JAC Advance Access published online on November 28, 2002
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkg020
© 2002 by The British Society for Antimicrobial Chemotherapy
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Original Paper
1 Department of Medical Microbiology, University Medical Center St Radboud, PO Box 9101,
6500 HB Nijmegen
* Corresponding author. E-mail: p.verweij{at}mmb.azn.nl.
Received 5 November 2001
; revised 4 June 2002
; accepted 27 September 2002
In vitro susceptibilities of 36 zygomycete
isolates, belonging to six genera, to itraconazole, posaconazole,
voriconazole, terbinafine, amphotericin B and 5-fluorocytosine were
determined by using a broth microdilution adaptation of the National
Committee for Clinical Laboratory Standards M-38P reference method.
The influence of incubation time on MIC values, and the performance
of a spectrophotometric method for MIC determination in comparison
with the visual reference method, were also evaluated. Amphotericin
B was active against most of the isolates. All the isolates were
highly resistant to 5-fluorocytosine (MICs > 256 mg/L).
Voriconazole was significantly less active than the other drugs
with an overall MIC90 (MIC at which 90% of the isolates
were inhibited) of 32 mg/L. In contrast, posaconazole showed good
activity (MIC90 1 mg/L). A wide range of MICs, from 0.03
to
In vitro susceptibilities of zygomycetes to conventional
and
new antifungals
2 Department of Medical Microbiology, Canisius-Wilhelmina
Hospital, PO Box 9015, 6500 GS, Nijmegen, The Netherlands
32 mg/L, was obtained for itraconazole
and terbinafine. Differences in susceptibility between and within
genera were noted. Rhizopus spp. were significantly
less susceptible to itraconazole, posaconazole, terbinafine and
amphotericin B than Absidia spp., and less susceptible
than Mucor spp. to amphotericin B. Terbinafine
appeared to be more active against Rhizopus microsporus than
against Rhizopus oryzae (geometric mean MIC of
0.15 and 64 mg/L, respectively). The activity of the drugs was dependent
on the incubation period. A significant increase in MICs was noted
between 24 and 48 h of incubation. On the other hand, the two methods
used for MIC determination (visual and spectrophotometric readings) showed
good agreement. These results suggest that the zygomycetes are a
heterogeneous group for antifungal susceptibility. Some of the conventional
and new antifungals are effective in vitro; their
efficacies in vivo remain to be determined. The
spectrophotometric method appears to be a valuable alternative to
the visual method for MIC determination for zygomycetes.
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