Antifungal susceptibilities of non-Aspergillus filamentous fungi causing invasive infection in Australia: support for current antifungal guideline recommendations

C.L. Halliday, S.C.A. Chen, S.E. Kidd, S. Van Hal, B. Chapman, Christopher Heath, A. Lee, K.J. Kennedy, K. Daveson, T.C. Sorrell, C.O. Morrissey, D.J. Marriott, M.A. Slavin

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    18 Citations (Scopus)

    Abstract

    © 2016 Elsevier B.V. and International Society of ChemotherapyAntifungal susceptibilities of non-Aspergillus filamentous fungal pathogens cannot always be inferred from their identification. Here we determined, using the Sensititre® YeastOne® YO10 panel, the in vitro activities of nine antifungal agents against 52 clinical isolates of emergent non-Aspergillus moulds representing 17 fungal groups in Australia. Isolates comprised Mucorales (n?=?14), Scedosporium/Lomentospora spp. (n?=?18) and a range of hyaline hyphomycetes (n?=?9) and other dematiaceous fungi (n?=?11). Excluding Verruconis gallopava, echinocandins demonstrated poor activity (MICs generally >8?mg/L) against these moulds. Lomentospora prolificans (n?=?4) and Fusarium spp. (n?=?6) demonstrated raised MICs to all antifungal drugs tested, with the lowest being to voriconazole and amphotericin B (AmB), respectively (geometric mean MICs of 3.4?mg/L and 2.2?mg/L, respectively). All Scedosporium apiospermum complex isolates (n?=?14) were inhibited by voriconazole concentrations of =0.25?mg/L, followed by posaconazole and itraconazole at =1?mg/L. Posaconazole and AmB were the most active agents against the Mucorales, with MIC90 values of 1?mg/L and 2?mg/L, respectively, for Rhizopus spp. For dematiaceous fungi, all isolates were inhibited by itraconazole and posaconazole concentrations of =0.5?mg/L (MIC90, 0.12?mg/L and 0.25?mg/L, respectively), but voriconazole and AmB also had in vitro activity (MIC90, 0.5?mg/L and 1?mg/L, respectively). Differences in antifungal susceptibility within species and between species within genera support the need for testing individual patient isolates to guide therapy. The Sensititre® YeastOne® offers a practical alternative to the reference methodology for susceptibility testing of moulds.
    Original languageEnglish
    Pages (from-to)453-458
    JournalInternational Journal of Antimicrobial Agents
    Volume48
    Issue number4
    DOIs
    Publication statusPublished - 2016

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