Background

Candida parapsilosis may acquire resistance to echinocandins, a fact that prompts the search for new therapeutic options.

Aims

The present study aimed to evaluate the in vitro activity of antifungal agents, alone and in combination, against four groups of C. parapsilosis strains: (1) echinocandin-susceptible (ES) clinical isolates (MIC ≤ 2 μg/ml), (2) anidulafungin-resistant strains (MIC ≥ 8 μg/ml), (3) caspofungin-resistant strains (MIC ≥ 8 μg/ml), and (4) micafungin-resistant strains (MIC ≥ 8 μg/ml).

Methods

Antifungal interactions were evaluated by a checkerboard micro-dilution method. The determination of the MIC to each drug for every isolate according to the Clinical and Laboratory Standards Institute documents M27 (2017) and M60 (2017) was also done.

Results

The echinocandins-resistant (ER) strains showed higher MICs to the tested antifungals than the ES strains, except for amphotericin B, for which the ER groups remained susceptible.

Conclusions

Most combinations showed indifferent interactions. The use of monotherapy still seems to be the best option. As resistance to echinocandins is an emergent phenomenon, further studies are required to provide clearer information on the susceptibility differences between strains to these antifungal agents.

中文翻译：

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单独和联合使用的抗真菌剂对棘球菌素敏感性和抗性假丝酵母念珠菌菌株具有活性。

背景

副念珠菌可能对棘球chin碱具有抗药性，这一事实促使人们寻找新的治疗选择。

目的

本研究旨在评估抗真菌药单独和联合使用对四组副寄生念珠菌菌株的体外活性：（1）棘皮菌素敏感性（ES）临床分离株（MIC≤2μg/ ml），（2 ）抗阿米芬净菌株（MIC≥8μg/ ml），（3）抗卡泊芬净菌株（MIC≥8μg/ ml）和（4）抗米卡芬净菌株（MIC≥8μg/ ml）。

方法

通过棋盘微稀释法评估抗真菌相互作用。还根据临床和实验室标准协会文件M27（2017）和M60（2017）确定每种分离物每种药物的MIC。

结果

除两性霉素B仍然对ER组敏感外，对棘孢菌素抗性（ER）菌株的抗MICs比对ES菌株高。

结论

大多数组合显示出无差别的相互作用。单一疗法的使用似乎仍然是最佳选择。由于对棘手oc蛋白的耐药性是一种新出现的现象，需要进一步研究以提供关于这些抗真菌剂之间的药敏性差异的更清晰信息。