In vitro susceptibility of filamentous fungi from mycotic keratitis to azole drugs

The in vitro antifungal activities of azole drugs viz., itraconazole, voriconazole, ketoconazole, econazole and clotrimazole were investigated in order to evaluate their efficacy against filamentous fungi isolated from mycotic keratitis. The specimen collection was carried out from fungal keratitis...

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Published in:	Journal de mycologie médicale Vol. 25; no. 1; pp. 44 - 49
Main Authors:	Shobana, C.S., Mythili, A., Homa, M., Galgóczy, L., Priya, R., Babu Singh, Y.R., Panneerselvam, K., Vágvölgyi, C., Kredics, L., Narendran, V., Manikandan, P.
Format:	Journal Article
Language:	English
Published:	France Elsevier Masson SAS 01-03-2015
Subjects:	Alternaria Antifungal Agents - pharmacology Antifungal susceptibility and azole drugs Aspergillus flavus Azoles - pharmacology Bipolaris Corneal Ulcer - drug therapy Corneal Ulcer - microbiology Curvularia Drug Resistance, Fungal - drug effects Exophiala Eye Infections, Fungal - drug therapy Eye Infections, Fungal - microbiology Fungal isolates Fungi - drug effects Fungi - isolation & purification Fusarium Humans Itraconazole - pharmacology Keratitis - drug therapy Keratitis - microbiology Ketoconazole - pharmacology Kératite mycosique Microbial Sensitivity Tests - methods Mycotic keratitis Médicaments azolés Sensibilité aux antifongique Fungal isolates Sensibilité aux antifongique Antifungal susceptibility and azole drugs Kératite mycosique Médicaments azolés Mycotic keratitis
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Summary:	The in vitro antifungal activities of azole drugs viz., itraconazole, voriconazole, ketoconazole, econazole and clotrimazole were investigated in order to evaluate their efficacy against filamentous fungi isolated from mycotic keratitis. The specimen collection was carried out from fungal keratitis patients attending Aravind eye hospital and Post-graduate institute of ophthalmology, Coimbatore, India and was subsequently processed for the isolation of fungi. The dilutions of antifungal drugs were prepared in RPMI 1640 medium. Minimum inhibitory concentrations (MICs) were determined and MIC50 and MIC90 were calculated for each drug tested. A total of 60 fungal isolates were identified as Fusarium spp. (n=30), non-sporulating moulds (n=9), Aspergillus flavus (n=6), Bipolaris spp. (n=6), Exserohilum spp. (n=4), Curvularia spp. (n=3), Alternaria spp. (n=1) and Exophiala spp. (n=1). The MICs of ketoconazole, clotrimazole, voriconazole, econazole and itraconazole for all the fungal isolates ranged between 16μg/mL and 0.03μg/mL, 4μg/mL and 0.015μg/mL, 8μg/mL and 0.015μg/mL, 8μg/mL and 0.015μg/mL and 32μg/mL and 0.06μg/mL respectively. From the MIC50 and MIC90 values, it could be deciphered that in the present study, clotrimazole was more active against the test isolates at lower concentrations (0.12–5μg/mL) when compared to other drugs tested. The results suggest that amongst the tested azole drugs, clotrimazole followed by voriconazole and econazole had lower MICs against moulds isolated from mycotic keratitis. L’activité antifongique in vitro des azolés à savoir, l’itraconazole, le voriconazole, le kétoconazole, l’éconazole et le clotrimazole a été étudiée afin d’évaluer leur efficacité vis-à-vis des champignons filamenteux isolés de kératite mycosique. Les échantillons provenant de patients consultant pour kératite fongique au Aravind Eye Hospital et au Post-Graduate Institute of Ophthalmology, Coimbatore, en Inde ont été mis en culture pour recherche de champignons. Les dilutions des antifongiques ont été réalisées en RPMI 1640. Les concentrations minimales inhibitrices (CMI) ont été déterminées et les CMI50 et CMI90 ont été calculées pour chaque antifongique étudié. Soixante souches de champignons ont été isolées: Fusarium spp. (n=30), moisissures ne fructifiant pas (n=9), Aspergillus flavus (n=6), Bipolaris spp. (n=6), Exserohilum spp. (n=4), Curvularia spp. (n=3), Alternaria spp. (n=1) et Exophiala spp. (n=1). Les CMI du kétoconazole, du clotrimazole, du voriconazole, de l’itraconazole et de l’éconazole vis-à-vis de l’ensemble des isolats fongiques variaient respectivement entre 16μg/mL et 0,03μg/mL, 4μg/mL et 0,015μg/mL, 8μg/mL et 0,015μg/mL, 8μg/mL et 0,015μg/mL et 32μg/mL et 0,06μg/mL. À partir des valeurs des CMI50 et CMI90 que nous avons obtenues, le clotrimazole serait la molécule la plus active vis-à-vis des isolats étudiés, avec des concentrations (0,12 à 5μg/mL) plus faibles que celles des autres antifongiques testés. Les résultats suggèrent que, parmi les antifongiques azolés testés, le clotrimazole suivi par le voriconazole et l’éconazole avaient les CMI les plus basses vis-à-vis des moisissures isolées de kératites mycosiques.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1156-5233 1773-0449
DOI:	10.1016/j.mycmed.2014.10.024