Purpose: Oropharyngeal candidiasis (OPC) is a fungal infection of the oral cavity caused by the members of C. albicans complex. Although C. africana, as a part of the complex, is considered to be mostly responsible for the development of vulvovaginal candidiasis, it may be associated with a wider clinical spectrum. Case report: This report described two cases diagnosed with oral candidiasis during the receipt of treatment for malignancies. Conventional and molecular tests were performed on the samples collected from the patients’ oral cavities. The test results revealed C. africana as the causative agent of oral candidiasis. Furthermore, in vitro antifungal susceptibility test indicated the full susceptibility of all C. africana isolates to caspofungin. However, the data were also suggestive of the resistance against fluconazole and amphotericin B. Caspofungin was used as the main antifungal agent for the treatment of oral candidiasis, resulting in the improvement of thrush in patients. The resistance of C. africana to fluconazole and amphotericin B suggests the necessity of performing in vitro susceptibility testing on the isolates for the selection of appropriate antifungal agents. Conclusion: As the findings indicated, the achievement of knowledge regarding C. africana as an emerging non-albicans Candida species and its antifungal susceptibility profile is crucial to select antifungal prophylaxis and empirical therapy for oral candidiasis in cancer patients undergoing chemotherapy.

Use of spectrophotometric reading for in vitro antifungal susceptibility testing ofAspergillusspp.

1999 ◽  
Vol 45 (10) ◽  
pp. 871-874 ◽  
Author(s):  
Eric Dannaoui ◽  
Florence Persat ◽  
Marie-France Monier ◽  
Elisabeth Borel ◽  
Marie-Antoinette Piens ◽  
...  
Keyword(s):  
Amphotericin B ◽  
Susceptibility Testing ◽  
Clinical Laboratory ◽  
Antifungal Susceptibility ◽  
Reference Method ◽  
Antifungal Susceptibility Testing ◽  
Aspergillus Species ◽  
National Committee ◽  
Broth Microdilution Method

A comparative study of visual and spectrophotometric MIC endpoint determinations for antifungal susceptibility testing of Aspergillus species was performed. A broth microdilution method adapted from the National Committee for Clinical Laboratory Standards (NCCLS) was used for susceptibility testing of 180 clinical isolates of Aspergillus species against amphotericin B and itraconazole. MICs were determined visually and spectrophotometrically at 490 nm after 24, 48, and 72h of incubation, and MIC pairs were compared. The agreement between the two methods was 99% for amphotericin B and ranged from 95 to 98% for itraconazole. It is concluded that spectrophotometric MIC endpoint determination is a valuable alternative to the visual reference method for susceptibility testing of Aspergillus species.Key words: antifungal, susceptibility testing, Aspergillus, spectrophotometric reading.

In vitro activity of olorofim against clinical isolates of Scedosporium species and Lomentospora prolificans using EUCAST and CLSI methodologies

2020 ◽  
Vol 75 (12) ◽  
pp. 3582-3585
Author(s):  
Olga Rivero-Menendez ◽  
Manuel Cuenca-Estrella ◽  
Ana Alastruey-Izquierdo
Keyword(s):  
Amphotericin B ◽  
Susceptibility Testing ◽  
Antifungal Susceptibility ◽  
Vitro Activity ◽  
Clinical Isolates ◽  
Scedosporium Apiospermum ◽  
In Vitro Activity ◽  
Scedosporium Dehoogii ◽  
Scedosporium Species

Abstract Objectives To evaluate the in vitro activity of olorofim, a new broad-spectrum antifungal with a novel mechanism of action, against a collection of 123 Spanish clinical isolates belonging to five Scedosporium species and Lomentospora prolificans. Methods The activity of olorofim against Scedosporium apiospermum (n = 30), Scedosporium boydii (n = 30), Scedosporium ellipsoideum (n = 10), Scedosporium aurantiacum (n = 20), Scedosporium dehoogii (n = 3) and Lomentospora prolificans (n = 30) was compared with that of amphotericin B, voriconazole, isavuconazole and micafungin by performing EUCAST and CLSI reference methods for antifungal susceptibility testing. Results Amphotericin B and isavuconazole showed MICs ≥2 mg/L for all the species evaluated and voriconazole was moderately active (GM, MIC50 and MIC90 values ≤2 mg/L) against all of them except L. prolificans. Micafungin was effective against S. apiospermum complex strains, but exhibited elevated MECs for S. dehoogii and S. aurantiacum. Olorofim showed low MICs for all the Scedosporium strains tested (GM values were lower than 0.130 and 0.339 by the EUCAST method and the CLSI method, respectively, for all of the species), including those belonging to the MDR species L. prolificans, for which GM values were 0.115 and 0.225 mg/L by the EUCAST method and the CLSI method, respectively, while the GMs for the rest of the antifungals evaluated were higher than 3.732 mg/L using both methodologies. Conclusions Olorofim displayed promising in vitro activity against the Scedosporium and L. prolificans strains tested, some of which have reduced susceptibility to the antifungals that are currently in use.

scholarly journals In Vitro Azole and Amphotericin B Susceptibilities of Malassezia furfur from Bloodstream Infections Using E-Test and CLSI Broth Microdilution Methods

Antibiotics ◽  
2020 ◽  
Vol 9 (6) ◽  
pp. 361 ◽  
Author(s):  
Wafa Rhimi ◽  
Chioma Inyang Aneke ◽  
Adriana Mosca ◽  
Domenico Otranto ◽  
Claudia Cafarchia
Keyword(s):  
Amphotericin B ◽  
Reading Time ◽  
Antifungal Susceptibility ◽  
Bloodstream Infections ◽  
Hospitalized Patients ◽  
Malassezia Furfur ◽  
Broth Microdilution ◽  
Test Procedures ◽  
The Media

The number of reports of Malassezia furfur bloodstream infections is constantly increasing and there is a need for more simple antifungal susceptibility methods for their management. In this study, a total of 39 M. furfur isolates collected from hospitalized patients with fungemia were screened for antifungal susceptibility to azole and amphotericin B (AmB) using Clinical and Laboratory Standards Institute broth microdilution (CLSI BMD) and E-test in Sabouraud dextrose agar + 1% Tween80 (SDAt) and mDixon agar (DIX). Essential agreement (EA) and discrepancies between the two methods were evaluated after 48 h and 72 h reading times. Itraconazole (ITZ) and posaconazole (POS) displayed the lowest MIC values whereas fluconazole (FLZ) and AmB the highest, regardless of the methods and the reading time. The EA between BMD was >95% for FLZ and voriconazole (VOR) regardless of the media in the E-tests and reading time. The EA between BMD with E-test for AmB was >97% only when E-test in SDAt was used. The EA between BMD and E-test for ITZ and POS varied according to the media in E-test procedures and the reading time and was higher than 66.6% (POS) or 72% (ITZ) only when SABt was used. Substantial discrepancies for ITZ and POS were >5.1% regardless of the media and the reading time. This study suggests that the E-test in SABt represents an alternative method to CLSI BMD to evaluate the susceptibility of M. furfur to FLZ, VOR and AmB and not for ITZ and POS.

scholarly journals A Revised Species Concept for OpportunisticMucorSpecies Reveals Species-Specific Antifungal Susceptibility Profiles

2019 ◽  
Vol 63 (8) ◽  
Author(s):  
Lysett Wagner ◽  
Sybren de Hoog ◽  
Ana Alastruey-Izquierdo ◽  
Kerstin Voigt ◽  
Oliver Kurzai ◽  
...  
Keyword(s):  
Amphotericin B ◽  
Susceptibility Testing ◽  
Species Concept ◽  
Antifungal Susceptibility ◽  
Content Type ◽  
Mucor Indicus ◽  
Species Specific ◽  
Susceptibility Profiles ◽  
High Mics

ABSTRACTRecently, the species concept of opportunisticMucor circinelloidesand its relatives has been revised, resulting in the recognition of its classical formae as independent species and the description of new species. In this study, we used isolates of all clinically relevantMucorspecies and performed susceptibility testing using the EUCAST reference method to identify potential species-specific susceptibility patterns.In vitrosusceptibility profiles of 101 mucoralean strains belonging to the genusMucor(72), the closely related speciesCokeromyces recurvatus(3),Rhizopus(12),Lichtheimia(10), andRhizomucor(4) to six antifungals (amphotericin B, natamycin, terbinafine, isavuconazole, itraconazole, and posaconazole) were determined. The most active drug for all Mucorales was amphotericin B. Antifungal susceptibility profiles of pathogenicMucorspecies were specific for isavuconazole, itraconazole, and posaconazole. The species formerly united inM. circinelloidesshowed clear differences in their antifungal susceptibilities.Cokeromyces recurvatus,Mucor ardhlaengiktus,Mucor lusitanicus(M. circinelloidesf.lusitanicus), andMucor ramosissimusexhibited high MICs to all azoles tested.Mucor indicuspresented high MICs for isavuconazole and posaconazole, andMucor amphibiorumandMucor irregularisshowed high MICs for isavuconazole. MIC values ofMucorspp. for posaconazole, isavuconazole, and itraconazole were high compared to those forRhizopusand the Lichtheimiaceae (LichtheimiaandRhizomucor). Molecular identification combined within vitrosusceptibility testing is recommended forMucorspecies, especially if azoles are applied in treatment.

scholarly journals Susceptibility Patterns and Molecular Identification of Trichosporon Species

2005 ◽  
Vol 49 (10) ◽  
pp. 4026-4034 ◽  
Author(s):  
Juan L. Rodriguez-Tudela ◽  
Teresa M. Diaz-Guerra ◽  
Emilia Mellado ◽  
Virginia Cano ◽  
Cecilia Tapia ◽  
...  
Keyword(s):  
Amphotericin B ◽  
Geometric Mean ◽  
Antifungal Susceptibility ◽  
Intergenic Spacer ◽  
Clinical Isolates ◽  
Rrna Genes ◽  
Correct Identification ◽  
Its Sequencing ◽  
Trichosporon Species

ABSTRACT The physiological patterns, the sequence polymorphisms of the internal transcriber spacer (ITS), and intergenic spacer regions (IGS) of the rRNA genes and the antifungal susceptibility profile were evaluated for their ability to identify Trichosporon spp. and their specificity for the identification of 49 clinical isolates of Trichosporon spp. Morphological and biochemical methodologies were unable to differentiate among the Trichosporon species. ITS sequencing was also unable to differentiate several species. However, IGS1 sequencing unambiguously identified all Trichosporon isolates. Following the results of DNA-based identification, Trichosporon asahii was the species most frequently isolated from deep sites (15 of 25 strains; 60%). In the main, other Trichosporon species were recovered from cutaneous samples. The majority of T. asahii, T. faecale, and T. coremiiforme clinical isolates exhibited resistance in vitro to amphotericin B, with geometric mean (GM) MICs >4 μg/ml. The other species of Trichosporon did not show high MICs of amphotericin B, and GM MICs were <1 μg/ml. Azole agents were active in vitro against the majority of clinical strains. The most potent compound in vitro was voriconazole, with a GM MIC ≤0.14 μg/ml. The sequencing of IGS correctly identified Trichosporon isolates; however, this technique is not available in many clinical laboratories, and strains should be dispatched to reference centers where these complex methods are available. Therefore, it seems to be more practical to perform antifungal susceptibility testing of all isolates belonging to Trichosporon spp., since correct identification could take several weeks, delaying the indication of an antifungal agent which exhibits activity against the infectious strain.

scholarly journals In VitroAntifungal Susceptibility of Yeast and Mold Phases of Isolates of Dimorphic Fungal Pathogen Emergomyces africanus (Formerly Emmonsia sp.) from HIV-Infected South African Patients

2017 ◽  
Vol 55 (6) ◽  
pp. 1812-1820 ◽  
Author(s):  
Tsidiso G. Maphanga ◽  
Erika Britz ◽  
Thokozile G. Zulu ◽  
Ruth S. Mpembe ◽  
Serisha D. Naicker ◽  
...  
Keyword(s):  
Amphotericin B ◽  
Fungal Pathogen ◽  
Geometric Mean ◽  
Antifungal Susceptibility ◽  
Outcome Data ◽  
Internal Transcribed Spacer Region ◽  
Content Type ◽  
Susceptibility Data ◽  
Custom Made

ABSTRACTDisseminated emmonsiosis is an important AIDS-related mycosis in South Africa that is caused byEmergomycesafricanus, a newly described and renamed dimorphic fungal pathogen.In vitroantifungal susceptibility data can guide management. Identification of invasive clinical isolates was confirmed phenotypically and by sequencing of the internal transcribed spacer region. Yeast and mold phase MICs of fluconazole, voriconazole, itraconazole, posaconazole, caspofungin, anidulafungin, micafungin, and flucytosine were determined with custom-made frozen broth microdilution (BMD) panels in accordance with Clinical and Laboratory Standards Institute recommendations. MICs of amphotericin B, itraconazole, posaconazole, and voriconazole were determined by Etest. Fifty uniqueE. africanusisolates were tested. The yeast and mold phase geometric mean (GM) BMD and Etest MICs of itraconazole were 0.01 mg/liter. The voriconazole and posaconazole GM BMD MICs were 0.01 mg/liter for both phases, while the GM Etest MICs were 0.001 and 0.002 mg/liter, respectively. The fluconazole GM BMD MICs were 0.18 mg/liter for both phases. The GM Etest MICs of amphotericin B, for the yeast and mold phases were 0.03 and 0.01 mg/liter. The echinocandins and flucytosine had very limitedin vitroactivity. Treatment and outcome data were available for 37 patients; in a multivariable model including MIC data, only isolation from blood (odds ratio [OR], 8.6; 95% confidence interval [CI], 1.3 to 54.4;P= 0.02) or bone marrow (OR, 12.1; 95% CI, 1.2 to 120.2;P= 0.03) (versus skin biopsy) was associated with death.In vitrosusceptibility data support the management of disseminated emmonsiosis with amphotericin B, followed by itraconazole, voriconazole, or posaconazole. Fluconazole was a relatively less potent agent.

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