Minimal Inhibitory Concentration Distributions and Epidemiological Cutoff Values of Five Antifungal Agents Against Sporothrix Brasiliensis

Overview

Journal Mem Inst Oswaldo Cruz

Specialties Parasitology
Tropical Medicine

Date 2017 Apr 27

PMID 28443986

Citations 25

Authors

Rodrigo Almeida-Paes

Fabio Brito-Santos

Maria Helena Galdino Figueiredo-Carvalho

Ana Caroline Sa Machado

Manoel Marques Evangelista Oliveira

Sandro Antonio Pereira

Maria Clara Gutierrez-Galhardo

Rosely Maria Zancope-Oliveira

Affiliations

Soon will be listed here.

Abstract

Background: Sporothrix brasiliensis is the most virulent sporotrichosis agent. This species usually responds to antifungal drugs, but therapeutic failure can occur in some patients. Antifungal susceptibility tests have been performed on this species, but no clinical breakpoints (CBPs) are available. In this situation, minimal inhibitory concentration (MIC) distributions and epidemiological cutoff values (ECVs) support the detection of identification of resistant strains.

Objectives: To study the MIC distributions of five antifungal drugs against S. brasiliensis and to propose tentative ECVs.

Methods: MICs of amphotericin B (AMB), itraconazole (ITR), ketoconazole (KET), posaconazole (POS), and terbinafine (TRB) against 335 S. brasiliensis strains were determined by the Clinical and Laboratory Standards Institute broth microdilution method.

Findings: The proposed ECV, in µg/mL, for AMB, ITR, KET, POS, and TRB were 4.0, 2.0, 1.0, 2.0, and 0.25, respectively. Percentages of wild-type strains in our population for the above antifungal drugs were 98.48, 95.22, 95.33, 100, and 97.67%, respectively.

Main Conclusions: These ECVs will be useful to detect strains with resistance, to define CBPs, and to elaborate specific therapeutic guidelines for S. brasiliensis. Rational use of antifungals is strongly recommended to avoid the emergence of resistant strains and ensure the therapeutic effectiveness of sporotrichosis.

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