In vitro resistance of clinical Fusarium species to amphotericin B and voriconazole using the EUCAST antifungal susceptibility method.
Susceptibility testing using the EUCAST-AFST method against 39 clinical Fusarium strains consecutively collected from local and invasive infections during the last 10years assessed the in vitro activities of amphotericin B (AmB) and triazole antifungal agents. In addition, the susceptibility pattern of 12 reference strains from the CBS-KNAW Fungal Biodiversity Centre (CBS) was evaluated. In particular Fusarium petroliphilum and F. solani sensu lato were involved in disseminated infections and known for treatment failure. AmB displayed the lowest MICs followed by voriconazole VRC, posaconazole (POC). Itraconazole (ITC) showed high MIC values, displaying in vitro resistance. Clinical isolates were significantly (P <0.05) more resistant to AmB, VRC, and POC, than the CBS reference isolates probably due to previous exposure to antifungal therapy. Resistant profiles to AmB and VRC, which are the currently recommended agents in the guidelines for treatments, and a late diagnosis may be associated with high mortality rate in immunocompromised patients. The present antifungal susceptibility profiles showed that species- and strain-specific differences in antifungal susceptibility exist within Fusarium and that susceptibility testing is important and may improve the prognosis of these infections.
Microbiology Division, Department of Laboratory Medicine and Pathology, Hamad Medical Corporation, P. O. Box 3050, Doha, Qatar; Weill Cornell Medical College, Doha, Qatar. Electronic address: saadtaj51@gmail.com.
Saad J
SJ
Taj-Aldeen
Microbiology Division, Department of Laboratory Medicine and Pathology, Hamad Medical Corporation, P. O. Box 3050, Doha, Qatar; CBS-KNAW Fungal Biodiversity Centre, Utrecht, The Netherlands.
Husam
H
Salah
CBS-KNAW Fungal Biodiversity Centre, Utrecht, The Netherlands; Institute of Biodiversity and Ecosystem Dynamics, University of Amsterdam, Amsterdam, the Netherlands; Directorate General of Health Services, Ministry of Health, Ibri Hospital, Ibri, Oman.
Abdullah M S
AM
Al-Hatmi
Microbiology Division, Department of Laboratory Medicine and Pathology, Hamad Medical Corporation, P. O. Box 3050, Doha, Qatar.
Manal
M
Hamed
CBS-KNAW Fungal Biodiversity Centre, Utrecht, The Netherlands.
Bart
B
Theelen
CBS-KNAW Fungal Biodiversity Centre, Utrecht, The Netherlands.
Anne D
AD
van Diepeningen
CBS-KNAW Fungal Biodiversity Centre, Utrecht, The Netherlands; Department of Dermatology, Shanghai Key Laboratory of Molecular Medical Mycology, Institute of Dermatology and Medical Mycology, Changzheng Hospital, Second Military Medical University, Shanghai, People's Republic of China; Institute of Microbiology, Chinese Academy of Science, Beijing, People's Republic of China.
Teun
T
Boekhout
Division of Hygiene and Medical Microbiology, Innsbruck Medical University, Innsbruck, Austria.
Cornelia
C
Lass-Flörl
D000328:Adult; D000369:Aged, 80 and over; D000666:Amphotericin B / Q000494:pharmacology*; D000935:Antifungal Agents / Q000494:pharmacology*; D025141:Drug Resistance, Fungal; D005260:Female; D060585:Fusariosis / Q000382:microbiology*; D005670:Fusarium / Q000187:drug effects* / Q000302:isolation & purification; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D065819:Voriconazole / Q000494:pharmacology*; D055815:Young Adult
D000935:Antifungal Agents; D000666:Amphotericin B; D065819:Voriconazole
Amphotericin B; EUCAST antifungal susceptibility; Fusarium; Resistance; Triazoles