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Comparative activity of posaconazole and systemic azole agents against clinical isolates of filamentous fungi from a global surveillance programme

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 Aspergillus fumigatus was investigated. METHODS: Isolates were susceptibili...

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Autores principales: Carvalhaes, Cecilia G, Rhomberg, Paul R, Pfaller, Michael, Castanheira, Mariana
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8251335/
https://www.ncbi.nlm.nih.gov/pubmed/34223145
http://dx.doi.org/10.1093/jacamr/dlab088
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author Carvalhaes, Cecilia G
Rhomberg, Paul R
Pfaller, Michael
Castanheira, Mariana
author_facet Carvalhaes, Cecilia G
Rhomberg, Paul R
Pfaller, Michael
Castanheira, Mariana
author_sort Carvalhaes, Cecilia G
collection PubMed
description 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 Aspergillus fumigatus 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: Aspergillus spp. (81.9%) remained the most common organism causing IMI worldwide; approximately two-thirds of Aspergillus spp. recovered were A. fumigatus. In general, more than 90% of 220 A. fumigatus isolates were wild type (WT) to all mould-active azoles, except itraconazole (84.5% WT). The voriconazole non-susceptible (NS) A. fumigatus rate was 7.7% overall and was higher in Europe (12.9%) than in the other regions (0%–5.8%). Posaconazole (MIC(50)/MIC(90), 0.25/0.5 mg/L) showed similar or slightly higher activity than voriconazole (MIC(50)/MIC(90), 0.5/0.5 mg/L) and isavuconazole (MIC(50)/MIC(90), 0.5/1 mg/L) against A. fumigatus. The mould-active azoles displayed similar activity against non-fumigatus Aspergillus (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 A. section Nigri; 100%, 100%, and 93.8% of A. section Terrei; and 97.3%, 100%, and 100% of A. section Flavi isolates. Posaconazole displayed potency greater than or equal to the other azoles against the Mucorales group and Scedosporium spp. CONCLUSIONS: Posaconazole and other mould-active azoles showed good activity against Aspergillus spp. causing IMI, but clinicians should be aware of regional rates of voriconazole-NS A. fumigatus.
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spelling pubmed-82513352021-07-02 Comparative activity of posaconazole and systemic azole agents against clinical isolates of filamentous fungi from a global surveillance programme Carvalhaes, Cecilia G Rhomberg, Paul R Pfaller, Michael Castanheira, Mariana JAC Antimicrob Resist Original Article 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 Aspergillus fumigatus 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: Aspergillus spp. (81.9%) remained the most common organism causing IMI worldwide; approximately two-thirds of Aspergillus spp. recovered were A. fumigatus. In general, more than 90% of 220 A. fumigatus isolates were wild type (WT) to all mould-active azoles, except itraconazole (84.5% WT). The voriconazole non-susceptible (NS) A. fumigatus rate was 7.7% overall and was higher in Europe (12.9%) than in the other regions (0%–5.8%). Posaconazole (MIC(50)/MIC(90), 0.25/0.5 mg/L) showed similar or slightly higher activity than voriconazole (MIC(50)/MIC(90), 0.5/0.5 mg/L) and isavuconazole (MIC(50)/MIC(90), 0.5/1 mg/L) against A. fumigatus. The mould-active azoles displayed similar activity against non-fumigatus Aspergillus (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 A. section Nigri; 100%, 100%, and 93.8% of A. section Terrei; and 97.3%, 100%, and 100% of A. section Flavi isolates. Posaconazole displayed potency greater than or equal to the other azoles against the Mucorales group and Scedosporium spp. CONCLUSIONS: Posaconazole and other mould-active azoles showed good activity against Aspergillus spp. causing IMI, but clinicians should be aware of regional rates of voriconazole-NS A. fumigatus. Oxford University Press 2021-06-26 /pmc/articles/PMC8251335/ /pubmed/34223145 http://dx.doi.org/10.1093/jacamr/dlab088 Text en © The Author(s) 2021. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) ), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Original Article
Carvalhaes, Cecilia G
Rhomberg, Paul R
Pfaller, Michael
Castanheira, Mariana
Comparative activity of posaconazole and systemic azole agents against clinical isolates of filamentous fungi from a global surveillance programme
title Comparative activity of posaconazole and systemic azole agents against clinical isolates of filamentous fungi from a global surveillance programme
title_full Comparative activity of posaconazole and systemic azole agents against clinical isolates of filamentous fungi from a global surveillance programme
title_fullStr Comparative activity of posaconazole and systemic azole agents against clinical isolates of filamentous fungi from a global surveillance programme
title_full_unstemmed Comparative activity of posaconazole and systemic azole agents against clinical isolates of filamentous fungi from a global surveillance programme
title_short Comparative activity of posaconazole and systemic azole agents against clinical isolates of filamentous fungi from a global surveillance programme
title_sort comparative activity of posaconazole and systemic azole agents against clinical isolates of filamentous fungi from a global surveillance programme
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8251335/
https://www.ncbi.nlm.nih.gov/pubmed/34223145
http://dx.doi.org/10.1093/jacamr/dlab088
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