title: Large-Scale Evaluation ofIn VitroAmphotericin B, Triazole, and Echinocandin Activity against Coccidioides Species from U.S. Institutions.
abstract: Large-scale testing ofCoccidioidesisolates has not been performed, and the frequency of clinical isolates with elevated amphotericin B or triazole MICs has not been evaluated.Coccidioidesisolates (n= 581) underwent antifungal susceptibility testing. Elevated MIC values were observed for fluconazole (≥16 μg/ml, 37.3% of isolates; ≥32 μg/ml, 7.9% of isolates), itraconazole (≥2 μg/ml, 1.0% of isolates), posaconazole (≥1 μg/ml, 1.0% of isolates), and voriconazole (≥2 μg/ml, 1.2% of isolates). However, mold-active triazoles exhibited low MICs for the majority of isolates tested. Additional correlation with patient outcomes to determine the relevance of elevated MICs inCoccidioidesisolates is needed.
authors.affiliation: Department of Medicine, Division of Infectious Diseases, University of California-Davis Medical Center, Sacramento, California, USA grthompson@ucdavis.edu.|Department of Medical Microbiology and Immunology, University of California-Davis, Davis, California, USA.
authors.forename: George R
authors.initials: GR
authors.lastname: Thompson
authors.affiliation: Pathogen and Microbiome Institute, Northern Arizona University, Flagstaff, Arizona, USA.
authors.forename: Bridget M
authors.identifier: 0000-0002-3439-4517
authors.initials: BM
authors.lastname: Barker
authors.affiliation: Fungus Testing Laboratory, Department of Pathology, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA.
authors.forename: Nathan P
authors.initials: NP
authors.lastname: Wiederhold
mesh_terms: D000666:Amphotericin B / Q000494:pharmacology*; D000935:Antifungal Agents / Q000494:pharmacology*; D000077336:Caspofungin; D003045:Coccidioides / Q000187:drug effects*; D003047:Coccidioidomycosis / Q000382:microbiology; D054714:Echinocandins / Q000494:pharmacology*; D005437:Flucytosine / Q000494:pharmacology; D017964:Itraconazole / Q000494:pharmacology; D055666:Lipopeptides / Q000494:pharmacology; D008826:Microbial Sensitivity Tests; D014230:Triazoles / Q000494:pharmacology*; D014481:United States; D065819:Voriconazole / Q000494:pharmacology
chemical_list: D000935:Antifungal Agents; D054714:Echinocandins; D055666:Lipopeptides; D014230:Triazoles; D017964:Itraconazole; C101425:posaconazole; D000666:Amphotericin B; D005437:Flucytosine; D000077336:Caspofungin; D065819:Voriconazole
keywords: Coccidioides; amphotericin B; antifungal susceptibility testing; caspofungin; coccidioidomycosis; endemic mycoses; fluconazole; flucytosine; itraconazole; posaconazole; voriconazole