依氟康唑与氟康唑、伊曲康唑和特比萘芬抗特比萘芬和伊曲康唑耐药/敏感临床皮肤癣菌、念珠菌和霉菌分离株的抗真菌活性。

Antifungal Activity of Efinaconazole Compared with Fluconazole, Itraconazole, and Terbinafine Against Terbinafine- and Itraconazole-Resistant/Susceptible Clinical Isolates of Dermatophytes, Candida, and Molds.

机构信息

*Center for Medical Mycology, and Integrated Microbiome Core, Department of Dermatology, Case Western Reserve University, Cleveland, OH.

†Clinical Pathology Department, Mansoura University Faculty of Medicine, Mansoura, Egypt.

出版信息

J Am Podiatr Med Assoc. 2024 Sep-Oct;114(5). doi: 10.7547/22-132.

DOI:10.7547/22-132

PMID:37040333

Abstract

BACKGROUND

Recently, an increasing number of resistant-to-terbinafine dermatophytosis cases have been reported. Thus, identifying an alternative antifungal agent that possesses broad-spectrum activity, including against resistant strains, is needed.

METHODS

We compared the antifungal activity of efinaconazole with that of fluconazole, itraconazole, and terbinafine against clinical isolates of dermatophytes, Candida, and molds using in vitro assays. Minimum inhibitory concentration (MIC) and minimum fungicidal concentration (MFC) of each antifungal agent were quantified and compared. Susceptible and resistant clinical isolates of Trichophyton mentagrophytes (n = 16), Trichophyton rubrum (n = 43), Trichophyton tonsurans (n = 18), Trichophyton violaceum (n = 4), Candida albicans (n = 55), Candida auris (n = 30), Fusarium spp, Scedosporium spp, and Scopulariopsis spp (n = 15 for each) were tested.

RESULTS

Efinaconazole was the most active antifungal agent tested against dermatophytes, with MIC50 and MIC90 (concentrations that inhibited 50% and 90% of strains tested, respectively) values of 0.002 and 0.03 µg/mL, respectively. Fluconazole, itraconazole, and terbinafine showed MIC50 and MIC90 values of 1 and 8 µg/mL, 0.03 and 0.25 µg/mL, and 0.03 and 16 µg/mL, respectively. Against Candida isolates, efinaconazole MIC50 and MIC90 values were 0.016 and 0.25 µg/mL, respectively, whereas fluconazole, itraconazole, and terbinafine had MIC50 and MIC90 values of 1 and 16 µg/mL, 0.25 and 0.5 µg/mL, and 2 and 8 µg/mL, respectively. Against various mold species, efinaconazole MIC values ranged from 0.016 to 2 µg/mL versus 0.5 to greater than 64 µg/mL for the comparators.

CONCLUSIONS

Efinaconazole showed superior potent activity against a broad panel of susceptible and resistant dermatophyte, Candida, and mold isolates.

摘要

背景

最近，越来越多的耐特比萘芬皮肤癣菌病病例被报告。因此，需要一种具有广谱活性的替代抗真菌药物，包括对耐药菌株的活性。

方法

我们使用体外检测方法比较了依氟康唑与氟康唑、伊曲康唑和特比萘芬对临床分离的皮肤癣菌、念珠菌和霉菌的抗真菌活性。定量比较了每种抗真菌药物的最低抑菌浓度（MIC）和最低杀菌浓度（MFC）。测试了易感和耐药的须癣毛癣菌（n=16）、红色毛癣菌（n=43）、断发毛癣菌（n=18）、紫色毛癣菌（n=4）、白色念珠菌（n=55）、耳念珠菌（n=30）、镰孢菌属、枝孢菌属和帚霉属（每种 15 株）的临床分离株。

结果

依氟康唑对皮肤癣菌的活性最强，MIC50 和 MIC90（分别抑制 50%和 90%测试菌株的浓度）值分别为 0.002 和 0.03μg/ml。氟康唑、伊曲康唑和特比萘芬的 MIC50 和 MIC90 值分别为 1 和 8μg/ml、0.03 和 0.25μg/ml 以及 0.03 和 16μg/ml。对于念珠菌分离株，依氟康唑的 MIC50 和 MIC90 值分别为 0.016 和 0.25μg/ml，而氟康唑、伊曲康唑和特比萘芬的 MIC50 和 MIC90 值分别为 1 和 16μg/ml、0.25 和 0.5μg/ml 以及 2 和 8μg/ml。对于各种霉菌种，依氟康唑的 MIC 值范围为 0.016 至 2μg/ml，而对照物的 MIC 值范围为 0.5 至大于 64μg/ml。