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In Vitro Antifungal Susceptibility of Yeast and Mold Phases of Isolates of Dimorphic Fungal Pathogen Emergomyces africanus (Formerly Emmonsia sp.) from HIV-Infected South African Patients.

Publication ,  Journal Article
Maphanga, TG; Britz, E; Zulu, TG; Mpembe, RS; Naicker, SD; Schwartz, IS; Govender, NP
Published in: J Clin Microbiol
June 2017

Disseminated emmonsiosis is an important AIDS-related mycosis in South Africa that is caused by Emergomycesafricanus, a newly described and renamed dimorphic fungal pathogen. In vitro antifungal susceptibility data can guide management. Identification of invasive clinical isolates was confirmed phenotypically and by sequencing of the internal transcribed spacer region. Yeast and mold phase MICs of fluconazole, voriconazole, itraconazole, posaconazole, caspofungin, anidulafungin, micafungin, and flucytosine were determined with custom-made frozen broth microdilution (BMD) panels in accordance with Clinical and Laboratory Standards Institute recommendations. MICs of amphotericin B, itraconazole, posaconazole, and voriconazole were determined by Etest. Fifty unique E. africanus isolates were tested. The yeast and mold phase geometric mean (GM) BMD and Etest MICs of itraconazole were 0.01 mg/liter. The voriconazole and posaconazole GM BMD MICs were 0.01 mg/liter for both phases, while the GM Etest MICs were 0.001 and 0.002 mg/liter, respectively. The fluconazole GM BMD MICs were 0.18 mg/liter for both phases. The GM Etest MICs of amphotericin B, for the yeast and mold phases were 0.03 and 0.01 mg/liter. The echinocandins and flucytosine had very limited in vitro activity. Treatment and outcome data were available for 37 patients; in a multivariable model including MIC data, only isolation from blood (odds ratio [OR], 8.6; 95% confidence interval [CI], 1.3 to 54.4; P = 0.02) or bone marrow (OR, 12.1; 95% CI, 1.2 to 120.2; P = 0.03) (versus skin biopsy) was associated with death. In vitro susceptibility data support the management of disseminated emmonsiosis with amphotericin B, followed by itraconazole, voriconazole, or posaconazole. Fluconazole was a relatively less potent agent.

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Published In

J Clin Microbiol

DOI

EISSN

1098-660X

Publication Date

June 2017

Volume

55

Issue

6

Start / End Page

1812 / 1820

Location

United States

Related Subject Headings

  • South Africa
  • Sequence Analysis, DNA
  • Mycoses
  • Microbiology
  • Microbial Sensitivity Tests
  • Male
  • Humans
  • HIV Infections
  • Female
  • DNA, Ribosomal Spacer
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Maphanga, T. G., Britz, E., Zulu, T. G., Mpembe, R. S., Naicker, S. D., Schwartz, I. S., & Govender, N. P. (2017). In Vitro Antifungal Susceptibility of Yeast and Mold Phases of Isolates of Dimorphic Fungal Pathogen Emergomyces africanus (Formerly Emmonsia sp.) from HIV-Infected South African Patients. J Clin Microbiol, 55(6), 1812–1820. https://doi.org/10.1128/JCM.02524-16
Maphanga, Tsidiso G., Erika Britz, Thokozile G. Zulu, Ruth S. Mpembe, Serisha D. Naicker, Ilan S. Schwartz, and Nelesh P. Govender. “In Vitro Antifungal Susceptibility of Yeast and Mold Phases of Isolates of Dimorphic Fungal Pathogen Emergomyces africanus (Formerly Emmonsia sp.) from HIV-Infected South African Patients.J Clin Microbiol 55, no. 6 (June 2017): 1812–20. https://doi.org/10.1128/JCM.02524-16.
Maphanga, Tsidiso G., et al. “In Vitro Antifungal Susceptibility of Yeast and Mold Phases of Isolates of Dimorphic Fungal Pathogen Emergomyces africanus (Formerly Emmonsia sp.) from HIV-Infected South African Patients.J Clin Microbiol, vol. 55, no. 6, June 2017, pp. 1812–20. Pubmed, doi:10.1128/JCM.02524-16.
Maphanga TG, Britz E, Zulu TG, Mpembe RS, Naicker SD, Schwartz IS, Govender NP. In Vitro Antifungal Susceptibility of Yeast and Mold Phases of Isolates of Dimorphic Fungal Pathogen Emergomyces africanus (Formerly Emmonsia sp.) from HIV-Infected South African Patients. J Clin Microbiol. 2017 Jun;55(6):1812–1820.

Published In

J Clin Microbiol

DOI

EISSN

1098-660X

Publication Date

June 2017

Volume

55

Issue

6

Start / End Page

1812 / 1820

Location

United States

Related Subject Headings

  • South Africa
  • Sequence Analysis, DNA
  • Mycoses
  • Microbiology
  • Microbial Sensitivity Tests
  • Male
  • Humans
  • HIV Infections
  • Female
  • DNA, Ribosomal Spacer