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Comparative Study
. 2017 May;112(5):376-381.
doi: 10.1590/0074-02760160527.

Minimal inhibitory concentration distributions and epidemiological cutoff values of five antifungal agents against Sporothrix brasiliensis

Rodrigo Almeida-Paes  1 , Fábio Brito-Santos  1 , Maria Helena Galdino Figueiredo-Carvalho  1 , Ana Caroline Sá Machado  2 , Manoel Marques Evangelista Oliveira  1 , Sandro Antonio Pereira  2 , Maria Clara Gutierrez-Galhardo  3 , Rosely Maria Zancopé-Oliveira  1
Affiliations
Comparative Study

Minimal inhibitory concentration distributions and epidemiological cutoff values of five antifungal agents against Sporothrix brasiliensis

Rodrigo Almeida-Paes et al. Mem Inst Oswaldo Cruz. 2017 May.

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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Figures

None
Minimal inhibitory concentration distribution of Sporothrix brasiliensis against amphotericin B (A), ketoconazole (B), itraconazole (C), posaconazole (D), and terbinafine (E), indicating wild-type strains (dotted bars) and non-wild-type strains (solid bars).
See this image and copyright information in PMC

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