In vitro activities of 8 antifungal drugs against 126 clinical and environmental Exophiala isolates. Issue 11 (23rd August 2021)

• Record Type: Journal Article
• Authors: Najafzadeh, Mohammad Javad; Dolatabadi, Somayeh; Vicente, Vania Aparecida; de Hoog, Gerrit Sybren; Meis, Jacques F.
• Is Part Of: Mycoses. Volume 64:Issue 11(2021)
• Page Start: 1328
• Page End: 1333
• Publication Date: 2021-08-23
• Subjects: antifungal susceptibility -- black yeast -- Exophiala spp. -- posaconazole; Pathogenic fungi -- Periodicals; Medical mycology -- Periodicals; 616.969
• DOI: 10.1111/myc.13364
• Languages: English
• ISSNs: 0933-7407

Abstract

Abstract: Background: Exophiala is the main genus of black fungi comprising numerous opportunistic species. Data on antifungal susceptibility of Exophiala isolates are limited, while infections are potentially fatal. Materials and methods: In vitro activities of eight antifungal drugs (AMB, five azoles, two echinocandins) against 126 clinical ( n = 76) and environmental ( n = 47) isolates from around the world were investigated. E. oligosperma ( n = 58), E. spinifera ( n = 33), E. jeanselmei ( n = 14) and E. xenobiotica ( n = 21) were included in our dataset. Results: The resulting MIC90 s of all strains were as follows, in increasing order: posaconazole 0.063 μg/ml, itraconazole 0.125 μg/ml, voriconazole and amphotericin B 1 μg/ml, isavuconazole 2 μg/ml, micafungin and caspofungin 4 μg/ml, and fluconazole 64 μg/ml. Posaconazole, itraconazole and micafungin were the drugs with the best overall activity against Exophiala species. Fluconazole could not be considered as a treatment choice. No significant difference could be found among antifungal drug activities between these four species, neither in clinical nor in environmental isolates. Conclusion: Antifungal susceptibility data for Exophiala spp. are crucial to improve the management of this occasionally fatal infection and the outcome of its treatment.