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Antifungal susceptibility testing of dermatophytes: development and evaluation of an optimized broth microdilution method
Mycoses ( IF 4.9 ) Pub Date : 2020-11-04 , DOI: 10.1111/myc.13202
Riccardo Curatolo 1, 2 , Nada Juricevic 1, 2 , Cheryl Leong 1, 2 , Philipp P Bosshard 1, 2
Affiliation  

BACKGROUND Dermatophytosis is one of the most common infections affecting 3-17 % of the population. Resistance to antifungals so far was not of concern in the therapeutic management. However, recent reports of terbinafine resistant strains in several countries are worrisome making antifungal susceptibility testing inevitable. OBJECTIVES We aimed to develop and evaluate an optimized broth microdilution assay for antifungal drug susceptibility testing of dermatophytes. METHODS We first studied the effect of different inocula, incubation temperatures and incubation times to establish an optimized assay. Subsequently, we tested 79 clinical strains of 11 dermatophyte species with 13 antifungals. RESULTS We found inoculating with 0.5 - 5 x 104 colony forming units (CFU) and incubating at 29°C ± 1°C for 4 days to be appropriate. Terbinafine was the most active antifungal agent with minimum inhibitory concentration (MIC) values ≤0.06 µg/ml, expect for one resistant T. mentagrophytes strain, which was isolated from an Indian patient. Also, a majority of MICs of other antifungals that are commonly used to treat dermatophytosis were low, except those of fluconazole. Fluconazole MICs do not correlate with the good efficacy in the clinical management. CONCLUSIONS Our assay enables fast and reliable susceptibility testing of dermatophytes with a large panel of different antifungals. This helps to improve the therapeutic management of dermatophytosis by detecting resistant strains.

中文翻译:

皮肤癣菌的抗真菌药敏试验:优化肉汤微量稀释方法的开发和评价

背景皮肤癣菌病是影响3-17%人口的最常见感染之一。迄今为止,抗真菌药的耐药性在治疗管理中并不重要。然而,最近几个国家关于特比萘芬耐药菌株的报道令人担忧,这使得抗真菌药敏试验不可避免。目标我们旨在开发和评估一种优化的肉汤微量稀释法,用于皮肤癣菌的抗真菌药物敏感性测试。方法我们首先研究了不同接种物、孵育温度和孵育时间的影响,以建立优化的检测方法。随后,我们用 13 种抗真菌药测试了 11 种皮肤癣菌的 79 种临床菌株。结果我们发现接种 0.5 - 5 x 104 菌落形成单位 (CFU) 并在 29°C ± 1°C 下孵育 4 天是合适的。特比萘芬是活性最强的抗真菌剂,最小抑菌浓度 (MIC) 值≤0.06 µg/ml,除了一种从印度患者身上分离的抗须须癣菌菌株外。此外,除氟康唑外,通常用于治疗皮肤癣菌病的其他抗真菌药的大多数 MIC 较低。氟康唑 MIC 与临床管理中的良好疗效无关。结论我们的检测能够使用大量不同的抗真菌剂对皮肤癣菌进行快速可靠的敏感性测试。这有助于通过检测耐药菌株来改善皮肤癣菌病的治疗管理。除氟康唑外,通常用于治疗皮肤癣菌病的其他抗真菌药的大多数 MIC 较低。氟康唑 MIC 与临床管理中的良好疗效无关。结论我们的检测能够使用大量不同的抗真菌剂对皮肤癣菌进行快速可靠的敏感性测试。这有助于通过检测耐药菌株来改善皮肤癣菌病的治疗管理。除氟康唑外,通常用于治疗皮肤癣菌病的其他抗真菌药的大多数 MIC 较低。氟康唑 MIC 与临床管理中的良好疗效无关。结论我们的检测能够使用大量不同的抗真菌剂对皮肤癣菌进行快速可靠的敏感性测试。这有助于通过检测耐药菌株来改善皮肤癣菌病的治疗管理。
更新日期:2020-11-04
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