Antifungal Susceptibility Pattern of Non - Dermatophytic Fungi Causing Onychomycosis

Introduction: Non-dermatophytic molds (NDM) are filamentous fungi or yeast, commonly found in nature as saprophytes and plant pathogens. The incidence of onychomycosis due to NDM is 1.45 – 16.6%. NDMs are usually resistant to conventional antifungal treatment. Objective: To know the anti-fungal susceptibility pattern of non-dermatophyte fungi causing onychomycosis. Materials and Methods: A prospective hospital based cross-sectional study was done on non - dermatophytic isolates from patients with clinical suspicion of onychomycosis. All non – dermatophytic isolates were subjected to anti-fungal susceptibility against terbinafine, itraconazole, fluconazole and griseofulvin by micro broth dilution method. Results: NDM were isolated in 20.2% cases of clinically suspected onychomycosis, among which Fusarium species was the most common followed by Aspergillus species and Candida species. MIC50 (Mean Inhibitory Concentration) for overall non - dermatophytic isolates for terbinafine, itraconazole, fluconazole and griseofulvin was 0.25μg/mL, 0.5μg/mL, 32μg/mL and 2μg/mL respectively and the order of sensitivity was Itraconazole (74.7%) > terbinafine (68%) > Fluconazole (60%) > Griseofulvin (51.6%) of the study samples. For Fusarium species, the sensitivity for terbinafine was (73.5%) > itraconazole (67.6%) > fluconazole (64.7%) and griseofulvin (64.7%). For Aspergillus species, the sensitivity for itraconazole was 79.1% > fluconazole (58.3%) > terbinafine (54.1%) > griseofulvin (50%). For Candida species, the sensitivity was fluconazole (83.3%) > itraconazole (75%) > terbinafine (41.6%), while no candida species was found sensitive to griseofulvin. Conclusion: Non-dermatophytes play a significant role in onychomycosis. On in vitro estimation, Itraconazole was the most sensitive drug, followed by terbinafine, fluconazole and griseofulvin.

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Oral Candidiasis among Cancer Patients Attending a Tertiary Care Hospital in Chennai, South India: An Evaluation of Clinicomycological Association and Antifungal Susceptibility Pattern

Canadian Journal of Infectious Diseases and Medical Microbiology ◽

10.1155/2016/8758461 ◽

2016 ◽

Vol 2016 ◽

pp. 1-6 ◽

Cited By ~ 8

Author(s):

Abirami Lakshmy Jayachandran ◽

Radhika Katragadda ◽

Ravinder Thyagarajan ◽

Leela Vajravelu ◽

Suganthi Manikesi ◽

...

Keyword(s):

Cancer Patients ◽

Amphotericin B ◽

Oral Candidiasis ◽

Antifungal Susceptibility ◽

Tertiary Care ◽

Antifungal Drug ◽

Dilution Method ◽

Care Hospital ◽

Susceptibility Pattern

Oropharyngeal candidiasis is one of the common manifestations seen in cancer patients on cytotoxic therapy and invasion into deeper tissues can occur if not treated promptly. Emergence of antifungal drug resistance is of serious concern owing to the associated morbidity and mortality. The present study aims at evaluation of clinicomycological association and antifungal drug susceptibility among the 180 recruited patients with cancer on chemotherapy and/or radiotherapy with signs or symptoms suggestive of oral candidiasis. Speciation and antifungal susceptibility was done by Microbroth dilution method for fluconazole, Itraconazole, and Amphotericin B as per standard microbiological techniques. Chi-square test was used for statistical analysis (p<0.05was considered statistically significant).Candida albicanswas the predominant species isolated (94) (58%) followed byCandida tropicalis(34) (20.9%). Fluconazole and Itraconazole showed an overall resistance rate of 14% and 14.8%, respectively. All the isolates were susceptible to Amphotericin B. There was a significant association between the presence of dry mouth and isolation ofCandida(p<0.001). Such clinicomicrobiological associations can help in associating certain symptoms with the isolation ofCandida. Species level identification with in vitro antifungal susceptibility pattern is essential to choose the appropriate drug and to predict the outcome of therapy.

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Antifungal Susceptibility Pattern among Candida species: An Evaluation of Disc Diffusion and Micro Broth Dilution Method

Journal of Microbiology and Infectious Diseases ◽

10.5799/jmid.458457 ◽

2018 ◽

pp. 97-101

Author(s):

Abirami Lakshmy Jayachandran ◽

Radhika Katragadda ◽

Thyagarajan Ravinder ◽

Leela Vajravelu ◽

Lavanya Manorajan ◽

...

Keyword(s):

Candida Species ◽

Antifungal Susceptibility ◽

Dilution Method ◽

Disc Diffusion ◽

Susceptibility Pattern ◽

Broth Dilution

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Molecular identification of Fusarium species complex isolated from clinical samples and its antifungal susceptibility patterns

Current Medical Mycology ◽

10.18502/cmm.5.4.2149 ◽

2019 ◽

Author(s):

Yashik Bansal ◽

Nidhi Singla ◽

Neelam Kaistha ◽

Sunandan Sood ◽

Jagdish Chander

Keyword(s):

Molecular Identification ◽

Species Complex ◽

Fusarium Species ◽

Antifungal Susceptibility ◽

Reference Method ◽

Pulmonary Involvement ◽

Clinical Samples ◽

Dilution Method ◽

Species Complexes

Background and Purpose: More than 300 Fusarium species are grouped into approximately 23 species complexes out of which around 70 are involved in human infections. The nomenclature of these species has undergone considerable changes in recent years. These species cause localized infections in individuals while inducing systemic infections mainly in immunocompromised patients. The present study was conducted to identify Fusarium species in clinical isolates by molecular methods and determine their in vitro minimum inhibitory concentration (MIC) patterns to address the lack of data in this domain in Northern India.Materials and Methods: For the purpose of the study, Fusarium isolates obtained from various clinical samples were sent to the Westerdijk Fungal Biodiversity Institute, Utrecht, the Netherlands, for molecular identification. The MIC testing was performed using the microbroth dilution method as per the Clinical and Laboratory Standards Institute reference method (M38-A2).Results: Fusarium was isolated from 33 patients (i.e., 1, 1, 2, 14, and 15 cases with endophthalmitis, sinusitis, pulmonary involvement, onychomycosis, and keratitis, respectively). These 33 isolates belonged to three species complexes, namely F. solani species complex (FSSC; n=13), F. fujikuroi species complex (FFSC; n=13), and F. incarnatum equiseti species complex (FIESC; n=7). The species identified within FSSC, FFSC, and FIESC included F. keratoplasticum (n=6)/F. falciforme (n=6)/F. solani (n=1), F. proliferatum (n=7)/F. sacchari (n=5)/F. anthophilum (n=1), and F. incarnatum SC species (n=6)/F. equiseti SC species (n=1), respectively. The MIC results showed that all isolates had a lower MIC against amphotericin B than against the other antifungal agents.Conclusion: Timely diagnosis and appropriate treatment will facilitate the improvement of patient outcomes.

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A study on the antifungal susceptibility pattern of dermatophytes isolated in a tertiary care hospital

International Journal of Bioassays ◽

10.21746/ijbio.2017.05.003 ◽

2017 ◽

Vol 6 (05) ◽

pp. 5379

Author(s):

Vanathi Sabtharishi* ◽

Radhika Katragadda ◽

Thyagarajan Ravinder

Keyword(s):

Tertiary Care Hospital ◽

Antifungal Susceptibility ◽

Tertiary Care ◽

Antifungal Drugs ◽

Dilution Method ◽

Care Hospital ◽

Susceptibility Pattern ◽

Superficial Mycosis ◽

Broth Dilution ◽

Common Infections

Recent years, due to increased usage of antifungal treatment worldwide, there is an increased chance of rising resistance among antifungal drugs too. Dermatophytic infections causes’ superficial mycosis and it affects skin, hair and nail. These infections are more common and antifungal drugs are used everywhere to treat those common infections. To conduct a study by determining the antifungal susceptibility pattern in dermatophytic isolates from patients attending dermatology OPD in a tertiary care hospital. A total of 217 samples like hair, nail and skin scrapings were obtained and isolation of dermatophytes was done. Antifungal susceptibility testing for dermatophytes was performed by micro broth dilution method. Antifungal drugs tested were Griseofulvin, Fluconazole, Itraconazole and Ketoconazole. Minimum inhibitory concentration for each drug for fungal isolates was tested and results studied. Fluconazole showed a higher MIC values in the range of 1-8µg/ml. Itraconazole showed the lowest MIC values by micro broth dilution method. Since there is limitation of standard guidelines and protocol, meticulous research must be conducted on effect of antifungals and derive at universally implementable guidelines.

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146. antifungal Susceptibility Patterns of candida Parapsilosis Bloodstream Isolates in the US, 2008–2018

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.456 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S203-S203

Author(s):

Brenda L Tesini ◽

Meghan Lyman ◽

Brendan R Jackson ◽

Anita Gellert ◽

William Schaffner ◽

...

Keyword(s):

Candida Species ◽

Regional Variation ◽

Antifungal Susceptibility ◽

Bloodstream Infections ◽

Emerging Infections ◽

In Vitro Susceptibility ◽

Fluconazole Resistance ◽

The Us ◽

Susceptibility Patterns

Abstract Background Multidrug resistant Candida is an increasing concern. C. parapsilosis in particular has decreased in vitro susceptibility to echinocandins. As a result, fluconazole had been favored for C. parapsilosis treatment. However, there is growing concern about increasing azole resistance among Candida species. We report on antifungal susceptibility patterns of C. parapsilosis in the US from 2008 through 2018. Methods Active, population-based surveillance for candidemia through the Centers for Disease Control and Prevention’s (CDC) Emerging Infections Program was conducted between 2008–2018, eventually encompassing 9 states (GA, MD,OR, TN, NY, CA, CO, MN, NM). Each incident isolate was sent to the CDC for species confirmation and antifungal susceptibility testing (AFST). Frequency of resistance was calculated and stratified by year and state using SAS 9.4 Results Of the 8,704 incident candidemia isolates identified, 1,471 (15%) were C. parapsilosis; the third most common species after C. albicans and C. glabrata. AFST results were available for 1,340 C. parapsilosis isolates. No resistance was detected to caspofungin (MIC50 0.25) or micafungin (MIC50 1.00) with only one (< 1%) isolate resistant to anidulafungin (MIC50 1.00). In contrast, 84 (6.3%) isolates were resistant to fluconazole and another 44 (3.3%) isolates had dose-dependent susceptibility to fluconazole (MIC50 1.00). Fluconazole resistance increased sharply from an average of 4% during 2008–2014 to a peak of 14% in 2016 with a subsequent decline to 6% in 2018 (see figure). Regional variation is also observed with fluconazole resistance ranging from 0% (CO, MN, NM) to 42% (NY) of isolates by site. Conclusion The recent marked increase in fluconazole resistance among C. parapsilosis highlights this pathogen as an emerging drug resistant pathogen of concern and the need for ongoing antifungal resistance surveillance among Candida species. Our data support the empiric use of echinocandins for C. parapsilosis bloodstream infections and underscore the need to obtain AFST prior to fluconazole treatment. Furthermore, regional variation in fluconazole resistance emphasizes the importance of understanding local Candida susceptibility patterns. Disclosures Lee Harrison, MD, GSK (Consultant)Merck (Consultant)Pfizer (Consultant)Sanofi Pasteur (Consultant)

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Symbiotic NCR Peptide Fragments Affect the Viability, Morphology and Biofilm Formation of Candida Species

International Journal of Molecular Sciences ◽

10.3390/ijms22073666 ◽

2021 ◽

Vol 22 (7) ◽

pp. 3666

Author(s):

Bettina Szerencsés ◽

Attila Gácser ◽

Gabriella Endre ◽

Ildikó Domonkos ◽

Hilda Tiricz ◽

...

Keyword(s):

Candida Species ◽

Biofilm Formation ◽

Therapeutic Potential ◽

Fungal Infections ◽

Combined Treatment ◽

Antimicrobial Activities ◽

Dilution Method ◽

Model Legume ◽

Anticandidal Activity

The increasing rate of fungal infections causes global problems not only in human healthcare but agriculture as well. To combat fungal pathogens limited numbers of antifungal agents are available therefore alternative drugs are needed. Antimicrobial peptides are potent candidates because of their broad activity spectrum and their diverse mode of actions. The model legume Medicago truncatula produces >700 nodule specific cysteine-rich (NCR) peptides in symbiosis and many of them have in vitro antimicrobial activities without considerable toxicity on human cells. In this work we demonstrate the anticandidal activity of the NCR335 and NCR169 peptide derivatives against five Candida species by using the micro-dilution method, measuring inhibition of biofilm formation with the XTT (2,3-Bis-(2-Methoxy-4-Nitro-5-Sulfophenyl)-2H-Tetrazolium-5-Carboxanilide) assay, and assessing the morphological change of dimorphic Candida species by microscopy. We show that both the N- and C-terminal regions of NCR335 possess anticandidal activity as well as the C-terminal sequence of NCR169. The active peptides inhibit biofilm formation and the yeast-hypha transformation. Combined treatment of C. auris with peptides and fluconazole revealed synergistic interactions and reduced 2-8-fold the minimal inhibitory concentrations. Our results demonstrate that shortening NCR peptides can even enhance and broaden their anticandidal activity and therapeutic potential.

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

Canadian Journal of Microbiology ◽

10.1139/w99-075 ◽

1999 ◽

Vol 45 (10) ◽

pp. 871-874 ◽

Cited By ~ 7

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.

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Spectrum and theIn VitroAntifungal Susceptibility Pattern of Yeast Isolates in Ethiopian HIV Patients with Oropharyngeal Candidiasis

International Journal of Microbiology ◽

10.1155/2016/3037817 ◽

2016 ◽

Vol 2016 ◽

pp. 1-8 ◽

Cited By ~ 10

Author(s):

Birhan Moges ◽

Adane Bitew ◽

Aster Shewaamare

Keyword(s):

Antifungal Agents ◽

Antifungal Susceptibility ◽

Antifungal Drugs ◽

Assay Method ◽

Cryptococcus Laurentii ◽

Susceptibility Pattern ◽

Test Procedures ◽

Disk Diffusion Assay ◽

Diffusion Assay

Background.In Ethiopia, little is known regarding the distribution and thein vitroantifungal susceptibility profile of yeasts.Objective.This study was undertaken to determine the spectrum and thein vitroantifungal susceptibility pattern of yeasts isolated from HIV infected patients with OPC.Method.Oral pharyngeal swabs taken from oral lesions of study subjects were inoculated onto Sabouraud Dextrose Agar. Yeasts were identified by employing conventional test procedures and the susceptibility of yeasts to antifungal agents was evaluated by disk diffusion assay method.Result.One hundred and fifty-five yeast isolates were recovered of which 91 isolates were from patients that were not under HAART and 64 were from patients that were under HAART.C. albicanswas the most frequently isolated species followed byC. glabrata, C. tropicalis, C. krusei, C. kefyr, Cryptococcus laurentii, and Rhodotorulaspecies. Irrespective of yeasts isolated and identified, 5.8%, 5.8%, 12.3%, 8.4%, 0.6%, and 1.3% of the isolates were resistant to amphotericin B, clotrimazole, fluconazole, ketoconazole, miconazole, and nystatin, respectively.Conclusion.Yeast colonization rate of 69.2% and 31% resistance to six antifungal agents was documented. These highlight the need for nationwide study on the epidemiology of OPC and resistance to antifungal drugs.

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Antifungal susceptibility profiles of otomycosis etiological agents in Ahvaz, Iran

Current Medical Mycology ◽

10.18502/cmm.6.2.2696 ◽

2020 ◽

Author(s):

Maral Gharaghani ◽

Marzieh Halvaeezadeh ◽

Gholam Ali Jalaee ◽

Simin Taghipour ◽

Neda Kiasat ◽

...

Keyword(s):

Aspergillus Niger ◽

Candida Species ◽

Geometric Mean ◽

Antifungal Susceptibility ◽

Morphological Characteristics ◽

Aspergillus Species ◽

Great Activity ◽

Minimum Effective Concentration ◽

Microdilution Method ◽

Physiological Tests

Background and Purpose: Otomycosis is a secondary ear fungal infection among predisposed individuals in humid conditions. Aspergillus species are the most common etiologic agents of this infection. Several ototopical antifungals are currently used for the treatment of this disease; however, recurrence and treatment failure are usually observed in some cases. Regarding this, the present study was conducted to investigate the antifungal activity of caspofungin, azoles, and terbinafine against the isolated agents of otomycosis. Materials and Methods: This study was conducted on the specimens collected from 90 patients with otomycosis. The samples were cultured on Sabouraud dextrose agar and identified based on morphological characteristics, physiological tests, and microscopic features. Furthermore, the microdilution method was used for antifungal susceptibility testing according to the Clinical and Laboratory Standards Institute (CLSI) guidelines. Finally, the minimum inhibitory concentration (MIC) and minimum effective concentration (MEC) ranges, MIC/MEC50, MIC/MEC90, and geometric mean (GM) MIC/MEC were calculated for the isolates. Results: According to the results, 77 patients with otomycosis were positive for different Aspergillus (88.3%) and Candida (11.7%) species. Aspergillus niger complex (n=36) was found to be the most common agent, followed by A. flavus, A. terreus, and A. nidulans complexes. Furthermore, epidemiological cutoff values (ECVs) were lower than those presented by the CLSI for itraconazole and caspofungin in 98.5% and 42.6% of Aspergillus species, respectively. Terbinafine exhibited a great activity against Aspergillus species, while fluconazole revealed a low activity against both Aspergillus species. Based on the results, 77.8% of Candida species were resistant to caspofungin; however, miconazole and econazole had low MIC ranges. Conclusion: Aspergillus niger and A. flavus complexes were identified as the most common agents accounting for 85.7% of the isolates. In addition, terbinafine was identified as the best antifungal for both Aspergillus and Candida species. Moreover, tested azoles had relatively low MICs, whereas most of the isolates had the MIC values beyond the caspofungin ECVs.

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Distribution and antifungal susceptibility of candida species isolated from blood culture

Journal of the Pakistan Medical Association ◽

10.47391/jpma.1464 ◽

2021 ◽

pp. 1-12

Author(s):

Selim Gorgun ◽

Melek Bilgin ◽

Suleyman Sirri Kilic ◽

Admin

Keyword(s):

Candida Species ◽

Antifungal Susceptibility ◽

Tube Formation ◽

Resistance Rate ◽

Blood Cultures ◽

Dilution Method ◽

Ethical Approval ◽

Immunosuppressed Patients ◽

Training And Research ◽

Vitek 2

Abstract Objective: The aim of this study is to determine the distribution of samples exhibiting Candida growth among the blood cultures, and the antifungal susceptibility. Methods: The retrospective study was conducted in Samsun Training and Research Hospital, Samsun, Turkey from January to December, 2018 and comprised immunosuppressed patients with sepsis. Ethical approval was obtained and consent was taken from all patients. Yeast growths were typed by means of colony morphology, germ tube formation and the VITEK 2 system. Their susceptibilities tests were determined using the same automatized system. Resistance strains were also tested using the dilution method. Results: Of the 50 patients, 19(38%) were females and 31(62%) were males. The overall mean age was 60.84 ± 22.05 years. 31 (62%) of the samples were received from intensive care units, 14 (28%) from the palliative care unit, and five from other inpatients. In our study, most common among our isolates was C. albicans, and C. parapsiosis was most common among non-albicans species. Resistance to antifungals was observed in 28% of Candida isolates. Of the total isolates, %10 were found to be naturally resistant to fluconazole, 8% to voriconazole, 4% to flucytosine, and amphotericin B. The high resistance rate for fluconazole in Candida species is noteworthy. The findings obtained through both the dilution method and the automatized system were consistent. Continuou....

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