Comparative in vitro activities of seven antifungal drugs against clinical isolates of Candida parapsilosis complex

Khodavaisy, S. and Badali, H. and Meis, J.F. and Modiri, M. and Mahmoudi, S. and Abtahi, H. and Salehi, M. and Dehghan Manshadi, S.A. and Aala, F. and Agha Kuchak Afshari, S. and Lotfali, E. and Ahangarkani, F. and Rezaie, S. (2020) Comparative in vitro activities of seven antifungal drugs against clinical isolates of Candida parapsilosis complex. Journal de Mycologie Medicale, 30 (3).

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Objective: Candida parapsilosis species complex, an important set of non-albicans Candida species, is known to cause candidaemia particularly in neonates and infants. However, the incidence has increased in recent years, owing to higher numbers of at individuals at risk for these infections. Our objective was to evaluate the in vitro susceptibility of clinical isolates of C. parapsilosis complex isolates from Iran to seven antifungal drugs. Material and methods: One hundred-one clinical isolates of C. parapsilosis species complex cultured from humans were included. Species identification had been previously confirmed by combined phenotypic characteristics, matrix-assisted laser desorption ionization-time of flight mass spectrometry-based assay and reconfirmed by DNA sequence analysis of the ITS rDNA region and D1/D2 gene. Minimum inhibitory concentrations (MICs) for amphotericin B, fluconazole, itraconazole, voriconazole, posaconazole, micafungin and anidulafungin were determined against well-characterized isolates by broth microdilution susceptibility testing according to the CLSI M27-A3 guideline. Results: Species identifications were performed on 101 isolates, of which 88 (87.2) C. parapsilosis sensu stricto and 13 (12.8) C. orthopsilosis. Amphotericin B and posaconazole were the most active drugs with 100 of isolates being wild-type (WT). Voriconazole and micafungin, 99 of isolates were WT. The low activity was recorded for fluconazole and itraconazole with 93.1 and 89.1 of isolates being WT, respectively. At the species level, all Candida parapsilosis sensu stricto isolates were WT to amphotericin B and posaconazole and all Candida orthopsilosis isolates were WT to amphotericin B, voriconazole, posaconazole, anidulafungin and micafungin. In contrast, the highest rate of non-WT was observed in C. orthopsilosis to itraconazole (4 of 13, 30.8). Conclusions: Although almost all of the tested drugs demonstrated potent activity against C. parapsilosis species complex, it seems that more especially C. orthopsilosis isolates had decreased susceptibility to itraconazole. Further studies are needed to determine how these findings may switch into in vivo efficacy. © 2020 Elsevier Masson SAS

Item Type: Article
Additional Information: cited By 1
Uncontrolled Keywords: amphotericin B; anidulafungin; fluconazole; itraconazole; micafungin; posaconazole; voriconazole; antifungal agent, adolescent; adult; antifungal resistance; antifungal susceptibility; Article; broth dilution; Candida parapsilosis; controlled study; female; fungal strain; fungus culture; fungus growth; fungus isolation; human; in vitro study; male; matrix assisted laser desorption ionization time of flight mass spectrometry; minimum inhibitory concentration; nonhuman; phenotype; practice guideline; species identification; young adult; aged; Candida parapsilosis; candidiasis; child; comparative study; drug effect; growth, development and aging; infant; Iran; isolation and purification; matrix-assisted laser desorption-ionization mass spectrometry; microbial sensitivity test; microbiology; middle aged; newborn; preschool child; very elderly, Adolescent; Adult; Aged; Aged, 80 and over; Antifungal Agents; Candida parapsilosis; Candidiasis; Child; Child, Preschool; Drug Resistance, Fungal; Female; Humans; Infant; Infant, Newborn; Iran; Male; Microbial Sensitivity Tests; Middle Aged; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization; Young Adult
Subjects: WC Communicable Diseases
QV Pharmacology
Depositing User: eprints admin
Date Deposited: 29 May 2021 08:06
Last Modified: 29 May 2021 08:06

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