艾沙康唑、伏立康唑、两性霉素B对我国多中心临床分离丝状真菌的体外药物敏感性评估

An Evaluation of in Vitro Antifungal Activities of Isavuconazole,Voriconazole and Amphotericin B on Clinical Filamentous Fungi Isolated from Multi-Centres in China

目的:比较艾沙康唑(ISA)和伏立康唑(VOR)及两性霉素B(AMB对我国多中心临床分离的曲霉属和毛霉目菌株的体外药物敏感性。方法:收集2017~2020年来自中国医院侵袭性真菌病监测网(CHIF-NET)北方合作医院的临床分离丝状真菌131株,包含曲霉属105株和毛霉目菌株26株。结果:ISA和VOR对曲霉属的体外活性相似,ISA对毛霉目菌株具有良好的活性,敏感株[最低抑菌浓度(MICs)在0.06~2μg/ml],各有1株卷枝毛霉和总状共头霉对ISA耐药(MIC≥8μg/ml)。而VOR对毛霉目菌株均无活性(MICs在4~>8μg/ml)。AMB对所有检测的毛霉目菌株均具有较强的活性(MICs在0.12~2μg/ml)。结论:本研究证实了ISA对绝大部分毛霉目和曲霉属具有较强的活性,可作为治疗侵袭性霉菌感染(IMIs)的有潜力的药物。

Objective:To compare the in vitro antifungal activities of isavuconazole(ISA),and its comparators[voriconazole(VOR)and amphotericin B(AMB)]against clinical isolates,including Aspergillus species and Mucorales order.Methods:A total of 131 clinical isolates of Aspergillus spp.(n=105)and Mucorales order(n=26)were retrieved between 2017 and 2020 in China Hospital Invasive Fungal Surveillance Net(CHIF-NET)North China Program.Results:ISA and VOR exhibited similar in vitro activity against Aspergillus spp.,and ISA performed an excellent activity against most of isolates of Mucorales order with a MIC range of 0.06~2μg/ml,but resistance to each one isolate of Mucor circinelloides and Syncephalastrum racemosum(MICs≥8μg/ml),respectively.However,VOR exhibited little and/or no activity against the Mucorales order with a MIC range of 4~>8μg/ml.AMB also exhibited an excellent activity against the Mucorales order with a range of 0.12~2μg/ml.Conclusion:This study demonstrated excellent activities of ISA against most species of Mucorales order and Aspergillus spp.,suggesting ISA as a potential alternative to VOR for clinical management of invasive mold infections(IMIs).