Details

Autor(en) / Beteiligte

• Haghani, Iman
• Yahyazadeh, Zahra
• Hedayati, Mohammad Taghi
• Shokohi, Tahereh
• Badali, Hamid
• Khojasteh, Shaghayegh
• Akhtari, Javad
• Javidnia, Javad
• Moazeni, Maryam
• Al-Harrasi, Ahmed
• Aghili, Seyed Reza
• Kermani, Firoozeh
• Hajheydari, Zohreh
• Al Hatmi, Abdullah M.S.
• Abastabar, Mahdi

Titel

Antifungal activity of miltefosine against both azole-susceptible and -resistant Aspergillus strains

Ist Teil von

• International journal of antimicrobial agents, 2023-03, Vol.61 (3), p.106715-106715, Article 106715

Ort / Verlag

Netherlands: Elsevier Ltd

Erscheinungsjahr

2023

Quelle

MEDLINE

Beschreibungen/Notizen

• •In immunocompromised populations, the prevalence of invasive aspergillosis (IA) has increased, particularly among patients with haematological malignancies, those receiving solid organ or stem cell transplants, and those taking immunosuppressive agents. The Aspergillus genus has primary resistance to antifungal agents, so there is a need for new therapeutic options.•The broth microdilution method (M38-A2) was used to assess the in-vitro susceptibility of 108 clinical and environmental azole-susceptible and -resistant Aspergillus strains isolated from Iran and other countries to an antiparasitic agent (miltefosine) and two antifungal agents (itraconazole and voriconazole).•Miltefosine appears to have a good in-vitro activity antifungal against azole-resistant Aspergillus strains.•Miltefosine could be a promising treatment for invasive or superficial aspergillosis caused by azole-resistant isolates. Miltefosine, an alkylphosphocholine, has been approved recently for the treatment of visceral leishmaniasis. Miltefosine has shown promise as a treatment for paracoccidioidomycosis, and has mixed activity against other fungi and yeast. There are limited data on the in-vitro activity of miltefosine against azole-resistant and -susceptible Aspergillus spp. As such, the aim of this study was to determine the in-vitro activity of miltefosine against Aspergillus strains. Miltefosine was tested against 108 azole-susceptible and -resistant Aspergillus strains isolated from Iran and other countries using the broth microdilution method. Miltefosine was found to be effective against azole-resistant Aspergillus isolates, with minimum inhibitory concentrations (MICs) ranging from 1.562 to 6.25 µg/mL. MIC50 and MIC90 were 1.562 and 3.125 µg/mL, respectively. Miltefosine had a higher geometric mean MIC (2.459 µg/mL) for wild-type Aspergillus isolates than itraconazole (0.220 µg/mL) and voriconazole (0.298 µg/mL). No significant difference was found between miltefosine MICs for azole-resistant Aspergillus isolates and azole-susceptible Aspergillus isolates (P>0.05). Miltefosine appears to have good in-vitro activity against azole-resistant Aspergillus strains, according to these findings. Furthermore, the findings suggest that miltefosine could be used to treat infections caused by azole-resistant Aspergillus spp.