探索醇抗真菌药物和针对Candida auris的他类药物之间的协同作用
Catriona Halliday1, Hannah Yejin Kim2,3,4, Enoch Tay5
1Centre for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, New South Wales Health Pathology, Westmead Hospital, Westmead, NSW, Australia.
The Journal of antimicrobial chemotherapy
|October 12, 2023
概括
类药物与醇抗真菌药物相结合,对Candida auris产生协同作用,为这种耐药真菌感染提供了新的治疗策略. 进一步的体内和临床研究是有必要的.
科学领域:
- 菌类学 菌类学是指菌类学.
- 传染性疾病 传染性疾病
- 药理学 药理学是指药理学的学科.
背景情况:
- 侵入性Candida auris感染由于广泛的抗真菌耐药性和高死亡率,构成了全球重大健康挑战.
- 迫切需要新的治疗策略,包括药物重用和组合疗法,以对抗这些感染.
- 类药物已证明对各种Candida物种具有潜在的抗真菌活性,这表明它们在组合治疗中的有用性.
研究的目的:
- 调查他类药物 (罗斯瓦斯塔丁和弗卢瓦斯塔丁) 和阿类抗真菌药物 (沃里康纳,波萨康纳和伊萨武康纳) 之间的潜在协同作用,以对抗Candida auris.的临床分离物.
- 通过象棋盘测定和分数抑制度指数 (FICI) 计算来评估这些药物的组合.
主要方法:
- 这项研究使用了21种Candida auris的临床分离物.
- 协同效应的评估是根据临床和实验室标准研究所 (CLSI) 的微稀释方法使用象棋板测试.
- 分数抑制度指数 (FICI) 计算用于确定药物组合的协同作用,添加作用或对抗作用.
主要成果:
- 作为单一药物 (≥128 mg/L),他类药物 (fluvastatin 和 rosuvastatin) 呈现出高的最小抑制度 (MIC).
- 弗卢瓦斯塔丁与阿佐尔的组合在70%-90%的C. auris分离物中显示出协同作用,阿佐尔MIC显著降低 (例如,沃里康纳的16倍,波萨康纳的8倍).
- 罗斯瓦斯塔丁组合在40%-60%的分离物中表现出协同作用,在40%-50%的分离物中表现出添加作用,没有观察到对抗性相互作用.
结论:
- 这些发现提供了一个强有力的理由来探索他-阿醇组合作为一种潜在的治疗方法对抗黄菌.
- 建议进行进一步的体内研究,以在临床环境中验证这些协同效应.
- 临床试验是必要的,以评估这些组合疗法的耐受性,疗效和最佳剂量.
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