Department of Medical Mycology, Institute of Dermatology, Chinese Academy of Medical Science and Peking Union Medical College, Nanjing, China.
Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Nanjing, China.
Mycoses. 2021 Jun;64(6):651-655. doi: 10.1111/myc.13260. Epub 2021 Mar 5.
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.
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.
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.
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).
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.
拉夫康唑是一种具有广谱抗真菌活性的三唑类药物，对念珠菌属具有高效的体外抗菌作用，并于 2018 年在日本被批准用于治疗甲真菌病的口服制剂。然而，目前还没有人确定拉夫康唑对耳念珠菌（一种已知的具有多重耐药性的酵母）的 MIC 值。同时，关于拉夫康唑对中国阴道念珠菌分离株的体外活性也知之甚少。
研究拉夫康唑对耳念珠菌和中国阴道念珠菌分离株的活性，并评估拉夫康唑治疗耳念珠菌和其他念珠菌引起的念珠菌病的可行性。
我们采用临床和实验室标准协会（CLSI）的方法，测定了 15 株耳念珠菌分离株对拉夫康唑和 9 种对照药物的体外活性，并测定了 525 株阴道念珠菌分离株（白色念珠菌、热带念珠菌、光滑念珠菌和近平滑念珠菌）对拉夫康唑的 MIC 值。
氟康唑和两性霉素 B 对耳念珠菌的 MIC 值明显高于第二代唑类和棘白菌素类药物。拉夫康唑对所有耳念珠菌分离株均具有活性，与伊曲康唑、伏立康唑和棘白菌素类药物相当，对耳念珠菌的抗真菌活性优于酮康唑、泊沙康唑。对于阴道念珠菌分离株，拉夫康唑耐药株的比例为 0.19%（1/525）。
拉夫康唑对耳念珠菌和阴道念珠菌分离株具有良好的活性，提示拉夫康唑可用于治疗耐药性念珠菌病。
