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Published on: February 14, 2018
[Antifungal susceptibility of Acremonium species using E-test and Sensititre]
A Saldarreaga1, P Garcia Martos, J Ruiz Aragón
1Servicio de Microbiologia, Hospital Universitario Puerta del Mar, Cadiz, Spain. abesalda@hotmail.com
Abstract:
Filamentous fungi have become a common cause of severe infections, especially in immunocompromised patients. In recent years, the number and diversity of the infections caused by Acremonium species have increased and numerous species have been implicated. As is the case for most emerging pathogens, the optimal therapeutic approach to Acremonium species remains to be determined. We used two methods to determine the in vitro susceptibility to amphotericin B, itraconazole and fluconazole for 15 clinical isolates of eight different species of Acremonium. The MICs were determined according to protocol M38-A of the National Committee for Clinical Laboratory Standards (NCCLS) document, using the Sensititre and E-test microdilution methods. Amphotericin B was effective in vitro for few species using the Sensititre method. However, high MICs were obtained with E-test. Fluconazole and itraconazole were ineffective according to both methods. Acremonium species are generally resistant to the most commonly used antifungal agents. Consequently, Acremonium susceptibility testing is recommended to assist in choosing adequate treatment of infections caused by this filamentous fungus.
Insights
Acremonium fungal infections are rising in immunocompromised patients. Antifungal drug susceptibility testing is crucial, as Acremonium species show resistance to common treatments like fluconazole and itraconazole.
Area of Science:
- Medical Mycology
- Infectious Diseases
- Antimicrobial Resistance
Background:
- Filamentous fungi, particularly Acremonium species, are increasingly recognized as significant pathogens.
- Immunocompromised individuals are at higher risk for severe infections caused by these emerging fungal pathogens.
- Optimal therapeutic strategies for Acremonium infections are not well-established.
Purpose of the Study:
- To evaluate the in vitro antifungal susceptibility of clinical isolates of Acremonium species.
- To compare the efficacy of amphotericin B, itraconazole, and fluconazole against Acremonium.
- To guide the selection of appropriate antifungal treatments for Acremonium infections.
Main Methods:
- In vitro susceptibility testing of 15 clinical Acremonium isolates from eight species.
- Utilized Sensititre and E-test microdilution methods according to NCCLS M38-A protocol.
- Determined Minimum Inhibitory Concentrations (MICs) for amphotericin B, itraconazole, and fluconazole.
Main Results:
- Amphotericin B demonstrated in vitro efficacy for a limited number of Acremonium species with the Sensititre method.
- Higher MICs for amphotericin B were observed using the E-test method.
- Fluconazole and itraconazole exhibited ineffectiveness against all tested Acremonium isolates by both methods.
Conclusions:
- Acremonium species generally display resistance to commonly used antifungal agents.
- Antifungal susceptibility testing is recommended for Acremonium infections to guide effective treatment selection.
- This study highlights the need for careful consideration of antifungal choices in managing Acremonium infections.
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