scholarly journals Real World Analysis of Response Rate and Efficacy of Oral Ketoconazole in Patients with Recalcitrant Tinea Corporis and Cruris

2021 ◽  
Author(s):  
Pooja Arora ◽  
Kabir Sardana ◽  
Anita Kulhari ◽  
Ravinder Kaur ◽  
Deepti Rawat ◽  
...  
Keyword(s):  
Response Rate ◽  
Antifungal Susceptibility ◽  
Trichophyton Mentagrophytes ◽  
Predisposing Factors ◽  
Antifungal Drugs ◽  
Tinea Corporis ◽  
Response To Treatment ◽  
Percentage Improvement ◽  
Alternative Drug ◽  
Susceptibility Tests

Recalcitrant dermatophytosis has had an alarming rise in India with concomitant decreased effectiveness of conventional antifungal agents. This has prompted the use of second-line agents for treatment. In this retrospective study, we aimed to analyze the response rate, efficacy, relapse rate, and side effects of oral ketoconazole (KZ) in the treatment of recalcitrant tinea corporis and cruris. Institutional records were reviewed for patients presenting with tinea cruris or corporis who had failed treatment with conventional antifungal drugs and treated with oral KZ. Potassium hydroxide (KOH) findings, culture reports, and response to treatment was noted based on the percentage improvement in lesions and reduction in itching compared with baseline. Fourty-three patients (mean age 31.3 years) with tinea corporis/cruris who had taken prior treatment with antifungals were recruited in the study. KOH mount and culture were positive in 76.7% patients. Trichophyton mentagrophytes was the commonest species, isolated in 62.8% of patients. Ketoconazole showed the lowest minimum inhibitory concentration on antifungal susceptibility tests with various antifungals. With a dose of 400 mg daily, 67.4% of patients were cured of disease with mean duration of 9.4 weeks. Patients having less than 40% clearance at 2 weeks had a 68.9% less probability of getting cured of disease. Of the 29 patients cured, 37.9% relapsed because of various predisposing factors. Two patients developed increase in liver enzymes on treatment. Our analysis suggests that KZ can be used as alternative drug in cases with failure to conventional antifungal drugs. Though there are relapses, these can be partially explained by various predisposing factors that support fungal survival and transmission.

scholarly journals Identification of Promising Antifungal Drugs against Scedosporium and Lomentospora Species after Screening of Pathogen Box Library

2021 ◽  
Vol 7 (10) ◽  
pp. 803
Author(s):  
Rodrigo Rollin-Pinheiro ◽  
Luana Pereira Borba-Santos ◽  
Mariana Ingrid Dutra da Silva Xisto ◽  
Yuri de Castro-Almeida ◽  
Victor Pereira Rochetti ◽  
...  
Keyword(s):  
Fungal Infections ◽  
Antifungal Susceptibility ◽  
Antifungal Drugs ◽  
Positive Interactions ◽  
Immunocompromised Patients ◽  
Planktonic Cells ◽  
Morphological Alterations ◽  
Susceptibility Tests ◽  
Therapeutic Alternatives ◽  
Scanning Electron

Fungal infections have been increasing during the last decades. Scedosporium and Lomentospora species are filamentous fungi most associated to those infections, especially in immunocompromised patients. Considering the limited options of treatment and the emergence of resistant isolates, an increasing concern motivates the development of new therapeutic alternatives. In this context, the present study screened the Pathogen Box library to identify compounds with antifungal activity against Scedosporium and Lomentospora. Using antifungal susceptibility tests, biofilm analysis, scanning electron microscopy (SEM), and synergism assay, auranofin and iodoquinol were found to present promising repurposing applications. Both compounds were active against different Scedosporium and Lomentospora, including planktonic cells and biofilm. SEM revealed morphological alterations and synergism analysis showed that both drugs present positive interactions with voriconazole, fluconazole, and caspofungin. These data suggest that auranofin and iodoquinol are promising compounds to be studied as repurposing approaches against scedosporiosis and lomentosporiosis.

scholarly journals In Vitro Antifungal Susceptibility Of Griseofulvin, Fluconazole, Itraconazole And Terbinafine Against Clinical Isolates Of Trichophyton Rubrum And Trichophyton Mentagrophytes

2014 ◽  
Vol 2 (1) ◽  
Author(s):  
K R Reddy ◽  
S Ram Reddy
Keyword(s):  
Trichophyton Rubrum ◽  
Clinical Laboratory ◽  
Antifungal Susceptibility ◽  
Trichophyton Mentagrophytes ◽  
Drug Susceptibility ◽  
Antifungal Drugs ◽  
Clinical Isolates ◽  
National Committee ◽  
In Vitro Antifungal Susceptibility

Investigations on antifungal drug susceptibility were carried out on 90 clinical isolates of Trichophyton rubrum, and Trichophyton mentagrophytes with four antifungal drugs, namely griseofulvin, fluconazole, itraconazole and terbinafine as suggested by National Committee for Clinical Laboratory Standards (NCCLS) M27–A (1997) document by broth macrodilution method to standardize in vitro antifungal susceptibility testing and to find out the Minimum Inhibitory Concentration (MIC) of the drugs. In this study, terbinafine was found to be the most efficient drug for all isolates. Terbinafine had the lowest MIC range of 0.001 g/ml to 0.09 g/ml and MIC50 was low at 0.005 g/ml and MIC90 was also low at 0.04 g/ml against T.rubrum; and MIC range of 0.001μg/ml to 0.19μg/ml with a MIC50 of 0.01μg/ml and MIC90 at 0.09μg/ml against T.mentagrophytes. Itraconazole showed antifungal activity superior to that of fluconazole, with a MIC range of 0.04g/ml to 1.56g/ml, with MIC50 at 0.19μg/ml and MIC90 at 1.56g/ml against T.rubrum; and MIC range of 0.04μg/ml to 1.56μg/ml, with MIC50 at 0.19μg/ml and MIC90 at 0.78μg/ml against T.mentagrophytes. Griseofulvin appears to be still a potent drug for management of dermatophytoses. Griseofulvin had a MIC range of 0.15g/ml to 5.07 g/ml with MIC50 at1.26 g/ml and MIC90 at 2.53 g/ml against T.rubrum; and MIC range of 0.31μg/ml to 5.07μg/ml with MIC50 at 1.26μg/ml and MIC90 at 2.53μg/ml against T.mentagrophytes. Fluconazole showed a high MIC range of 0.19 g/ml to 50 g/ml and MIC50 was high at 1.56g/ml and MIC90 was also high at 12.5 g/ml against T.rubrum; and a high MIC range of 0.09μg/ml to 25.0μg/ml, with MIC50 at 1.56μg/ml and MIC90 at 12.5μg/ml towards T.mentagrophytes. The technique was found to be easy to perform and reliable with consistent results.

Molecular Identification, And Antifungal Susceptibility Patterns of Candida Species Isolated From Candidemia Patients in Yasuj, Southwestern Iran

2021 ◽  
Author(s):  
Shaghayegh Rostami Yasuj ◽  
Seyed Sajad Khoramrooz ◽  
Marjan Salahi ◽  
Ali Keshtkari ◽  
Jabar Taghavi ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Amphotericin B ◽  
Molecular Identification ◽  
Antifungal Susceptibility ◽  
Hospitalized Patients ◽  
Antifungal Drugs ◽  
Its2 Region ◽  
Susceptibility Tests ◽  
Susceptibility Patterns

Abstract Candidemia is the most common systemic infection in hospitalized patients and causing high mortality. Hence, the diagnosis of this infection in the early-stage with appropriate antifungal therapy has been attributed to the lowest mortality. The aims of this study are molecular identification of Candida species isolated from candidemia patients and evaluated the in vitro antifungal susceptibility patterns of these strains to fluconazole, amphotericin B, and caspofungin. In the present study, 800 hospitalized patients who suspected candidemia were sampled. Candida species were isolated and identified based on morphological and PCR-sequencing of the ITS1-5.8S-ITS2 region. Antifungal susceptibility tests for fluconazole, amphotericin B, and caspofungin was performed according to the Clinical and Laboratory Standards Institute M27-A3. Also, clinical data were recorded from patient's records. Overall, 27 candidemia patients were detected among hospitalized patients. 33.3% of candidemia patients were treated with amphotericin B, however, the mortality rate was 14.8%. The majority of patients (59%) were from the neonatal intensive care unit and premature born was the most underlying condition. C. albicans (n = 18; 66.6%) was the most common species isolated from blood cultures, followed by C.parapsilosis (n = 7; 25.9%), C.pelliculosa ( n = 1;3.7% ) and C.tropicalis (n = 1;3.7%). Only one C. albicans isolate were resistance to fluconazole (MIC = 32 µg/mL). Generally, C. albicans has been the most frequent causative agent of candidemia. Resistance to antifungal drugs among candidemia agents was rare. Also, the identification of Candida isolates at the species level with in-vitro antifungal susceptibility tests can manage and decrease the mortality rate among candidemia patients.

scholarly journals Candida species cause vulvovaginitis and resistance to antifungals used for treatment

2021 ◽  
Vol 14 ((Supl. 1)) ◽  
pp. 1-13
Author(s):  
Diogo Luan de Oliveira ◽  
Juliana Cristina Schmidt
Keyword(s):  
Candida Species ◽  
Care Service ◽  
Antifungal Susceptibility ◽  
Antifungal Drugs ◽  
Antifungal Susceptibility Test ◽  
Polymerase Chain ◽  
Susceptibility Tests ◽  
Susceptibility Profiles ◽  
Dose Dependent

In this study were identified Candida species from vaginal secretion isolates, evaluated their in vitro antifungal susceptibilities, and correlated these features with antifungal agents prescribed for patients assisted in a primary care service. Species identification by Polymerase Chain Reaction showed that 36.5% of isolates were characterized as non-C. albicans species. In antifungal susceptibility tests most isolates were susceptible to ketoconazole, fluconazole, and itraconazole, although between 40% and 50% of isolates show resistance or dose-dependent susceptibility to miconazole and nystatin, respectively. Analysis of drugs prescribed to patients revealed that 34.2% of the isolates were considered resistant to agents used in treatment. Several Candida species can cause vulvovaginitis and exhibit different susceptibility profiles to antifungal drugs used in treatment. The identification of Candida species is relevant and useful to the epidemiological management of infections. The antifungal susceptibility test may also be useful for choosing most effective drug treatment for each patient.

In vitro antifungal susceptibility of griseofulvin, fluconazole, itraconazole and terbinafine against clinical isolates of Trichophyton rubrum and Trichophyton mentagrophytes

2014 ◽  
Vol 1 (4) ◽  
pp. 26-28
Author(s):  
KR Reddy ◽  
SR Reddy
Keyword(s):  
Trichophyton Rubrum ◽  
Clinical Laboratory ◽  
Antifungal Susceptibility ◽  
Trichophyton Mentagrophytes ◽  
Drug Susceptibility ◽  
Antifungal Drugs ◽  
Clinical Isolates ◽  
National Committee ◽  
In Vitro Antifungal Susceptibility

Investigations on antifungal drug susceptibility were carried out on 90 clinical isolates of Trichophyton rubrum, and Trichophyton mentagrophytes with four antifungal drugs, namely griseofulvin, fluconazole, itraconazole and terbinafine as suggested by National Committee for Clinical Laboratory Standards (NCCLS) M27A (1997) document by broth macrodilution method to standardize in vitro antifungal susceptibility testing and to find out the Minimum Inhibitory Concentration (MIC) of the drugs. In this study, terbinafine was found to be the most efficient drug for all isolates. Terbinafine had the lowest MIC range of 0.001 g/mlto 0.09 g/ml and MIC50 was low at 0.005 g/ml and MIC90 was also low at 0.04 g/ml against T. rubrum; and MIC range of 0.001pg/ml to 0.19pg/ml with a MIC50 of 0.01pg/ml and MIC90 at 0.09 pg/ml against T. mentagrophytes. Itraconazole showed antifungal activity superior to that of fluconazole, with a MIC range of 0.04g/ml to l.56g/ml, with MIC50 at 0.19pg/m land MIC90 at l.56g/ml against T. rubrum; and MIC range of 0.04.g/ml to 1.56pg/ml, with MIC50 at 0.19pg/ml and MIC90 at 0.78pg/ml against T. mentagrophytes. Griseofulvin appears to be still a potent drug for management of dermatophytoses. Griseofulvin had a MIC range of 0.15g/ml to 5.07 g/ml with MIC50 at l.26 g/ml and MIC90 at 2.53 g/ml against T. rubrum; and MIC range of 0.31pg/ml to 5.07pg/ml with MIC50 at 1.26pg/ml and MIC90 at 2.53pg/ml against T. mentagrophytes. Fluconazole showed a high MIC range of 0.19 g/ml to 50 g/ml and MIC50 was high at 1.56g/ml and MIC90 was also high at 12.5 g/ml against T. rubrum; and a high MIC range of 0.09pg/ml to 25.0pg/ml, with MIC50 at 1.56pg/ml and MIC90 at 12.5pg/ml towards T. mentagrophytes. The technique was found to be easy to perform and reliable with consistent results.DOI: http://dx.doi.org/10.3126/jucms.v1i4.9569 Journal of Universal College of Medical Sciences (2013) Vol.1 No.04: 26-28

scholarly journals Dermatophyte Profile in Patients with Dermatophytosis in Polyclinic Dermatology and Venerology of the General Hospital Dr. Ferdinand Lumbantobing Sibolga in 2019

2021 ◽  
Vol 4 (2) ◽  
Author(s):  
May Iyasya Sarumpaet ◽  
Dian Dwi Wahyuni
Keyword(s):  
Trichophyton Rubrum ◽  
Trichophyton Mentagrophytes ◽  
Antifungal Drugs ◽  
Tinea Corporis ◽  
Observational Research ◽  
Microsporum Canis ◽  
Cross Sectional ◽  
Superficial Skin ◽  
Cross Sectional Design

Dermatophytosis is a superficial skin infection caused by dermatophytes that infected keratinous skin tissue, dermatophytes form molecules that bind to keratin as a source of nutrients in the formation of colonization. Dermatophytes that cause dermatophytosis are Tricophyton sp, Epidermophyton sp and Microsporum sp. To find out the Profile of dermatophytes in patients with dermatophytosis in the Polyclinic of Dermatology and Venerology Dr. Ferdinand Lumbantobing Sibolga in 2019 conducted observational research with cross sectional design. The sample of this study were 75 patients who were new patients and had not used antifungal drugs. This sample is then examined by examination of KOH and cultured and then identified by Scotch-tape Preparation in a microscope. The prevalence of dermatophytosis in this study was 23% of skin cases. The majority of dermatophytosis patients are women (52%), the most age group is 46-65 years (30.7%) and is most often found in housewives (24%). The dermatophytes species found were Trichophyton rubrum, Trichophyton mentagrophytes and Microsporum canis with the most species Trichophyton rubrum (37.3%), which was then followed by Trichophyton mentagrophytes (16%). Tinea corporis, tinea cruris, tinea capitis, tinea pedis and tinea unguinum are dermatophytosis cases that were found in this study. It can be concluded that Trichophyton rubrum is the most common cause of dermatophytosis in Dr. Ferdinand Lumbantobing Sibolga with Tinea corporis is the most classified classification of dermatophytosis.

scholarly journals New Antifungal Susceptibility Test Based on Chitin Detection by Image Cytometry

2019 ◽  
Vol 64 (1) ◽  
Author(s):  
Yan Wang ◽  
Arisandy N. Andriampamonjy ◽  
Sebastien Bailly ◽  
Cécile Garnaud ◽  
Danièle Maubon ◽  
...  
Keyword(s):  
Antifungal Susceptibility ◽  
Image Cytometry ◽  
Culture Conditions ◽  
Fungal Species ◽  
Antifungal Drugs ◽  
Calcofluor White ◽  
Content Type ◽  
Antifungal Susceptibility Test ◽  
Susceptibility Tests

ABSTRACT The antifungal susceptibility tests used in clinical laboratories have several limitations. We developed a new test, SensiFONG, based on the detection of chitin levels after exposure to antifungal drugs. The optimal culture conditions were 30°C for 6 h for yeast strains and 26°C for 16 h for molds. The strains were exposed to a range of echinocandin or azole concentrations. Chitin was stained with calcofluor white. The percentage of fungal cells with high chitin levels was determined with an automatic epifluorescence microscope. The SensiFONG results were compared to those with the EUCAST method. Image acquisition and analysis were performed with ScanR software. Fifty-nine strains (28 Candida albicans, 17 Candida glabrata, and 14 Aspergillus fumigatus) were analyzed. Thresholds for the classification of strains as resistant or susceptible were determined for each fungal species. The strains displaying an increase in chitin content of ≥32% for C. albicans, ≥6% for C. glabrata, and ≥17% for A. fumigatus were considered susceptible. The application of these thresholds to all 59 strains resulted in a sensitivity of 0.87, 0.93, and 1.00 and a specificity of 0.93, 0.84, and 0.82 for C. albicans, C. glabrata, and A. fumigatus, respectively. The correlation between the results obtained in the SensiFONG and EUCAST assays was excellent. We developed a new test, SensiFONG, based on a new concept. While current assays assess growth inhibition, our test detects changes in chitin levels after exposure to antifungal drugs. Here, we present preliminary results and we propose a proof of concept of this methodology.

scholarly journals Population differentiation, antifungal susceptibility, and host range of Trichophyton mentagrophytes isolates causing recalcitrant infections in humans and animals

2020 ◽  
Vol 39 (11) ◽  
pp. 2099-2113
Author(s):  
Sebastian Gnat ◽  
Dominik Łagowski ◽  
Aneta Nowakiewicz ◽  
Marcelina Osińska ◽  
Łukasz Kopiński
Keyword(s):  
Host Range ◽  
Susceptibility Testing ◽  
Antifungal Susceptibility ◽  
Trichophyton Mentagrophytes ◽  
Antifungal Susceptibility Testing ◽  
Antifungal Drugs ◽  
Genomic Diversity ◽  
Clinical Isolates ◽  
Chemical Groups

Abstract The major problems in determining the causative factors of the high prevalence of dermatophytoses include the lack of a well-standardized antifungal susceptibility testing method, the low consistency of in vitro and clinical minimal inhibitory concentration values, the high genomic diversity of the population, and the unclear mechanism of pathogenicity. These factors are of particular importance when the disease is recalcitrant and relapses. Herein, we identified and characterized Trichophyton mentagrophytes isolates obtained from therapy-resistant cases in humans and animals. We used genomic diversity analysis of 17 human and 27 animal clinical isolates with the MP-PCR technique, determined their phenotypic enzymatic activity and host range, and performed antifungal susceptibility testing to currently available antifungal drugs from various chemical groups. Genomic diversity values of 35.3% and 33.3% were obtained for clinical isolates from humans and animals, respectively, yet without any relationship to the host species or antifungal drug to which resistance in therapy was revealed. The highest activity of keratinase enzymes was recorded for fox, guinea pig, and human hairs. These hosts can be considered as the main species in the host range of these isolates. A phenyl morpholine derivative, i.e. amorolfine, exhibited superior activity against strains obtained from both humans and animals with the lowest MIC50. Interestingly, high compliance of terbinafine in vitro resistance with clinical problems in the treatment with this substance was shown as well. The high resistance of dermatophytes to drugs is the main cause of the recalcitrance of the infection, whereas the other features of the fungus are less important.

scholarly journals In vitro antifungal susceptibilities of six antifungal drugs against clinical Candida glabrata isolates according to EUCAST

2020 ◽  
Author(s):  
Mahnaz Fatahinia ◽  
Ali Zarei Mahmoudabadi ◽  
Marzieh Halvaeizadeh ◽  
Elham AboualiGalehdari ◽  
Neda Kiasat
Keyword(s):  
Candida Glabrata ◽  
Antifungal Susceptibility ◽  
Antifungal Drugs ◽  
Health Centers ◽  
Regional Patterns ◽  
Alternative Drug ◽  
Life Threatening ◽  
Immunocompromised Hosts ◽  
Dose Dependent

Background and Purpose: Candida glabrata is the second cause of candidiasis. The mortality rate of C. glabrata infections is about 40%; accordingly, it may be life threatening, especially in immunocompromised hosts. Regarding this, the current study was conducted to evaluate the regional patterns of the antifungal susceptibility of clinical C. glabrata isolated from the patients referring to the health centers located in Ahvaz, Iran. Materials and Methods: In this study, a total of 30 clinical strains of C. glabrata isolates were recovered from different body sites (i.e., vagina, mouth, and urine). Phenotypic characteristics and molecular methods were used to identify the isolates. The minimum inhibitory concentration (MIC) was determined according to the European Committee on Antimicrobial Susceptibility Testing. Results: Our findings demonstrated that 20%, 80%, and 6.7% of the isolates were resistant to amphotericin B, terbinafine, and posaconazole, respectively, while all the isolates were found to be fluconazole susceptible dose dependent and susceptible to voriconazole and caspofungin. Conclusion: Our study suggested that voriconazole had high potency against C. glabrata isolates. Consequently, this antifungal agent can be an alternative drug in the treatment of resistant patients. These results can be helpful for the successful treatment of patients in different regions.

Conventional therapy and new antifungal drugs against Malassezia infections

2020 ◽  
Author(s):  
Wafa Rhimi ◽  
Bart Theelen ◽  
Teun Boekhout ◽  
Chioma Inyang Aneke ◽  
Domenico Otranto ◽  
...  
Keyword(s):  
Antifungal Susceptibility ◽  
Clinical Signs ◽  
Bloodstream Infections ◽  
Antifungal Drugs ◽  
Malassezia Spp ◽  
Susceptibility Tests ◽  
In Vitro Antifungal Susceptibility ◽  
Susceptibility Profiles

ABSTRACT Malassezia yeasts are commensal microorganisms occurring on the skin of humans and animals causing dermatological disorders or systemic infections in severely immunocompromised hosts. Despite attempts to control such yeast infections with topical and systemic antifungals, recurrence of clinical signs of skin infections as well as treatment failure in preventing or treating Malassezia furfur fungemia have been reported most likely due to wrong management of these infections (e.g., due to early termination of treatment) or due to the occurrence of resistant phenomena. Standardized methods for in vitro antifungal susceptibility tests of these yeasts are still lacking, thus resulting in variable susceptibility profiles to azoles among Malassezia spp. and a lack of clinical breakpoints. The inherent limitations to the current pharmacological treatments for Malassezia infections both in humans and animals, stimulated the interest of the scientific community to discover new, effective antifungal drugs or substances to treat these infections. In this review, data about the in vivo and in vitro antifungal activity of the most commonly employed drugs (i.e., azoles, polyenes, allylamines, and echinocandins) against Malassezia yeasts, with a focus on human bloodstream infections, are summarized and their clinical implications are discussed. In addition, the usefulness of alternative compounds is discussed.

Sign in / Sign up

Export Citation Format

Share Document