In vitro polymyxin activity against clinical multidrug-resistant fungi

Abstract Background Although antifungals are available and usually used against fungal infections, multidrug-resistant (MDR) fungal pathogens are a growing problem for public health. Moreover, fungal infections have become more prevalent nowadays due to the increasing number of people living with im...

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Main Authors: Hanane Yousfi, Stéphane Ranque, Jean-Marc Rolain, Fadi Bittar
Format: Article
Language:English
Published: BMC 2019-04-01
Series:Antimicrobial Resistance and Infection Control
Subjects:
Online Access:http://link.springer.com/article/10.1186/s13756-019-0521-7
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author Hanane Yousfi
Stéphane Ranque
Jean-Marc Rolain
Fadi Bittar
author_facet Hanane Yousfi
Stéphane Ranque
Jean-Marc Rolain
Fadi Bittar
author_sort Hanane Yousfi
collection DOAJ
description Abstract Background Although antifungals are available and usually used against fungal infections, multidrug-resistant (MDR) fungal pathogens are a growing problem for public health. Moreover, fungal infections have become more prevalent nowadays due to the increasing number of people living with immunodeficiency. Thus, previously rarely-isolated and/or unidentified fungal species including MDR yeast and moulds have emerged around the world. Recent works indicate that polymyxin antibiotics (polymyxin B and colistin) have potential antifungal proprieties. Therefore, investigating the in vitro activity of these molecules against clinical multidrug-resistant yeast and moulds could be very useful. Methods In this study, a total of 11 MDR yeast and filamentous fungal strains commonly reported in clinical settings were tested against polymyxin antibiotics. These include strains belonging to the Candida, Cryptococcus and Rhodotorula yeast genera, along with others belonging to the Aspergillus, Fusarium, Scedosporium, Lichtheimia and Rhizopus mould genera. The fungicidal or fungistatic action of colistin against clinical yeast strains was determined by the time-kill study. Further, a checkerboard assay for its combination with antifungal agents, usually used in clinical practices (amphotericin B, itraconazole, voriconazole), was carried out against multi-drug resistant fungal strains. Results Polymyxin B and colistin exhibited an antifungal activity against all MDR fungal strains tested with MICs ranging from 16 to 128 μg/ml, except for the Aspergillus species. In addition, colistin has a fungicidal action against yeast species, with minimum fungicidal concentrations ranging from 2 to 4 times MICs. It induces damage to the MDR Candida albicans membrane. A synergistic activity of colistin-amphotericin B and colistin-itraconazole associations against Candida albicans and Lichtheimia corymbifera strains, respectively, and colistin-fluconazole association against Rhodotorula mucilaginosa, was demonstrated using a checkerboard microdilution assay. Conclusion colistin could be proposed, in clinical practice, in association with other antifungals, to treat life-threatening fungal infections caused by MDR yeasts or moulds.
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spelling doaj.art-149687f187354b2f911bcbd2563296762022-12-22T00:13:14ZengBMCAntimicrobial Resistance and Infection Control2047-29942019-04-018111010.1186/s13756-019-0521-7In vitro polymyxin activity against clinical multidrug-resistant fungiHanane Yousfi0Stéphane Ranque1Jean-Marc Rolain2Fadi Bittar3Aix Marseille Univ, IRD, APHM, MEPHI, IHU Méditerranée InfectionAix Marseille Univ, IRD, APHM, SSA, VITROME, IHU-Méditerranée InfectionAix Marseille Univ, IRD, APHM, MEPHI, IHU Méditerranée InfectionAix Marseille Univ, IRD, APHM, MEPHI, IHU Méditerranée InfectionAbstract Background Although antifungals are available and usually used against fungal infections, multidrug-resistant (MDR) fungal pathogens are a growing problem for public health. Moreover, fungal infections have become more prevalent nowadays due to the increasing number of people living with immunodeficiency. Thus, previously rarely-isolated and/or unidentified fungal species including MDR yeast and moulds have emerged around the world. Recent works indicate that polymyxin antibiotics (polymyxin B and colistin) have potential antifungal proprieties. Therefore, investigating the in vitro activity of these molecules against clinical multidrug-resistant yeast and moulds could be very useful. Methods In this study, a total of 11 MDR yeast and filamentous fungal strains commonly reported in clinical settings were tested against polymyxin antibiotics. These include strains belonging to the Candida, Cryptococcus and Rhodotorula yeast genera, along with others belonging to the Aspergillus, Fusarium, Scedosporium, Lichtheimia and Rhizopus mould genera. The fungicidal or fungistatic action of colistin against clinical yeast strains was determined by the time-kill study. Further, a checkerboard assay for its combination with antifungal agents, usually used in clinical practices (amphotericin B, itraconazole, voriconazole), was carried out against multi-drug resistant fungal strains. Results Polymyxin B and colistin exhibited an antifungal activity against all MDR fungal strains tested with MICs ranging from 16 to 128 μg/ml, except for the Aspergillus species. In addition, colistin has a fungicidal action against yeast species, with minimum fungicidal concentrations ranging from 2 to 4 times MICs. It induces damage to the MDR Candida albicans membrane. A synergistic activity of colistin-amphotericin B and colistin-itraconazole associations against Candida albicans and Lichtheimia corymbifera strains, respectively, and colistin-fluconazole association against Rhodotorula mucilaginosa, was demonstrated using a checkerboard microdilution assay. Conclusion colistin could be proposed, in clinical practice, in association with other antifungals, to treat life-threatening fungal infections caused by MDR yeasts or moulds.http://link.springer.com/article/10.1186/s13756-019-0521-7Polymyxin antibioticsMDR-fungiRepurposing-drugCandida albicansMolds
spellingShingle Hanane Yousfi
Stéphane Ranque
Jean-Marc Rolain
Fadi Bittar
In vitro polymyxin activity against clinical multidrug-resistant fungi
Antimicrobial Resistance and Infection Control
Polymyxin antibiotics
MDR-fungi
Repurposing-drug
Candida albicans
Molds
title In vitro polymyxin activity against clinical multidrug-resistant fungi
title_full In vitro polymyxin activity against clinical multidrug-resistant fungi
title_fullStr In vitro polymyxin activity against clinical multidrug-resistant fungi
title_full_unstemmed In vitro polymyxin activity against clinical multidrug-resistant fungi
title_short In vitro polymyxin activity against clinical multidrug-resistant fungi
title_sort in vitro polymyxin activity against clinical multidrug resistant fungi
topic Polymyxin antibiotics
MDR-fungi
Repurposing-drug
Candida albicans
Molds
url http://link.springer.com/article/10.1186/s13756-019-0521-7
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AT fadibittar invitropolymyxinactivityagainstclinicalmultidrugresistantfungi