Scopulariopsis brevicaulis: a Fungal Pathogen Resistant to Broad-Spectrum Antifungal Agents.

M. CUENCA-ESTRELLA, E. MELLADO, A. GOMEZ-LOPEZ, A. MONZON, J.L. RODRIGUEZ-TUDELA

Abstract: 

Background: S. brevicaulis (Sb) is a common soil saprophyte that has been associated with cases of onychomycosis, fungus ball, keratitis, pneumonia, endocarditis and subcutaneous infections. Some isolates of Sb have demonstrated to be pathogenic in murine model of disseminated infections. Several reports have suggested that Sb is resistant in vitro to antifungal agents available today. We have analyzed the activity of antifungal agents against clinical isolates of Sb. Methods: A panel of 25 clinical isolates were included. Candida krusei ATCC6258 and Candida parapsilosis ATCC22019 were used as QC strains. Fungi were tested using the NCCLS M38-P standard vs. amphotericin B (AMB), flucytosine (5FC), fluconazole (FLZ), itraconazole (ITZ), voriconazole (VRZ), and terbinafina (TBF). Results: All strains had been isolated from skin and nails. There was not history of antifungal treatment in 15 patients (60%). The mode and geometric mean per antifungal agent studied were as follows: (i) AMB: 16 µg/ml and 13 µg/ml; (ii) 5FC: >128 µg/ml and >128 µg/ml; (iii) FLZ: >128 µg/ml and >128 µg/ml; (iv) ITZ: >8 µg/ml and >8 µg/ml; (v) VRZ: 32 µg/ml and 25.8 µg/ml; (vi) TBF: >16 µg/ml and 14.4 µg/ml. Conclusions: (i)Scopulariopsis brevicaulis is a multi-resistant species to broad-spectrum antifungal agents available today. (ii) It could be a species intrinsically resistant to antifungal agents. (iii) Taking into account its resistance in vitro, invasive infections due to Sb are unlikely to respond to particular antifungal treatment, and other therapeutic approaches should be considered (combined therapy, immunotherapy...).
2002

abstract No: 

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Full conference title: 

42nd Interscience Conference on Antimicrobial Agents and Chemotherapy
    • ICAAC 42nd