Antifungal drug susceptibility testing

Synthesis of new quinoxalinophenazinediones and tetrahydrobenzodipyrrolotetrones of biological interest

The reaction of two equivalents of sodium azide with diarylaminodibromo-p-benzoquinone (I) in DMF for 15–24 h produced quinoxalinophenazinediones together with a byproduct identified as diarylaminodiaminobenzoquinone. On the other hand, the reaction of bromanil with active methylenes, such as diethyl malonate and ethyl acetoacetate, resulted in disubstitution products which, on treatment with primary amines, cyclized into benzodipyrroletetrones. Comparative antifungal and antibacterial studies were made.

Study on the hyphal responses of Aspergillus fumigatus to the antifungal agent by Bio-Cell Tracer

The hyphal responses of an A. fumigatus isolate to a trizole derivative-fluconazole (FCZ) were studied with a Bio-Cell Tracer system. The numerical data were recorded as the original growth rate (Pre-GR), the time needed for FCZ reaching to its target in hypha (tau on), the growth rate under the FCZ effect (Exp-GR) and the growth rate after FCZ was removed (Post-GR). Based on above numerical data, the inhibitory rates in the exposure and post exposure periods were calculated as the Exp-I% and Post-I% values. It was found there were variable inhibitory rate values (I%) in individual hyphae corresponding to different FCZ concentrations. It was shown by correlation analysis of the numerical data that the Pre-GR values were negatively correlated with the tau on values and positively correlated with both the Exp-I% and Post-I% values. Additionally, the tau on values are negatively correlated with the Exp-I% and Post-I% values. Those results suggested that the hyphal growth rate and the susceptibility of the FCZ target be the important factors to determine the hyphal responses to the FCZ effect. Serial morphological alternations were captured while the hyphal growth curves were changing under the FCZ effects. Of the morphological data, the interesting alternations were visualized when the hyphae were affected by 16 micrograms/ml FCZ. As shifting of the hyphal growth curves, the hyphae were repeatedly seen as swollen tips and germination from the swollen sites. It is indicated that the hyphal tips are the most sensitive parts of this mycelia fungus to the FCZ affects. Additionally, because the hyphal regrowth was observed as germination from the swollen tips before FCZ was removed, an adaptation phenomenon could be proposed.

In vitro susceptibility testing of Fonsecaea pedrosoi to antifungals

Based on the difficulties experienced in the treatment of chromoblastomycosis, 12 primary human isolates of F. pedrosoi, were tested for their in vitro susceptibility to various antimycotics. We adapted the recommendations of the NCCLS for yeasts and followed the indications for mold testing from other authors in order to determine their MIC's and the MLC's. It was found that a significant proportion of the isolates were resistant to 3 of the 4 antimycotics tested, as revealed by high MIC values, as follows: 33% were resistant to amphotericin B (AMB), 58.3% to 5 fluocytosine (5 FC) and 66.7% to fluconazole (FLU). Contrarywise, none of the isolates proved resistant to itraconazole (ITZ). Determination of the MLC's revealed that a larger proportion of the isolates were not killed by AMB, 5 FC (91.7%), FLU (100%) or even, ITZ (41.7%). These data indicate that it would be desirable to determine the susceptibility of F. pedrosoi before initiating therapy, in order to choose the more effective antifungal and avoid clinical failure.

Serotyping of Cryptococcus neoformans strains isolated from clinical specimens in Thailand and their susceptibility to various antifungal agents

One hundred and thirty-nine strains of Cryptococcus neoformans were isolated in Thailand from clinical specimens including 97 AIDS patients: 67 from Northern, 48 from Central, 17 from Northeastern and 7 from Southern regional hospitals. Six out of the 139 strains were serotype B and the remaining 133 were A. There was no correlation between serotypes and regional distribution. To our knowledge, this is the first report of serotyping studies on C. neoformans in Thailand. Studies on random amplified polymorphic DNA (RAPD) analysis showed that this method is useful for the differentiation of C. neoformans var. gattii (serotypes B and C) and C. neoformans var. neoformans (serotypes A and D). They also indicated that Thai isolates of C. neoformans var. gattii (serotype B) were a homogeneous group on the basis of their genotypes. Antifungal susceptibility tests using 5 antifungal agents including amphotericin B, fluconazole, flucytosine, itraconazole and micronazole against 50 selected strains of C. neoformans showed that they were sensitive to all of the antifungal agents tested except for one strain that was resistant to flucytosine.

In vitro antifungal activity of the new triazole D0870 against Penicillium marneffei compared with that of amphotericin B, fluconazole, itraconazole, miconazole and flucytosine

The in vitro activity of D0870, a new triazole, was compared with that of fluconazole, itraconazole, miconazole, amphotericin B and flucytosine against recent clinical isolates of Penicillium marneffei in Thailand. The minimum inhibitory concentrations (MIC) values were determined by a microbroth dilution method using morpholinopropanesulphonic acid (MOPS)-buffered RPMI-1640 and brain heart infusion (BHI) medium. Yeast nitrogen base (YNB) medium with glucose was also used for the assay of flucytosine. D0870 was less active against P. marneffei than itraconazole, but its activity was similar to that of miconazole, superior to that of amphotericin B and markedly superior to that of fluconazole and flucytosine. Much lower MIC values of D0870 were observed with BHI medium.

In vitro susceptibilities of clinical and environmental isolates of Cryptococcus neoformans to five antifungal drugs

A total of 53 Cryptococcus neoformans strains, including clinical and environmental Brazilian isolates, were tested for their susceptibilities to amphotericin B, 5-flucytosine, ketoconazole, fluconazole, and itraconazole. The tests were performed according to the National Committee of Clinical Laboratory Standards recommendations (document M27-P). In general, there was a remarkable homogeneity of results for all strains, and comparable MICs were found for environmental and clinical isolates. This paper represents the first contribution in which susceptibility data for Brazilian C. neoformans isolates are provided.