info:eu-repo/semantics/article
Antifungal susceptibility and phylogeny of opportunistic members of the order Mucorales
Registro en:
Vitale, Roxana Gabriela; De Hoog, G. Sybren; Schwarz, Patrick; Dannaoui, Eric; Deng, Shuwen; et al.; Antifungal susceptibility and phylogeny of opportunistic members of the order Mucorales; American Society for Microbiology; Journal of Clinical Microbiology; 50; 1; 1-2012; 66-75
0095-1137
CONICET Digital
CONICET
Autor
Vitale, Roxana Gabriela
De Hoog, G. Sybren
Schwarz, Patrick
Dannaoui, Eric
Deng, Shuwen
Machouart, Marie
Voigt, Kerstin
Van De Sande, Wendy W. J.
Dolatabadi, Somayeh
Meis, Jacques F.
Walther, Grit
Resumen
The in vitro susceptibilities of 66 molecularly identified strains of the Mucorales to eight antifungals (amphotericin B, terbinafine, itraconazole, posaconazole, voriconazole, caspofungin, micafungin, and 5-fluorocytosine) were tested. Molecular phylogeny was reconstructed based on the nuclear ribosomal large subunit to reveal taxon-specific susceptibility profiles. The impressive phylogenetic diversity of the Mucorales was reflected in susceptibilities differing at family, genus, and species levels. Amphotericin B was the most active drug, though somewhat less against Rhizopus and Cunninghamella species. Posaconazole was the second most effective antifungal agent but showed reduced activity in Mucor and Cunninghamella strains, while voriconazole lacked in vitro activity for most strains. Genera attributed to the Mucoraceae exhibited a wide range of MICs for posaconazole, itraconazole, and terbinafine and included resistant strains. Cunninghamella also comprised strains resistant to all azoles tested but was fully susceptible to terbinafine. In contrast, the Lichtheimiaceae completely lacked strains with reduced susceptibility for these antifungals. Syncephalastrum species exhibited susceptibility profiles similar to those of the Lichtheimiaceae. Mucor species were more resistant to azoles than Rhizopus species. Species-specific responses were obtained for terbinafine where only Rhizopus arrhizus and Mucor circinelloides were resistant. Complete or vast resistance was observed for 5-fluorocytosine, caspofungin, and micafungin. Intraspecific variability of in vitro susceptibility was found in all genera tested but was especially high in Mucor and Rhizopus for azoles and terbinafine. Accurate molecular identification of etiologic agents is compulsory to predict therapy outcome. For species of critical genera such as Mucor and Rhizopus, exhibiting high intraspecific variation, susceptibility testing before the onset of therapy is recommended. Fil: Vitale, Roxana Gabriela. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Gobierno de la Ciudad de Buenos Aires. Hospital General de Agudos "Ramos Mejía"; Argentina. Westerdijk Fungal Biodiversity Institute; Países Bajos Fil: De Hoog, G. Sybren. Westerdijk Fungal Biodiversity Institute; Países Bajos. University of Amsterdam; Países Bajos. Peking University Health Science Center; China Fil: Schwarz, Patrick. Instituto Pasteur; Francia Fil: Dannaoui, Eric. Instituto Pasteur; Francia Fil: Deng, Shuwen. Westerdijk Fungal Biodiversity Institute; Países Bajos Fil: Machouart, Marie. CHRU de Nancy - Hôpitaux de Brabois; Francia Fil: Voigt, Kerstin. Institute for Natural Product Research and Infection Biology; Alemania. Hans-Knöll-Institute; Alemania. Universitat Jena; Alemania Fil: Van De Sande, Wendy W. J.. Erasmus Medical Centre; Países Bajos Fil: Dolatabadi, Somayeh. Westerdijk Fungal Biodiversity Institute; Países Bajos. University of Amsterdam; Países Bajos Fil: Meis, Jacques F.. Canisius Wilhelmina Hospital; Países Bajos Fil: Walther, Grit. Westerdijk Fungal Biodiversity Institute; Países Bajos. Universitat Jena; Alemania