Amphotericin B in vitro resistance is associated with fatal Aspergillus flavus infection

Medical Mycology
Inès HadrichStéphane Ranque

Abstract

Whether in vitro antifungal susceptibility findings correlate with the outcome of patients with invasive aspergillosis (IA) remains debated. This study aimed to test whether IA patients' outcomes were associated with in vitro susceptibility results. To do so, we determined the in vitro susceptibility to amphotericin B (AMB) of 37 Aspergillus flavus isolates from 14 patients with haematological malignancies diagnosed with proven or probable IA, of which 13 were treated with AMB deoxycholate. Minimal inhibitory concentrations (MICs) were determined by Etest with the isolates classified as in vitro sensitive (AMB-S) or resistant (AMB-R) if their MICs were < 2 or ≥ 2 mg/l, respectively. The association of the patients' death with primary disease, administered antifungal treatment, and infection with AMB-R A. flavus was tested using generalized estimating equations logistic regression. We assessed AMB-R in 31/37 (84%) isolates. In the patients treated with AMB, the survival rate was 2/3 (67%) and 2/9 (22%) for those infected with AMB-S or AMB-R A. flavus, respectively. Both infection with AMB-R A. flavus (P = 0.014) strain and acute myelocytic leukaemia as the underlying primary disease (P = 0.036) were independent predictors of dea...Continue Reading

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Citations

Oct 15, 2013·Applied and Environmental Microbiology·Kiril TuntevskiSlawomir Lukomski
Jan 27, 2016·Mycoses·Sarah Santos GonçalvesArnaldo Lopes Colombo
Apr 23, 2014·British Journal of Haematology·Laura Alcazar-Fuoli, Emilia Mellado
Sep 21, 2015·Comparative Immunology, Microbiology and Infectious Diseases·Jessica J TalbotVanessa R Barrs
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Jun 6, 2016·Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases·M GautierS Ranque
Dec 12, 2019·Frontiers in Microbiology·Soraia L LimaJoão N de Almeida Junior
Dec 1, 2012·Current Fungal Infection Reports·Cau D Pham, Shawn R Lockhart

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