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In Vitro activity of ravuconazole against Candida auris and vaginal candida isolates
Jiacheng Dong1, Guanzhao Liang1,2, Hailin Zheng1,2
1Department of Medical Mycology, Institute of Dermatology, Chinese Academy of Medical Science and Peking Union Medical College, Nanjing, China.
Background:
Ravuconazole is an extended-spectrum triazole agent that is efficient in vitro against Candida spp. and has been approved to work as an oral formulae for onychomycosis in Japan in 2018. However, nobody had determined the MIC of ravuconazole against the Candida auris, which is known as an emerging multidrug-resistant yeast. Meanwhile, rare is known of the in vitro activity of ravuconazole against vaginal Candida isolates.
Objectives:
To investigate the activity of ravuconazole against C. auris and vaginal Candida isolates of China and assess the feasibility of ravuconazole in the treatment of candidiasis caused by C. auris and other Candida spp.
Methods:
We determined the in vitro activity of ravuconazole and 9 comparators against 15 C. auris isolates and determined the MIC of ravuconazole on 525 vaginal Candida isolates (Candida albicans, Candida tropicalis, Candida glabrata and Candida parapsilosis) from 9 provinces of China by Clinical and Laboratory Standards Institute (CLSI) methodology.
Results:
The MICs of fluconazole and amphotericin B on C. auris were much higher than second-generation azoles and echinocandins. Ravuconazole was active against all the C. auris isolates and as effective as isavuconazole, posaconazole and echinocandins while showed a better antifungal activity than itraconazole, voriconazole to C. auris. For vaginal Candida isolates, the proportion of ravuconazole-resistant isolates is 0.19% (1/525).
Conclusions:
Ravuconazole was in good active against C. auris and vaginal Candida isolates, which suggested ravuconazole could be used in the treatment of drug-resistant candidiasis.
Insights
Ravuconazole demonstrates potent in vitro activity against the multidrug-resistant yeast Candida auris and common vaginal Candida isolates. This suggests its potential for treating resistant candidiasis.
Area of Science:
- Mycology
- Infectious Diseases
- Antimicrobial Resistance
Background:
- Ravuconazole is an oral triazole antifungal approved for onychomycosis in Japan.
- Candida auris is an emerging multidrug-resistant yeast with limited treatment options.
- The in vitro activity of ravuconazole against Candida auris and vaginal Candida isolates is largely unknown.
Purpose of the Study:
- To evaluate the in vitro activity of ravuconazole against Candida auris.
- To assess ravuconazole's efficacy against vaginal Candida isolates in China.
- To determine the feasibility of using ravuconazole for candidiasis treatment.
Main Methods:
- Determined the minimum inhibitory concentration (MIC) of ravuconazole against 15 Candida auris isolates.
- Assessed ravuconazole's activity against 525 vaginal Candida isolates (C. albicans, C. tropicalis, C. glabrata, C. parapsilosis) using CLSI methodology.
- Compared ravuconazole's activity with 9 other antifungal agents.
Main Results:
- Ravuconazole exhibited potent activity against all tested Candida auris isolates, comparable to isavuconazole, posaconazole, and echinocandins.
- Ravuconazole demonstrated superior activity against Candida auris compared to itraconazole and voriconazole.
- A low resistance rate (0.19%) to ravuconazole was observed in vaginal Candida isolates.
Conclusions:
- Ravuconazole shows significant in vitro activity against both Candida auris and common vaginal Candida species.
- Ravuconazole is a promising therapeutic option for treating drug-resistant candidiasis caused by Candida auris and other Candida species.
