Naeimi Eshkaleti Mahsa, Kordbacheh Parivash, Hashemi Seyed Jamal, Falahati Mehraban, Zaini Farideh, Mirhendi Hossein, Safara Mahin, Hosseinpoor Leila
Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
Department of Medical Parasitology and Mycology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
Iran J Public Health. 2019 May;48(5):943-948.
Mucormycosis is an acute and invasive fungal infection with a high mortality rate. Mucorales are less sensitive than other types of fungi to most antifungal agents. Amphotericin B (AMB) is one treatment option for this infection, but in recent studies, the antifungal activity of statins against Mucorales was shown. Therefore, therapy that combines AMB with these agents may have better effects in management of patients with mucormycosis. We evaluated the in vitro activity of AMB alone and in combination with statins, against Mucorales.
Susceptibility profiles of AMB alone and in combination with two statins, atorvastatin (ATO) and lovastatin (LOV) determined against clinical (n: 15) and environmental (n: 5) isolates, obtained between Jan 2009 and Oct 2016 from patients with uncontrolled diabetes mellitus and cancer referred to the Department of Parasitology and Medical Mycology of Tehran University of Medical Sciences, Tehran, Iran. It was performed by microdilution method, based on the Clinical and Laboratory Standard Institute (CLSI) M38-A2 guideline.
All clinical and environmental isolates were susceptible to AMB (MIC≤1 μg/mL). The results of the interactions between AMB and the two statins were positive. The AMB-ATO (GM: 0.13 μg/Ml) combination produced greater activity than the AMB-LOV (GM: 0.26 μg/mL) combination. AMB, in combination with ATO and LOV, reacts positively against clinical and environmental isolates.
This combination strategy may lead to more effective treatment of mucormycosis and fewer side effects using low dose of AMB.
毛霉病是一种急性侵袭性真菌感染，死亡率很高。毛霉目真菌对大多数抗真菌药物的敏感性低于其他类型的真菌。两性霉素B（AMB）是治疗这种感染的一种选择，但最近的研究表明他汀类药物对毛霉目真菌具有抗真菌活性。因此，将AMB与这些药物联合使用的疗法可能对毛霉病患者的治疗有更好的效果。我们评估了AMB单独及与他汀类药物联合对毛霉目的体外活性。
测定AMB单独及与两种他汀类药物阿托伐他汀（ATO）和洛伐他汀（LOV）联合对2009年1月至2016年10月期间从伊朗德黑兰医科大学寄生虫学和医学真菌学系转诊的未控制糖尿病和癌症患者中分离出的临床（n = 15）和环境（n = 5）分离株的敏感性。根据临床和实验室标准协会（CLSI）M38 - A2指南，采用微量稀释法进行。
所有临床和环境分离株对AMB敏感（MIC≤1μg/mL）。AMB与两种他汀类药物之间的相互作用结果为阳性。AMB - ATO组合（GM：0.13μg/Ml）比AMB - LOV组合（GM：0.26μg/mL）产生更强的活性。AMB与ATO和LOV联合对临床和环境分离株有阳性反应。
这种联合策略可能导致使用低剂量AMB更有效地治疗毛霉病且副作用更少。
