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Antifungal Drug Resistance (antifungal + drug_resistance)

Distribution by Scientific Domains

Medical Sciences	80%

Selected Abstracts

In vitro antifungal susceptibility patterns of dermatophyte strains causing tinea unguium

CLINICAL & EXPERIMENTAL DERMATOLOGY, Issue 6 2007
E. Sarifakioglu
Summary Background., Dermatophytes are the major responsible organisms in onychomycosis. Although recent antifungal agents have high success rates in treating this condition, lack of clinical response may occur in 20%. Antifungal drug resistance may be one of the causes of treatment failure. The need for in vitro antifungal drug resistance in daily practice is still under discussion. Objective., We aimed to determine the in vitro susceptibility patterns of dermatophytes causing onychomycosis, against the traditionally available systemic antifungal agents terbinafine, itraconazole and fluconazole. Methods., In total, 100 otherwise healthy patients with suspected onychomycosis were included. Nail clippings were cultured on Sabouraud dexrose agar, mycobiotic agar and dermatophyte test medium. Antifungal susceptibility tests were carried out, mainly following The National Committee for Clinical and Laboratory Standards (M38-P) protocol standard for filamentous fungi. Different concentrations of terbinafine (0.008,8 µg/mL), itraconazole (0.015,16 µg/mL) and fluconazole (0.06,64 µg/mL) were tested. Minimum inhibitory concentration end-point determination was chosen as 100% growth inhibition for terbinafine and 80% for azoles. Results., Of the 100 nail samples, 43% grew dermatophytes. The main causative organism was Trichophyton rubrum (91%) followed by Trichophyton mentagrophytes (9%). Terbinafine had the lowest minimum inhibitory concentration (0.008 µg/mL) followed by itraconazole. Fluconazole showed the greatest variation in minimum inhibitory concentration (0.03,2 µg/mL) and had different susceptibility patterns for the two species. Conclusions., Of the three antifungals tested, terbinafine had the most potent in vitro antifungal activity against dermatophytes. Antifungal susceptibility tests would be useful to screen antifungal-resistant dermatophyte strains. [source]

Predicting the emergence of resistance to antifungal drugs

FEMS MICROBIOLOGY LETTERS, Issue 1 2001
Leah E Cowen
Abstract The emergence of antifungal drug resistance is inevitable. Here I discuss antibiotic resistance in the context of the adaptive potential of fungi and I propose an approach to predicting the evolution of antifungal resistance using experimental evolution of DNA sequences and microbial populations. Prediction is based on determination of evolutionary potential at two levels, the gene and the genome. At the level of the gene, evolutionary potential depends on the sequence space of candidate resistance genes defined by the fitness effects of all possible mutations in all possible combinations. At the level of the genome, evolutionary potential depends on the adaptive landscape defined by the fitness effects of all possible interactions among alleles constituting the genotype. [source]

In vitro susceptibility testing in fungi: a global perspective on a variety of methods

MYCOSES, Issue 1 2010
Cornelia Lass-Flörl
Summary Candida and Aspergillus species are the most common causes of invasive fungal infections in immunocompromised patients. The introduction of new antifungal agents and recent reports of resistance emerging during treatment have highlighted the need for in vitro susceptibility testing. For some drugs, there is a supporting in vitro,in vivo correlation available from studies of clinical efficacy. Both intrinsic and emergent antifungal drug resistance are encountered. Various testing procedures have been proposed, including macrodilution and microdilution, agar diffusion, disk diffusion and Etest. Early recognition of infections caused by pathogens that are resistant to one or more antifungals is highly warranted to optimise treatment and patient outcome. [source]

Antifungal susceptibility testing by flow cytometry: is it the future?

MYCOSES, Issue 4 2006
Luís André Vale-Silva
Summary The current increase in the number and significance of fungal infections, the expanding armamentarium of antifungal agents, and the emergence of the problem of antifungal drug resistance have been intensifying the importance of antifungal susceptibility testing (AST). The Clinical and Laboratory Standards Institute (CLSI, formerly NCCLS) in the United States and the Antifungal Susceptibility Testing Subcommittee of the European Committee on Antimicrobial Susceptibility Testing (AFST-EUCAST) published standard methodologies in order to achieve higher reproducibility and allow direct inter-laboratory comparison of the susceptibility results. Nevertheless, several problems remain unresolved and the methods depend on long incubation periods of a minimum of 24 h (EUCAST) or even 48 h (CLSI). Over the last 15 years, successful applications of flow cytometric techniques to AST of both yeast and moulds have been reported. These techniques are based on the analysis of a great number of fungal cells individually and frequently rely on short incubation times of no more than a few hours. Considering these attributes, flow cytometry (FC) seems to have the potential to achieve clinical usefulness in the near future. The collection of data on the reproducibility of the results and on the correlation with clinical outcomes has barely started, however. Practical validation of the experimental methodologies is not granted before a significant amount of data addressing those questions is available. [source]