In Vitro Susceptibilities of 217 Clinical Isolates of Zygomycetes to Conventional and New Antifungal Agents

Abstract

We evaluated the in vitro susceptibilities of 217 zygomycetes to amphotericin B, ketoconazole, fluconazole, itraconazole, voriconazole, posaconazole, caspofungin, and flucytosine. The significant in vitro activity of posaconazole against several species appears to support its reported clinical efficacy. Decreased susceptibility to amphotericin B was noted with Cunninghamella bertholletiae.

Combined antifungal approach for the treatment of invasive mucormycosis in patients with hematologic diseases: a report from the SEIFEM and FUNGISCOPE registries

“…Livio Pagano, 1 Oliver A. Cornely, 2,3 Alessandro Busca, 4 Morena Caira, 1 Simone Cesaro, 5 Cristiana Gasbarrino, 6 Corrado Girmenia, 7 Werner J. Heinz, 8 Raoul Herbrecht, 9 Cornelia Lass-Flörl, 10 Annamaria Nosari, 11 Leonardo Potenza, 12 Zdenek Racil, 13 1-2011-2012).…”

“…[1][2][3] Among the available antifungals, amphotericin B (AmB) formulations and posaconazole demonstrate the most promising in vitro activities against Mucorales, 4,5 and their combination displays synergistic in vitro activity. 6,7 However, pre-clinical studies in neutropenic and diabetic ketoacidotic mice with IM reported no improvement in survival under a combination of posaconazole and liposomal amphotericin B (LAmB), compared to L-AmB monotherapy.…”

Identification of fungal pathogens in a patient with acute myelogenic leukemia using a pathogen detection array technology

“…Studies have shown in vitro susceptibility to anti-fungal agents to vary within the zygomycetes family and thus, identification of the species provides clues for optimization of treatment. 4 Thus, molecular assays were developed to identify specific species of zygomycetes. These include sequencing of internal transcribed spacer (ITS) region, [5][6][7][8] 28S rRNA 9 and non-sequencing based tests like polymerase chain reaction (PCR) with restriction fragment length polymorphism (RFLP), 10,11 real-time PCR using melting curve analysis, 12 multiplex PCR using specific DNA probes in a microarray based assay, 13 and PCR assay using the Luminex xMAP hybridization method.…”

Molecular Methods To Improve Diagnosis and Identification of Mucormycosis

“…In comparison to Aspergillus species, which are typically susceptible to voriconazole, amphotericin B, and echinocandins, Mucorales are usually susceptible only to amphotericin B and less frequently to posaconazole (1). Furthermore, there is significant variability in susceptibility by genus; in a study of 217 clinical isolates of Mucorales, 100% of Lichtheimia spp.…”