Antifungal drug susceptibility of oralCandida albicansisolates may be associated with apoptotic responses to Amphotericin B

2010 ◽  
Vol 39 (2) ◽  
pp. 182-187 ◽  
Author(s):  
Chengzhe Yang ◽  
Weiyu Gong ◽  
Jingting Lu ◽  
Xiujuan Zhu ◽  
Qingguo Qi
Keyword(s):  
Amphotericin B ◽  
Drug Susceptibility ◽  
Antifungal Drug

scholarly journals Trends in Antifungal Drug Susceptibility of Cryptococcus neoformans Isolates in the United States: 1992 to 1994 and 1996 to 1998

2001 ◽  
Vol 45 (11) ◽  
pp. 3065-3069 ◽  
Author(s):  
Mary E. Brandt ◽  
Michael A. Pfaller ◽  
Rana A. Hajjeh ◽  
Richard J. Hamill ◽  
Peter G. Pappas ◽  
...  
Keyword(s):  
Cryptococcus Neoformans ◽  
Amphotericin B ◽  
Antifungal Agents ◽  
Clinical Laboratory ◽  
The United States ◽  
Drug Susceptibility ◽  
Antifungal Drug ◽  
National Committee ◽  
Broth Microdilution Method

ABSTRACT The antifungal drug susceptibilities of two collections ofCryptococcus neoformans isolates obtained through active laboratory-based surveillance from 1992 to 1994 (368 isolates) and 1996 to 1998 (364 isolates) were determined. The MICs of fluconazole, itraconazole, and flucytosine were determined by the National Committee for Clinical Laboratory Standards broth microdilution method; amphotericin B MICs were determined by the E-test. Our results showed that the MIC ranges, the MICs at which 50% of isolates are inhibited (MIC50s), and the MIC90s of these four antifungal agents did not change from 1992 to 1998. In addition, very small numbers of isolates showed elevated MICs suggestive of in vitro resistance. The MICs of amphotericin B were elevated (≥2 μg/ml) for 2 isolates, and the MICs of flucytosine were elevated (≥32 μg/ml) for 14 isolates. Among the azoles, the fluconazole MIC was elevated (≥64 μg/ml) for 8 isolates and the itraconazole MIC (≥1 μg/ml) was elevated for 45 isolates. Analysis of 172 serial isolates from 71 patients showed little change in the fluconazole MIC over time. For isolates from 58 patients (82% of serial cases) there was either no change or a twofold change in the fluconazole MIC. In contrast, for isolates from seven patients (12% of serial cases) the increase in the MIC was at least fourfold. For isolates from another patient there was a 32-fold decrease in the fluconazole MIC over a 1-month period. We conclude that in vitro resistance to antifungal agents remains uncommon in C. neoformans and has not significantly changed with time during the past decade.

scholarly journals Increased Antifungal Drug Resistance in Clinical Isolates of Cryptococcus neoformans in Uganda

2015 ◽  
Vol 59 (12) ◽  
pp. 7197-7204 ◽  
Author(s):  
Kyle D. Smith ◽  
Beatrice Achan ◽  
Kathy Huppler Hullsiek ◽  
Tami R. McDonald ◽  
Laura H. Okagaki ◽  
...  
Keyword(s):  
Amphotericin B ◽  
Low Income ◽  
Low Cost ◽  
Drug Susceptibility ◽  
Antifungal Drug ◽  
Clinical Isolates ◽  
Hiv Care ◽  
Low Income Countries ◽  
Broth Microdilution ◽  
Content Type

ABSTRACTCryptococcal antigen screening is recommended among people living with AIDS when entering HIV care with a CD4 count of <100 cells/μl, and preemptive fluconazole monotherapy treatment is recommended for those with subclinical cryptococcal antigenemia. Yet, knowledge is limited of current antimicrobial resistance in Africa. We examined antifungal drug susceptibility in 198 clinical isolates collected from Kampala, Uganda, between 2010 and 2014 using the CLSI broth microdilution assay. In comparison with two previous studies from 1998 to 1999 that reported an MIC50of 4 μg/ml and an MIC90of 8 μg/ml prior to widespread human fluconazole and agricultural azole fungicide usage, we report an upward shift in the fluconazole MIC50to 8 μg/ml and an MIC90value of 32 μg/ml, with 31% of isolates with a fluconazole MIC of ≥16 μg/ml. We observed an amphotericin B MIC50of 0.5 μg/ml and an MIC90of 1 μg/ml, of which 99.5% of isolates (197 of 198 isolates) were still susceptible. No correlation between MIC and clinical outcome was observed in the context of amphotericin B and fluconazole combination induction therapy. We also analyzedCryptococcussusceptibility to sertraline, with an MIC50of 4 μg/ml, suggesting that sertraline is a promising oral, low-cost, available, novel medication and a possible alternative to fluconazole. Although the CLSI broth microdilution assay is ideal to standardize results, limit human bias, and increase assay capacity, such assays are often inaccessible in low-income countries. Thus, we also developed and validated an assay that could easily be implemented in a resource-limited setting, with similar susceptibility results (P= 0.52).

scholarly journals Trends in Antifungal Drug Susceptibility of Cryptococcus neoformans Isolates Obtained through Population-Based Surveillance in South Africa in 2002-2003 and 2007-2008

2011 ◽  
Vol 55 (6) ◽  
pp. 2606-2611 ◽  
Author(s):  
Nelesh P. Govender ◽  
Jaymati Patel ◽  
Marelize van Wyk ◽  
Tom M. Chiller ◽  
Shawn R. Lockhart ◽  
...  
Keyword(s):  
South Africa ◽  
Cryptococcus Neoformans ◽  
Amphotericin B ◽  
Fungal Infections ◽  
Antifungal Susceptibility ◽  
Drug Susceptibility ◽  
Population Based ◽  
Content Type ◽  
Microdilution Method ◽  
Broth Microdilution Method

ABSTRACTCryptococcus neoformansis the most common cause of meningitis among adult South Africans with HIV infection/AIDS. Widespread use of fluconazole for treatment of cryptococcal meningitis and other HIV-associated opportunistic fungal infections in South Africa may lead to the emergence of isolates with reduced fluconazole susceptibility. MIC testing using a reference broth microdilution method was used to determine if isolates with reduced susceptibility to fluconazole or amphotericin B had emerged among cases of incident disease. Incident isolates were tested from two surveillance periods (2002-2003 and 2007-2008) when population-based surveillance was conducted in Gauteng Province, South Africa. These isolates were also tested for susceptibility to flucytosine, itraconazole, voriconazole, and posaconazole. Serially collected isolate pairs from cases at several large South African hospitals were also tested for susceptibility to fluconazole. Of the 487 incident isolates tested, only 3 (0.6%) demonstrated a fluconazole MIC of ≥16 μg/ml; all of these isolates were from 2002-2003. All incident isolates were inhibited by very low concentrations of amphotericin B and exhibited very low MICs to voriconazole and posaconazole. Of 67 cases with serially collected isolate pairs, only 1 case was detected where the isolate collected more than 30 days later had a fluconazole MIC value significantly higher than the MIC of the corresponding incident isolate. Although routine antifungal susceptibility testing of incident isolates is not currently recommended in clinical settings, it is still clearly important for public health to periodically monitor for the emergence of resistance.

scholarly journals Deletion ofADA2Increases Antifungal Drug Susceptibility and Virulence inCandida glabrata

2018 ◽  
Vol 62 (3) ◽  
Author(s):  
Shang-Jie Yu ◽  
Ya-Lin Chang ◽  
Ying-Lien Chen
Keyword(s):  
Cell Wall ◽  
Systemic Infection ◽  
Drug Tolerance ◽  
Drug Susceptibility ◽  
Antifungal Drugs ◽  
Antifungal Drug ◽  
Saga Complex ◽  
Necrosis Factor Alpha ◽  
Content Type ◽  
Downstream Target

ABSTRACTCandida glabrata, the second most frequent cause of candidiasis afterCandida albicans, is an emerging human fungal pathogen that is intrinsically drug tolerant. Currently, studies ofC. glabratagenes involved in drug tolerance are limited. Ada2, a component serving as a transcription adaptor of the Spt-Ada-Gcn5 acetyltransferase (SAGA) complex, is required for antifungal drug tolerance and virulence inC. albicans. However, its roles inC. glabrataremain elusive. In this study, we found thatada2mutants demonstrated severe growth defects at 40°C but only mild defects at 37°C or 25°C. In addition,C. glabrata ada2mutants exhibited pleiotropic phenotypes, including susceptibility to three classes of antifungal drugs (i.e., azoles, echinocandins, and polyenes) and cell wall-perturbing agents but resistance to the endoplasmic reticulum stressor tunicamycin. According to RNA sequence analysis, the expression of 43 genes was downregulated and the expression of 442 genes was upregulated in theada2mutant compared to their expression in the wild type.C. glabrata ADA2, along with its downstream targetERG6, controls antifungal drug tolerance and cell wall integrity. Surprisingly,ada2mutants were hypervirulent in a murine model of systemic infection, possibly due to the upregulation of multiple adhesin-like genes, increased agar invasion, and overstimulation of murine tumor necrosis factor alpha production.

Reducing the toxicity of amphotericin B by encapsulation using methoxy poly(ethylene glycol)-b-poly(l-glutamic acid-co-l-phenylalanine)

2018 ◽  
Vol 6 (8) ◽  
pp. 2189-2196 ◽  
Author(s):  
Chenguang Yang ◽  
Baiji Xue ◽  
Wantong Song ◽  
Bo Kan ◽  
Dawei Zhang ◽  
...  
Keyword(s):  
Ethylene Glycol ◽  
Glutamic Acid ◽  
Amphotericin B ◽  
Fungal Infections ◽  
Antifungal Drug ◽  
Poly Ethylene Glycol ◽  
Poly Ethylene

Amphotericin B (AmB) is an antifungal drug used for serious fungal infections and leishmaniosis.

High diversity of Candida glabrata in a tertiary hospital—Mwanza, Tanzania

2018 ◽  
Vol 57 (7) ◽  
pp. 914-917 ◽  
Author(s):  
Martha F Mushi ◽  
Uwe Gross ◽  
Stephen E Mshana ◽  
Oliver Bader
Keyword(s):  
Candida Glabrata ◽  
Tertiary Hospital ◽  
Drug Susceptibility ◽  
Antifungal Drug ◽  
Population Difference ◽  
Genetic Population ◽  
Pathogenic Yeast ◽  
Sequence Types ◽  
High Diversity

Abstract Candida glabrata is a genetically diverse human pathogenic yeast, whose subpopulations have been documented to vary geographically. Here, we report MLST genotypes and antifungal drug susceptibility of C. glabrata isolates from Africa. Among 47 mostly urogenital isolates, we found 13 sequence types, amounting to a 27% genetic population difference. More than half of the isolates were of novel sequence types. ST18 was most predominant and had reduced susceptibility to fluconazole. There was clear segregation of STs between urine and vaginal specimen. In Tanzania, the C. glabrata population is genetically diverse, and divergent from those seen in other countries.

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