Carvalhaes Cecilia G, Rhomberg Paul R, Huband Michael D, Pfaller Michael A, Castanheira Mariana
JMI Laboratories, 345 Beaver Kreek Centre, North Liberty, IA 52317, USA.
J Fungi (Basel). 2023 Feb 11;9(2):241. doi: 10.3390/jof9020241.
Isavuconazole is the only US FDA-approved antifungal for treating invasive mucormycosis. We evaluated isavuconazole activity against a global collection of Mucorales isolates. Fifty-two isolates were collected during 2017-2020 from hospitals located in the USA, Europe, and the Asia-Pacific. Isolates were identified by MALDI-TOF MS and/or DNA sequencing and susceptibility tested by the broth microdilution method following CLSI guidelines. Isavuconazole (MIC, 2/>8 mg/L) inhibited 59.6% and 71.2% of all Mucorales isolates at ≤2 mg/L and ≤4 mg/L, respectively. Among comparators, amphotericin B (MIC, 0.5/1 mg/L) displayed the highest activity, followed by posaconazole (MIC, 0.5/8 mg/L). Voriconazole (MIC, >8/>8 mg/L) and the echinocandins (MIC, >4/>4 mg/L) had limited activity against Mucorales isolates. Isavuconazole activity varied by species and this agent inhibited at ≤4 mg/L 85.2%, 72.7%, and 25% of spp. ( = 27; MIC, 1/>8 mg/L), spp. ( = 11; MIC, 4/8 mg/L), and spp. ( = 8; MIC, >8 mg/L) isolates, respectively. Posaconazole MIC values against , , and species were 0.5/8 mg/L, 0.5/1 mg/L, and 2/- mg/L, respectively; amphotericin B MIC values were 1/1 mg/L, 0.5/1 mg/L, and 0.5/- mg/L, respectively. As susceptibility profiles varied among Mucorales genera, species identification and antifungal susceptibility testing are advised whenever possible to manage and monitor mucormycosis.
艾沙康唑是美国食品药品监督管理局（FDA）批准的唯一用于治疗侵袭性毛霉病的抗真菌药物。我们评估了艾沙康唑对全球收集的毛霉目分离株的活性。2017年至2020年期间，从美国、欧洲和亚太地区的医院收集了52株分离株。通过基质辅助激光解吸电离飞行时间质谱（MALDI-TOF MS）和/或DNA测序鉴定分离株，并按照美国临床和实验室标准协会（CLSI）指南采用肉汤微量稀释法进行药敏试验。艾沙康唑（MIC，2/>8 mg/L）在≤2 mg/L和≤4 mg/L时分别抑制了59.6%和71.2%的所有毛霉目分离株。在比较的药物中，两性霉素B（MIC，0.5/1 mg/L）活性最高，其次是泊沙康唑（MIC，0.5/8 mg/L）。伏立康唑（MIC，>8/>8 mg/L）和棘白菌素类药物（MIC，>4/>4 mg/L）对毛霉目分离株的活性有限。艾沙康唑的活性因菌种而异，该药物在≤4 mg/L时分别抑制了85.2%、72.7%和25%的根霉属（n = 27；MIC，1/>8 mg/L）、毛霉属（n = 11；MIC，4/8 mg/L）和犁头霉属（n = 8；MIC，>8 mg/L）分离株。泊沙康唑对根霉属、毛霉属和犁头霉属菌种的MIC值分别为0.5/8 mg/L、0.5/1 mg/L和2/- mg/L；两性霉素B的MIC值分别为1/1 mg/L、0.5/1 mg/L和0.5/- mg/L。由于毛霉目各属之间的药敏谱不同，建议尽可能进行菌种鉴定和抗真菌药敏试验，以管理和监测毛霉病。
