title: Comparative study of the in vitro activity of various antifungal drugs against Scedosporium spp. in aerobic and hyperbaric atmosphere versus normal atmosphere.
abstract: BACKGROUND
  Scedosporium spp. have been observed with increasing frequency over the last decade in immunocompromised patients and trauma patients. This mould is often multi-drug resistant and its mortality rate remains very high.
  
  
  OBJECTIVE
  The primary goal of this study was to obtain data concerning the in vitro susceptibility of 13 Scedosporium strains comparing the in vitro incubation in aerobic versus hyperbaric conditions.
  
  
  METHODS
  Chemosensitivity of thirteen Scedosporium strains was evaluated after a 72h-incubation in a normoxic (21% O2) normobaric (1 ATA) atmosphere versus a hyperoxic (100% O2) hyperbaric (2-3 ATA), and after a re-incubation at room temperature for an additional 72h.
  
  
  RESULTS
  All S. apiospermum and S. prolificans strains showed no growth after incubation in hyperbaric hyperoxic atmosphere. However, when plates were then maintained at room temperature in aerobic conditions, growth was systematically observed from 36 to 96h, and Minimal inhibitory concentration (MIC) values were the same obtained after incubation in aerobic conditions.
  
  
  CONCLUSIONS
  These results suggest impressive in vitro fungistatic activity of the hyperoxic hyperbaric atmosphere, even if its effect is strictly time-dependent. This preliminary in vitro study has potential clinical relevance because it focuses on examining in vitro combination therapy using hyperoxic hyperbaric conditions plus a single antifungal agent, rather than using combinations of different antifungal drugs, to potentially increase the antifungal activity.
authors.affiliation: Microbiology Institute, UOC Microbiologia e Virologia AO Ospedale San Carlo Borromeo, via Pio II no. 3, Milan, Italy. farina.claudio@sancarlo.mi.it
authors.forename: C
authors.initials: C
authors.lastname: Farina
authors.forename: G
authors.initials: G
authors.lastname: Marchesi
authors.forename: M
authors.initials: M
authors.lastname: Passera
authors.forename: C
authors.initials: C
authors.lastname: Diliberto
authors.forename: G
authors.initials: G
authors.lastname: Russello
mesh_terms: D000332:Aerobiosis; D000935:Antifungal Agents / Q000494:pharmacology*; D001274:Atmospheric Pressure; D004353:Drug Evaluation, Preclinical; D006801:Humans; D006931:Hyperbaric Oxygenation; D009181:Mycoses / Q000382:microbiology; D010100:Oxygen / Q000494:pharmacology; D021681:Scedosporium / Q000187:drug effects* / Q000254:growth & development / Q000302:isolation & purification
chemical_list: D000935:Antifungal Agents; D010100:Oxygen