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In-Vitro Antifungal Susceptibility Testing of Lanoconazole and Luliconazole Against Aspergillus Flavus As an Important Agent of Invasive Aspergillosis Publisher Pubmed



Omran SM1 ; Taghizadeharmaki M1, 2 ; Zarrinfar H3 ; Hedayati MT2, 4 ; Abastabar M2, 4 ; Moqarabzadeh V5 ; Ansari S6 ; Saber S7 ; Hoseinnejad A2 ; Miri A8 ; Verweij PE9 ; Seyedmousavi S2, 10, 11
Authors
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Authors Affiliations
  1. 1. Department of Medical Mycology and Parasitology, School of Medicine, Babol University of Medical Sciences, Babol, Iran
  2. 2. Invasive Fungi Research Center, Mazandaran University of Medical Sciences, Sari, Iran
  3. 3. Allergy Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
  4. 4. Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
  5. 5. Department of Biostatistics, Faculty of Health, Mazandaran University of Medical Sciences, Sari, Iran
  6. 6. Department of Parasitology and Mycology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  7. 7. School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
  8. 8. School of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran
  9. 9. Department of Medical Microbiology, Center of Expertise in Mycology Radboudumc/CWZ, Nijmegen, Netherlands
  10. 10. Middle East Center of Excellence for Infection Biology and Antimicrobial Pharmacology, Tehran, Iran
  11. 11. Molecular Microbiology Section, Laboratory of Clinical Infectious Diseases (LCID), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Bethesda, MD, United States

Source: Journal of Infection and Chemotherapy Published:2019


Abstract

Introduction: The incidence of Aspergillus infections has recently increased remarkably in certain tropical and sub-tropical countries, with Aspergillus flavus being identified as the leading cause of infections after A. fumigatus. Lanoconazole (LAN) and luliconazole (LUL) are currently approved for topical treatment of cutaneous fungal infections. We aimed the in-vitro antifungal susceptibility testing of two imidazole, LAN and LUL against A. flavus. Methods: One hundred and eighty-seven clinical and environmental A. flavus were tested originating from different climate zones of Iran between 2008 and 2015. The identification of all isolates was confirmed by using PCR-sequencing of β-tubuline ribosomal DNA gene. In-vitro antifungal susceptibility test was performed using CLSI guidelines against LAN, LUL, itraconazole (ITC), voriconazole (VRC), posaconazole (POS), Isavuconazole (ISA), amphotericin B (AMB), 5-flucytosine (5FC), caspofungin (CAS) and anidulafungin (AFG). The minimum inhibitory concentration (MIC) and minimum effect concentration (MEC) values were evaluated according to CLSI M38-A2 guidelines. Results: The geometric mean MICs for tested antifungals, in increasing order, were: 0.009 μg/mL for LUL (ranging from 0.004 to 0.062), 0.02 μg/mL for LAN (ranging from 0.004 to 0.125), POS (0.10), ISA (0.16), ITC (0.24), VRC (0.27), AMB (1.8) and 5FC (63.06) μg/mL. The mean value of MECs for AFG and CAS were 0.06 and 0.07, respectively. Conclusion: Overall, LUL and LAN showed the lowest MIC against all isolates of A. flavus. Further studies are required to evaluate the in-vivo efficacy of these agents, and the possibility of using these agents in systemic infections. © 2018 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases
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