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Lefranc M, Accoceberry I, Fitton-Ouhabi V, Biteau N, Noël T. Rapamycin and caspofungin show synergistic antifungal effects in caspofungin-susceptible and caspofungin-resistant Candida strains in vitro. J Antimicrob Chemother 2024; 79:151-156. [PMID: 37991226 DOI: 10.1093/jac/dkad359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 11/07/2023] [Indexed: 11/23/2023] Open
Abstract
OBJECTIVES Caspofungin is an echinocandin antifungal agent that inhibits synthesis of glucan required for the fungal cell wall. Resistance is mediated by mutation of Fks1 glucan synthase, among which S645P is the most common resistance-associated polymorphism. Rapamycin is a macrolide that inhibits the mechanistic target of rapamycin (mTOR) protein kinase activity. This study investigated the interaction between rapamycin and caspofungin in inhibiting the growth of WT Candida albicans and Fks1 S645P mutant clinical isolate, and WT Candida lusitaniae and genetically engineered isogenic strain with Fks1 S645P mutation at equivalent position. METHODS Interactions between caspofungin and rapamycin were evaluated using the microdilution chequerboard method in liquid medium. The results were analysed using the Loewe additivity model (FIC index, FICI) and the Bliss independence model (response surface, RS, analysis). RESULTS Synergy between rapamycin and caspofungin was shown for C. albicans and C. lusitaniae strains by RS analysis of the chequerboard tests. Synergy was observed in strains susceptible and resistant to caspofungin. Weak subinhibitory concentrations of rapamycin were sufficient to restore caspofungin susceptibility. CONCLUSIONS We report here, for the first time, synergy between caspofungin and rapamycin in Candida species. Synergy was shown for strains susceptible and resistant to caspofungin. This study highlights the possible implication of the TOR pathway in sensing antifungal-mediated cell wall stress and in modulating the cellular response to echinocandins in Candida yeasts.
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Affiliation(s)
- Maxime Lefranc
- University Bordeaux, CNRS, Microbiologie Fondamentale et Pathogénicité, UMR 5234, 33000 Bordeaux, France
- University Bordeaux, CNRS, Microbiologie Fondamentale et Pathogénicité, UMR 5234, CHU Bordeaux, 33000 Bordeaux, France
| | - Isabelle Accoceberry
- University Bordeaux, CNRS, Microbiologie Fondamentale et Pathogénicité, UMR 5234, 33000 Bordeaux, France
- University Bordeaux, CNRS, Microbiologie Fondamentale et Pathogénicité, UMR 5234, CHU Bordeaux, 33000 Bordeaux, France
| | - Valérie Fitton-Ouhabi
- University Bordeaux, CNRS, Microbiologie Fondamentale et Pathogénicité, UMR 5234, 33000 Bordeaux, France
| | - Nicolas Biteau
- University Bordeaux, CNRS, Microbiologie Fondamentale et Pathogénicité, UMR 5234, 33000 Bordeaux, France
| | - Thierry Noël
- University Bordeaux, CNRS, Microbiologie Fondamentale et Pathogénicité, UMR 5234, 33000 Bordeaux, France
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Khalifa HO, Arai T, Majima H, Watanabe A, Kamei K. Evaluation of Surveyor nuclease for rapid identification of FKS genes mutations in Candida glabrata. J Infect Chemother 2021; 27:834-839. [PMID: 33582033 DOI: 10.1016/j.jiac.2021.01.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 01/22/2021] [Accepted: 01/25/2021] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Infections with Candida glabrata have recently gained worldwide attention owing to its association with long hospitalizations and high mortality rates. This problem is highlighted when the infection is associated with echinocandin resistance, which is used for first-line therapy. Echinocandin resistance is exclusively attributed to functional mutations in FKS genes, and especially in hot spot (HS) regions. Unfortunately, few studies have focused on the rapid identification of FKS mutations associated with echinocandin resistance in C. glabrata. This study was intended to evaluate and validate the use of Surveyor nuclease assay (SN) for detection of FKS gene mutations. METHODS SN was evaluated against three segments of FKS1 and FKS2 genes including whole gene, regions including all HSs, and the region including only HS1. RESULTS Our results showed that SN results are basically dependent on the type of gene as well as the segment type. Interestingly, SN can detect mutations in the region containing HS1 in both FKS1 and FKS2 genes. Furthermore, SN can detect mutations in the segment containing all HS regions for FKS1 but not FKS2. SN was unable to detect mutations in the whole FKS1 and FKS2 genes. CONCLUSIONS As far as we know, this is the first study to validate SN for rapid identification of FKS gene mutations. This assay could be used as a sample for rapid identification of mutations associated with HS1 region in FKS genes, which have a predominant role for echinocandin resistance induction in C. glabrata.
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Affiliation(s)
- Hazim O Khalifa
- Division of Clinical Research, Medical Mycology Research Center, Chiba University, Chiba, 260-8673, Japan; Department of Pharmacology, Faculty of Veterinary Medicine, Kafrelsheikh University, Kafr El-Sheikh, 33516, Egypt
| | - Teppei Arai
- Division of Clinical Research, Medical Mycology Research Center, Chiba University, Chiba, 260-8673, Japan
| | - Hidetaka Majima
- Division of Clinical Research, Medical Mycology Research Center, Chiba University, Chiba, 260-8673, Japan
| | - Akira Watanabe
- Division of Clinical Research, Medical Mycology Research Center, Chiba University, Chiba, 260-8673, Japan.
| | - Katsuhiko Kamei
- Division of Clinical Research, Medical Mycology Research Center, Chiba University, Chiba, 260-8673, Japan
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Medina N, Soto-Debrán JC, Seidel D, Akyar I, Badali H, Barac A, Bretagne S, Cag Y, Cassagne C, Castro C, Chakrabarti A, Dannaoui E, Cardozo C, Garcia-Rodriguez J, Guitard J, Hamal P, Hoenigl M, Jagielski T, Khodavaisy S, Lo Cascio G, Martínez-Rubio MC, Meletiadis J, Muñoz P, Ochman E, Peláez T, Perez-Ayala Balzola A, Prattes J, Roilides E, Ruíz-Pérez de Pipaón M, Stauf R, Steinmann J, Suárez-Barrenechea AI, Tejero R, Trovato L, Viñuela L, Wongsuk T, Żak I, Zarrinfar H, Lass-Flörl C, Arikan-Akdagli S, Alastruey-Izquierdo A. MixInYeast: A Multicenter Study on Mixed Yeast Infections. J Fungi (Basel) 2020; 7:jof7010013. [PMID: 33383783 PMCID: PMC7823447 DOI: 10.3390/jof7010013] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 12/20/2020] [Accepted: 12/21/2020] [Indexed: 01/08/2023] Open
Abstract
Invasive candidiasis remains one of the most prevalent systemic mycoses, and several studies have documented the presence of mixed yeast (MY) infections. Here, we describe the epidemiology, clinical, and microbiological characteristics of MY infections causing invasive candidiasis in a multicenter prospective study. Thirty-four centers from 14 countries participated. Samples were collected in each center between April to September 2018, and they were sent to a reference center to confirm identification by sequencing methods and to perform antifungal susceptibility testing, according to the European Committee on Antimicrobial Susceptibility Testing (EUCAST). A total of 6895 yeast cultures were identified and MY occurred in 150 cases (2.2%). Europe accounted for the highest number of centers, with an overall MY rate of 4.2% (118 out of 2840 yeast cultures). Of 122 MY cases, the most frequent combinations were Candida albicans/C. glabrata (42, 34.4%), C. albicans/C. parapsilosis (17, 14%), and C. glabrata/C. tropicalis (8, 6.5%). All Candida isolates were susceptible to amphotericin B, 6.4% were fluconazole-resistant, and two isolates (1.6%) were echinocandin-resistant. Accurate identification of the species involved in MY infections is essential to guide treatment decisions.
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Affiliation(s)
- Narda Medina
- Mycology Reference Laboratory, National Centre for Microbiology, Instituto de Salud Carlos III, 28220 Madrid, Spain; (N.M.); (J.C.S.-D.)
| | - Juan Carlos Soto-Debrán
- Mycology Reference Laboratory, National Centre for Microbiology, Instituto de Salud Carlos III, 28220 Madrid, Spain; (N.M.); (J.C.S.-D.)
| | - Danila Seidel
- Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), Department I of Internal Medicine, Faculty of Medicine and University Hospital of Cologne, University of Cologne, 50937 Cologne, Germany;
- European Diamond Excellence Center for Medical Mycology of the European Confederation of Medical Mycology (ECMM), 50937 Cologne, Germany
- Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, 50931 Cologne, Germany
| | - Isin Akyar
- Department of Medical Microbiology, Acibadem Mehmet Ali Aydinlar University School of Medicine, 34758 Istanbul, Turkey;
- Acibadem Labmed Laboratories, 34752 Istanbul, Turkey
| | - Hamid Badali
- Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari 48157-33971, Iran;
| | - Aleksandra Barac
- Clinic for Infectious and Tropical Diseases, Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia;
| | - Stéphane Bretagne
- Laboratoire de Parasitologie-Mycologie, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris (AP-HP), 75010 Paris, France;
- Department of Infectious Agents, Université de Paris, 75006 Paris, France
| | - Yasemin Cag
- Istanbul Medeniyet University Goztepe Training and Research Hospital, 34722 Istanbul, Turkey;
- Department of Infectious Diseases and Clinical Microbiology, Istanbul Medeniyet University School of Medicine, 34093 Istanbul, Turkey
| | - Carole Cassagne
- Aix-Marseille University, UMR MD3 IP-TPT, 13885 Marseilles, France;
| | - Carmen Castro
- Microbiology Service, Clinical Unit of Infectious Diseases and Microbiology, Hospital Universitario Valme, 41014 Sevilla, Spain;
| | - Arunaloke Chakrabarti
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India;
| | - Eric Dannaoui
- Unité de Parasitologie-Mycologie, Service de Microbiologie, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris (AP-HP) Université de Paris, 75015 Paris, France;
| | - Celia Cardozo
- Hospital Universitario Clínic, 08036 Barcelona, Spain;
| | | | - Juliette Guitard
- Service de Parasitologie-Mycologie, Centre de Recherche Saint-Antoine, CRSA, AP-HP, Hôpital Saint-Antoine, Sorbonne Université, Inserm, 75012 Paris, France;
| | - Petr Hamal
- Department of Microbiology, Palacky University, Faculty of Medicine and Dentistry and University Hospital, 775 15 Olomouc, Czech Republic;
| | - Martin Hoenigl
- Division of Infectious Diseases and Global Public Health, University of California San Diego, San Diego, CA 92093, USA;
| | - Tomasz Jagielski
- Department of Medical Microbiology, Institute of Microbiology, Faculty of Biology, University of Warsaw, I. Miecznikowa 1, 02-096 Warsaw, Poland;
| | - Sadegh Khodavaisy
- Division of Molecular Biology & Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran 14167-53955, Iran;
| | - Giuliana Lo Cascio
- Microbiology and Virology Unit, Department of Pathology and Diagnostic, Azienda Ospedaliera Universitaria Integrata, 30126 Verona, Italy;
| | | | - Joseph Meletiadis
- Clinical Microbiology Laboratory, Attikon University Hospital, Medical School, National and Kapodistrian University of Athens, Haidari, 12462 Athens, Greece;
| | - Patricia Muñoz
- Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañon, 28007 Madrid, Spain;
- Department of Medicine, Universidad Complutense de Madrid, CIBERES (CB06/06/0058), 28040 Madrid, Spain
| | - Elżbieta Ochman
- Department of Clinical Microbiology, The Maria Skłodowska-Curie Institute of Oncology, W. K. Roentgena 5, 02-781 Warsaw, Poland;
| | - Teresa Peláez
- Hospital Universitario Central de Asturias (HUCA), Fundación para la Investigación Biomédica y la Innovación Biosanitaria del Principado de Asturias (FINBA), 33011 Asturias, Spain;
| | | | - Juergen Prattes
- Section of Infectious Diseases and Tropical Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria;
| | - Emmanuel Roilides
- Infectious Diseases Unit, 3rd Department of Pediatrics, Faculty of Medicine, Aristotle University School of Health Sciences, Hippokration General Hospital, 54642 Thessaloniki, Greece;
| | - Maite Ruíz-Pérez de Pipaón
- Department of Infectious Diseases, Microbiology and Preventive Medicine, University Hospital Virgen del Rocío, 41013 Seville, Spain;
| | - Raphael Stauf
- Institute of Clinical Hygiene, Medical Microbiology and Infectiology, Klinikum Nürnberg, Paracelsus Medical University, 90419 Nuremberg, Germany; (R.S.); (J.S.)
- Institute of Medical Microbiology, University Hospital Essen, 45122 Essen, Germany
| | - Jörg Steinmann
- Institute of Clinical Hygiene, Medical Microbiology and Infectiology, Klinikum Nürnberg, Paracelsus Medical University, 90419 Nuremberg, Germany; (R.S.); (J.S.)
- Institute of Medical Microbiology, University Hospital Essen, 45122 Essen, Germany
| | | | - Rocío Tejero
- Unit of Microbiology, Hospital Universitario Reina Sofía, 14004 Cordoba, Spain;
| | - Laura Trovato
- U.O.C. Laboratory Analysis Unit, A.O.U. “Policlinico-Vittorio Emanuele”, 95123 Catania, Italy;
- Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy
| | - Lourdes Viñuela
- Servicio de Microbiología Hospital Universitario Río Hortega, 47012 Valladolid, Spain;
| | - Thanwa Wongsuk
- Department of Clinical Pathology, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok 10300, Thailand;
| | - Iwona Żak
- Department of Clinical Microbiology, Children’s University Hospital of Cracow, 30-663 Kraków, Poland;
| | - Hossein Zarrinfar
- Allergy Research Center, Mashhad University of Medical Sciences, Mashhad 91766-99199, Iran;
| | - Cornelia Lass-Flörl
- Department of Hygiene und Medical Microbiology, Medical University of Innsbruck, 6020 Innsbruck, Austria;
| | - Sevtap Arikan-Akdagli
- Department of Medical Microbiology, Hacettepe University Medical School, 06100 Ankara, Turkey;
| | - Ana Alastruey-Izquierdo
- Mycology Reference Laboratory, National Centre for Microbiology, Instituto de Salud Carlos III, 28220 Madrid, Spain; (N.M.); (J.C.S.-D.)
- Correspondence: ; Tel.: +34-918-223-784
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