In vitro interactions of antifungal agents against clinical and environmental isolates of Fusarium spp.
YANG Hang
ZHOU Meng
ZHENG Hailin
ZHOU Xiaowei
MEI Huan
LI Dongmei
XU Heping
SHE Xiaodong
LIU Weida
Abstract：Objective To examine sensitivity of clinical and environmentally isolated Fusarium spp.to the clinical antifungal agents available.Methods Flucytosine(FCY),terbinafine(TBF),fluconazole(FCZ),ketoconazole(KTZ),itraconazole(ITZ),voriconazole(VRZ),posaconazole(PSZ),isavuconazole(IAZ),amphotericin B(AMB),and capsafungin(CAS)were choosed as the agents.We measured the agents'minimum inhibitory concentrations(MIC)or minimum effective concentrations(MEC)separately according to CLSI(Clinical and Laboratory Standards Institute)document M38-A3.Drug interactions in vitro drug sensitivity tests were assessed with the FIC index by the agar dilution checkerboard assay.Results Clinical and environmentally Fusarium spp.isolates were resistant to flucytosine,fluconazole,caspofungin,and itraconazole in the study.Fusarium solani species complex(FSSC)was sensitive to voriconazole and amphotericin B.Fusarium fujikuroi species complex(FFSC)showed sensitivity to voriconazole,amphotericin B,ketoconazole,posaconazole,and isavuconazole.Fusarium incarnatum equiseti species complex(FIESC)was sensitive to voriconazole,amphotericin B,and ketoconazole.Voriconazole,amphotericin B,ketoconazole,posaconazole,isavuconazole,and itraconazole had an effect on some other Fusarium.In addition,the susceptibility of Fusarium spp.derived from various sources varied slightly.Compared with the strains from skin and environment,the strains from cornea were more sensitive to ketoconazole,and the strains from cornea and blood were more sensitive to amphotericin B.Amphotericin B combined with ketoconazole,isavuconazole,and terbinafine combined with posaconazole,isavuconazole had synergistic effects on some Fusarium spp.Some other Fusarium responded to amphotericin B combined with isavuconazole.Caspofungin combined with acrylamide,azole,and polyene antifungal drugs did not show any synergistic effects.Conclusions Fusarium spp.apart from clinic are most sensitive to voriconazole and amphotericin B,and terbinafine is partially sensitive.Amphotericin B and azole drugs have obvious synergistic effects and have certain potential for combined treatment in clinical practice.
Keywords：Fusarium spp.susceptibilityantifungal agentsazolesacrylamidespolyenesminimum inhibitory concentrationagar dilution checkerboard assay
Publication Date：2025-02-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：7( 1-7 )