Comparative Activity of Posaconazole and Systemic Azole Agents Against Clinical Isolates of Filamentous Fungi from a Global Surveillance Programme

Overview

Journal JAC Antimicrob Resist

Publisher Oxford University Press

Specialty Infectious Diseases

Date 2021 Jul 5

PMID 34223145

Citations 2

Authors

Cecilia G Carvalhaes

Paul R Rhomberg

Michael Pfaller

Mariana Castanheira

Affiliations

Soon will be listed here.

Abstract

Objectives: The activity of mould-active azoles was evaluated against 397 filamentous fungi causing invasive mould infections (IMI) worldwide. In addition, a tentative posaconazole epidemiological cut-off value (ECV) against was investigated.

Methods: Isolates were susceptibility tested by the CLSI reference broth microdilution methods. Species identification was confirmed by MALDI-TOF and/or sequencing analysis.

Results: spp. (81.9%) remained the most common organism causing IMI worldwide; approximately two-thirds of spp. recovered were . In general, more than 90% of 220 isolates were wild type (WT) to all mould-active azoles, except itraconazole (84.5% WT). The voriconazole non-susceptible (NS) rate was 7.7% overall and was higher in Europe (12.9%) than in the other regions (0%-5.8%). Posaconazole (MIC/MIC, 0.25/0.5 mg/L) showed similar or slightly higher activity than voriconazole (MIC/MIC, 0.5/0.5 mg/L) and isavuconazole (MIC/MIC, 0.5/1 mg/L) against . The mould-active azoles displayed similar activity against non- (WT rates >93%), but differences were observed among the main species/sections. Posaconazole, voriconazole, and isavuconazole inhibited at their respective ECVs 100%, 97.0%, and 100% of section ; 100%, 100%, and 93.8% of section ; and 97.3%, 100%, and 100% of section isolates. Posaconazole displayed potency greater than or equal to the other azoles against the Mucorales group and spp.

Conclusions: Posaconazole and other mould-active azoles showed good activity against spp. causing IMI, but clinicians should be aware of regional rates of voriconazole-NS .

Citing Articles

Trends in the activity of mold-active azole agents against clinical isolates with and without alterations from Europe and North America (2017-2021).

Pfaller M, Carvalhaes C, Rhomberg P, Desphande L, Castanheira M J Clin Microbiol. 2024; 62(2):e0114123.

PMID: 38193696 PMC: 10865804. DOI: 10.1128/jcm.01141-23.

The Synergistic Effect of Tacrolimus (FK506) or Everolimus and Azoles Against and Species and .

Wang Z, Liu M, Liu L, Li L, Tan L, Sun Y Front Cell Infect Microbiol. 2022; 12:864912.

PMID: 35493742 PMC: 9046971. DOI: 10.3389/fcimb.2022.864912.

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