A Revised Species Concept for Opportunistic Mucor Species Reveals Species-Specific Antifungal Susceptibility Profiles
A Revised Species Concept for Opportunistic Mucor Species Reveals Species-Specific Antifungal Susceptibility Profiles
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DOI：
10.1128/aac.00653-19
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发表时间：
2019-08-01
影响因子：
4.9
通讯作者：
Walther, Grit
中科院分区：
文献类型：
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作者：
Wagner, Lysett;de Hoog, Sybren;Walther, Grit
近年来，对机会毛霉及其近缘种的种概念进行了修正，将其经典型确认为独立种，并描述了新种。在本研究中，我们使用了所有临床相关毛霉菌种的分离株，并使用EUCAST参考方法进行了药敏试验，以确定潜在的种属特异性药敏模式。测定了101株毛霉属（毛霉属72株）、近缘种反曲科克酵母（3株）、根霉属（12株）、地衣属（10株）和根核霉属（4株）毛霉属菌株对6种抗真菌药（红霉素B、那他霉素、特比萘芬、艾沙康唑、伊曲康唑和泊沙康唑）的体外敏感性。对所有毛霉菌目最具活性的药物是白曲霉素B。致病毛霉属的抗真菌药敏谱对艾沙康唑、伊曲康唑和泊沙康唑具有特异性。该种以前在M.卷枝藻属在它们的抗真菌能力上显示出明显的差异。反曲科克氏菌（Cokeromycesrecurvatus）、阿尔氏毛霉（Mucorardhlaengiktus）、葡萄牙毛霉（Mucorlusitanicus（M.卷枝藻属lusitanicus）和多枝毛霉对所有测试的唑类均表现出高MIC。印度毛霉对艾沙康唑和泊沙康唑的MIC较高，两栖毛霉和不规则毛霉对艾沙康唑的MIC较高。毛霉属的MIC值泊沙康唑、艾沙康唑和伊曲康唑对根霉属和地衣科（地衣属和根毛霉属）的抗性较高。对于毛霉菌属，尤其是唑类药物治疗时，建议结合分子鉴定和体外药敏试验。
Recently, the species concept of opportunistic Mucor circinelloides and its relatives has been revised, resulting in the recognition of its classical formae as independent species and the description of new species. In this study, we used isolates of all clinically relevant Mucor species and performed susceptibility testing using the EUCAST reference method to identify potential species-specific susceptibility patterns. In vitro susceptibility profiles of 101 mucoralean strains belonging to the genus Mucor (72), the closely related species Cokeromyces recurvatus (3), Rhizopus (12), Lichtheirnia (10), and Rhizornucor (4) to six antifungals (amphotericin B, natamycin, terbinafine, isavuconazole, itraconazole, and posaconazole) were determined. The most active drug for all Mucorales was amphotericin B. Antifungal susceptibility profiles of pathogenic Mucor species were specific for isavuconazole, itraconazole, and posaconazole. The species formerly united in M. circinelloides showed clear differences in their antifungal susceptibilities. Cokeromyces recurvatus, Mucor ardhlaengiktus, Mucor lusitanicus (M. circinelloides f. lusitanicus), and Mucor ramosissimus exhibited high MICs to all azoles tested. Mucor indicus presented high MICs for isavuconazole and posaconazole, and Mucor amphibiorum and Mucor irregularis showed high MICs for isavuconazole. MIC values of Mucor spp. for posaconazole, isavuconazole, and itraconazole were high compared to those for Rhizopus and the Lichtheimiaceae (Lichtheirnia and Rhizomucor). Molecular identification combined with in vitro susceptibility testing is recommended for Mucor species, especially if azoles are applied in treatment.