Antifungal Activity of Isavuconazole and Comparator Agents against Contemporaneous Mucorales Isolates from USA, Europe, and Asia-Pacific
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...
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MDPI AG
2023-02-01
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| Series: | Journal of Fungi |
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| Online Access: | https://www.mdpi.com/2309-608X/9/2/241 |
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| author | Cecilia G. Carvalhaes Paul R. Rhomberg Michael D. Huband Michael A. Pfaller Mariana Castanheira |
| author_facet | Cecilia G. Carvalhaes Paul R. Rhomberg Michael D. Huband Michael A. Pfaller Mariana Castanheira |
| author_sort | Cecilia G. Carvalhaes |
| collection | DOAJ |
| description | 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<sub>50/90</sub>, 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<sub>50/90</sub>, 0.5/1 mg/L) displayed the highest activity, followed by posaconazole (MIC<sub>50/90</sub>, 0.5/8 mg/L). Voriconazole (MIC<sub>50/90</sub>, >8/>8 mg/L) and the echinocandins (MIC<sub>50/90</sub>, >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 <i>Rhizopus</i> spp. (<i>n</i> = 27; MIC<sub>50/90</sub>, 1/>8 mg/L), <i>Lichtheimia</i> spp. (<i>n</i> = 11; MIC<sub>50/90</sub>, 4/8 mg/L), and <i>Mucor</i> spp. (<i>n</i> = 8; MIC<sub>50</sub>, >8 mg/L) isolates, respectively. Posaconazole MIC<sub>50/90</sub> values against <i>Rhizopus</i>, <i>Lichtheimia</i>, and <i>Mucor</i> species were 0.5/8 mg/L, 0.5/1 mg/L, and 2/- mg/L, respectively; amphotericin B MIC<sub>50/90</sub> 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. |
| first_indexed | 2024-03-11T08:35:16Z |
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| institution | Directory Open Access Journal |
| issn | 2309-608X |
| language | English |
| last_indexed | 2024-03-11T08:35:16Z |
| publishDate | 2023-02-01 |
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| spelling | doaj.art-0ce1fa506faf4f1692048a83fe0045692023-11-16T21:31:02ZengMDPI AGJournal of Fungi2309-608X2023-02-019224110.3390/jof9020241Antifungal Activity of Isavuconazole and Comparator Agents against Contemporaneous Mucorales Isolates from USA, Europe, and Asia-PacificCecilia G. Carvalhaes0Paul R. Rhomberg1Michael D. Huband2Michael A. Pfaller3Mariana Castanheira4JMI Laboratories, 345 Beaver Kreek Centre, North Liberty, IA 52317, USAJMI Laboratories, 345 Beaver Kreek Centre, North Liberty, IA 52317, USAJMI Laboratories, 345 Beaver Kreek Centre, North Liberty, IA 52317, USAJMI Laboratories, 345 Beaver Kreek Centre, North Liberty, IA 52317, USAJMI Laboratories, 345 Beaver Kreek Centre, North Liberty, IA 52317, USAIsavuconazole 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<sub>50/90</sub>, 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<sub>50/90</sub>, 0.5/1 mg/L) displayed the highest activity, followed by posaconazole (MIC<sub>50/90</sub>, 0.5/8 mg/L). Voriconazole (MIC<sub>50/90</sub>, >8/>8 mg/L) and the echinocandins (MIC<sub>50/90</sub>, >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 <i>Rhizopus</i> spp. (<i>n</i> = 27; MIC<sub>50/90</sub>, 1/>8 mg/L), <i>Lichtheimia</i> spp. (<i>n</i> = 11; MIC<sub>50/90</sub>, 4/8 mg/L), and <i>Mucor</i> spp. (<i>n</i> = 8; MIC<sub>50</sub>, >8 mg/L) isolates, respectively. Posaconazole MIC<sub>50/90</sub> values against <i>Rhizopus</i>, <i>Lichtheimia</i>, and <i>Mucor</i> species were 0.5/8 mg/L, 0.5/1 mg/L, and 2/- mg/L, respectively; amphotericin B MIC<sub>50/90</sub> 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.https://www.mdpi.com/2309-608X/9/2/241<i>Rhizopus</i><i>Rhizomucor</i><i>Lichtheimia</i>azolesantifungal activitymucormycosis |
| spellingShingle | Cecilia G. Carvalhaes Paul R. Rhomberg Michael D. Huband Michael A. Pfaller Mariana Castanheira Antifungal Activity of Isavuconazole and Comparator Agents against Contemporaneous Mucorales Isolates from USA, Europe, and Asia-Pacific Journal of Fungi <i>Rhizopus</i> <i>Rhizomucor</i> <i>Lichtheimia</i> azoles antifungal activity mucormycosis |
| title | Antifungal Activity of Isavuconazole and Comparator Agents against Contemporaneous Mucorales Isolates from USA, Europe, and Asia-Pacific |
| title_full | Antifungal Activity of Isavuconazole and Comparator Agents against Contemporaneous Mucorales Isolates from USA, Europe, and Asia-Pacific |
| title_fullStr | Antifungal Activity of Isavuconazole and Comparator Agents against Contemporaneous Mucorales Isolates from USA, Europe, and Asia-Pacific |
| title_full_unstemmed | Antifungal Activity of Isavuconazole and Comparator Agents against Contemporaneous Mucorales Isolates from USA, Europe, and Asia-Pacific |
| title_short | Antifungal Activity of Isavuconazole and Comparator Agents against Contemporaneous Mucorales Isolates from USA, Europe, and Asia-Pacific |
| title_sort | antifungal activity of isavuconazole and comparator agents against contemporaneous mucorales isolates from usa europe and asia pacific |
| topic | <i>Rhizopus</i> <i>Rhizomucor</i> <i>Lichtheimia</i> azoles antifungal activity mucormycosis |
| url | https://www.mdpi.com/2309-608X/9/2/241 |
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