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Susceptibility profile of echinocandins, azoles and amphotericin B against yeast phase of Talaromyces marneffei isolated from HIV-infected patients in Guangdong, China

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Abstract

Talaromyces marneffei (T. marneffei) can cause talaromycosis, a fatal systemic mycosis, in patients with AIDS. With the increasing number of talaromycosis cases in Guangdong, China, we aimed to investigate the susceptibility of 189 T. marneffei clinical strains to eight antifungal agents, including three echinocandins (anidulafungin, micafungin, and caspofungin), four azoles (posaconazole, itraconazole, voriconazole, and fluconazole), and amphotericin B, with determining minimal inhibition concentrations (MIC) by Sensititre YeastOne™ YO10 assay in the yeast phase. The MICs of anidulafungin, micafungin, caspofungin, posaconazole, itraconazole, voriconazole, fluconazole, and amphotericin B were 2 to > 8 μg/ml, >8 μg/ml, 2 to > 8 μg/ml, ≤ 0.008 to 0.06 μg/ml, ≤ 0.015 to 0.03 μg/ml, ≤ 0.008 to 0.06 μg/ml, 1 to 32 μg/ml, and ≤ 0.12 to 1 μg/ml, respectively. The MICs of all echinocandins were very high, while the MICs of posaconazole, itraconazole, and voriconazole, as well as amphotericin B were comparatively low. Notably, fluconazole was found to have a higher MIC than other azoles, and exhibited particularly weak activity against some isolates with MICs over 8 μg/ml. Our data in vitro support the use of amphotericin B, itraconazole, voriconazole, and posaconazole in management of talaromycosis and suggest potential resistance to fluconazole.

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References

  1. Vanittanakom N, Cooper CR Jr, Fisher MC, Sirisanthana T (2006) Penicillium marneffei infection and recent advances in the epidemiology and molecular biology aspects. Clin Microbiol Rev 19(1):95–110. https://doi.org/10.1128/CMR.19.1.95-110.2006

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Chan JF, Lau SK, Yuen KY, Woo PC (2016) Talaromyces (Penicillium) marneffei infection in non-HIV-infected patients. Emerg Microbes Infect 5:e19. https://doi.org/10.1038/emi.2016.18

    Article  PubMed  PubMed Central  Google Scholar 

  3. Peng J, Chen Z, Cai R, Huang X, Lin L, Liang W, Xiong Z, Chen J, Chen H, Yang Y, Liu S, Jiang Q (2017) Recovery from Talaromyces marneffei involving the kidney in a renal transplant recipient: a case report and literature review. Transpl Infect Dis 19(4). https://doi.org/10.1111/tid.12710

  4. Luo DQ, Chen MC, Liu JH, Li Z, Li HT (2011) Disseminated Penicillium marneffei infection in an SLE patient: a case report and literature review. Mycopathologia 171(3):191–196. https://doi.org/10.1007/s11046-010-9363-9

    Article  PubMed  Google Scholar 

  5. Le T, Wolbers M, Chi NH, Quang VM, Chinh NT, Lan NP, Lam PS, Kozal MJ, Shikuma CM, Day JN, Farrar J (2011) Epidemiology, seasonality, and predictors of outcome of AIDS-associated Penicillium marneffei infection in Ho Chi Minh City, Viet Nam. Clin Infect Dis 52(7):945–952. https://doi.org/10.1093/cid/cir028

    Article  PubMed  PubMed Central  Google Scholar 

  6. Nong S, Liang J (2013) Bone marrow Penicillium marneffei infection in acquired immunodeficiency syndrome patients: report of 35 cases. Trop Biomed 30(1):89–91

    CAS  PubMed  Google Scholar 

  7. Cao C, Liang L, Wang W, Luo H, Huang S, Liu D, Xu J, Henk DA, Fisher MC (2011) Common reservoirs for Penicillium marneffei infection in humans and rodents, China. Emerg Infect Dis 17(2):209–214. https://doi.org/10.3201/eid1702.100718

    Article  PubMed  PubMed Central  Google Scholar 

  8. Masur H, Brooks JT, Benson CA, Holmes KK, Pau AK, Kaplan JE, National Institutes of H, Centers for Disease C, Prevention, America HIVMAotIDSo (2014) Prevention and treatment of opportunistic infections in HIV-infected adults and adolescents: updated guidelines from the Centers for Disease Control and Prevention, National Institutes of Health, and HIV Medicine Association of the Infectious Diseases Society of America. Clin Infect Dis 58(9):1308–1311. https://doi.org/10.1093/cid/ciu094

    Article  PubMed  PubMed Central  Google Scholar 

  9. Ouyang Y, Cai S, Liang H, Cao C (2017) Administration of voriconazole in disseminated Talaromyces (Penicillium) marneffei infection: a retrospective study. Mycopathologia 182(5–6):569–575. https://doi.org/10.1007/s11046-016-0107-3

    Article  CAS  PubMed  Google Scholar 

  10. Li HR, Cai SX, Chen YS, Yu ME, Xu NL, Xie BS, Lin M, Hu XL (2016) Comparison of Talaromyces marneffei infection in human immunodeficiency virus-positive and human immunodeficiency virus-negative patients from Fujian, China. Chin Med J 129(9):1059–1065. https://doi.org/10.4103/0366-6999.180520

    Article  PubMed  PubMed Central  Google Scholar 

  11. Pappas PG, Kauffman CA, Andes DR, Clancy CJ, Marr KA, Ostrosky-Zeichner L, Reboli AC, Schuster MG, Vazquez JA, Walsh TJ, Zaoutis TE, Sobel JD (2016) Clinical practice guideline for the Management of Candidiasis: 2016 update by the Infectious Diseases Society of America. Clin Infect Dis 62(4):e1–50. https://doi.org/10.1093/cid/civ933

    Article  PubMed  Google Scholar 

  12. Clark NM, Grim SA, Lynch JP 3rd (2015) Posaconazole: use in the prophylaxis and treatment of fungal infections. Semin Respir Crit Care Med 36(5):767–785. https://doi.org/10.1055/s-0035-1562902

    Article  PubMed  Google Scholar 

  13. Vanittanakom N, Vanittanakom P, Hay RJ (2002) Rapid identification of Penicillium marneffei by PCR-based detection of specific sequences on the rRNA gene. J Clin Microbiol 40(5):1739–1742. https://doi.org/10.1128/JCM.40.5.1739-1742.2002

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Chaiwarith R, Supparatpinyo K (2016) Talaromyces (Penicillium) marneffei and HIV.1–9. https://doi.org/10.1007/978-1-4614-9610-6_419-1

  15. Liu D, Liang L, Chen J (2013) In vitro antifungal drug susceptibilities of Penicillium marneffei from China. J Infect Chemother 19(4):776–778. https://doi.org/10.1007/s10156-012-0511-7

    Article  CAS  PubMed  Google Scholar 

  16. Lau SKP, Lo GCS Lam CS, Chow WN, Ngan AH, Wu AK, Tsang DN, Tse CW, Que TL, Tang BS, Woo PC (2017) In vitro activity of posaconazole against Talaromyces marneffei by broth microdilution and Etest methods and comparison to itraconazole, voriconazole, and anidulafungin. Antimicrob Agents Chemother 61 (3). https://doi.org/10.1128/AAC.01480-16

  17. Alexander BD, Byrne TC, Smith KL, Hanson KE, Anstrom KJ, Perfect JR, Reller LB (2007) Comparative evaluation of Etest and sensititre yeastone panels against the clinical and laboratory standards institute M27-A2 reference broth microdilution method for testing Candida susceptibility to seven antifungal agents. J Clin Microbiol 45(3):698–706. https://doi.org/10.1128/JCM.01840-06

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Clinical and Laboratory Standards Institute (2013) Reference method for broth dilution antifungal susceptibility testing of yeasts. Fourth Informat Suppl 32:1–23

    Google Scholar 

  19. Nakai T, Uno J, Ikeda F, Tawara S, Nishimura K, Miyaji M (2003) In vitro antifungal activity of micafungin (FK463) against dimorphic fungi: comparison of yeast-like and mycelial forms. Antimicrob Agents Chemother 47(4):1376–1381. https://doi.org/10.1128/aac.47.4.1376-1381.2003

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Zekaver O, Paetznick VL, Rodriguez JR, Enuo C, Ostrosky-Zeichner L (2004) In vitro activity of anidulafungin against selected clinically important mold isolates. Antimicrob Agents Chemother 48(5):1912–1915. https://doi.org/10.1128/AAC.48.5.1912-1915.2003

    Article  Google Scholar 

  21. Sapmak A, Kaewmalakul J, Nosanchuk JD, Vanittanakom N, Andrianopoulos A, Pruksaphon K, Youngchim S (2016) Talaromyces marneffei laccase modifies THP-1 macrophage responses. Virulence 7(6):702–717. https://doi.org/10.1080/21505594.2016.1193275

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Goncalves D, Ferraz C, Vaz L (2013) Posaconazole as rescue therapy in African histoplasmosis. Braz J Infect Dis 17(1):102–105. https://doi.org/10.1016/j.bjid.2012.06.027

    Article  PubMed  Google Scholar 

  23. Schein R, Homans J, Larsen RA, Neely M (2011) Posaconazole for chronic refractory coccidioidal meningitis. Clin Infect Dis 53(12):1252–1254. https://doi.org/10.1093/cid/cir734

    Article  PubMed  Google Scholar 

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Acknowledgements

We thank Thomas Fitzpatrick (University of Washington School of Medicine) for the language organization and editing.

Funding

The study was supported by the National Natural Science Foundation of China (Grant No. 81301480).

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Author notes

  1. H.-L. Lei and L.-H. Li contributed equally to this work.

Authors and Affiliations

  1. Research Institute of Infectious Diseases, Guangzhou Eighth People’s Hospital, Guangzhou Medical University, Guangzhou, Guangdong Province, 510060, People’s Republic of China

    H.-L. Lei, F.-Y. Hu & X.-P. Tang

  2. Department of Infectious Diseases, Guangzhou Eighth People’s Hospital, Guangzhou Medical University, Guangzhou, Guangdong Province, 510060, People’s Republic of China

    L.-H. Li, X.-J. Chen & W.-P. Cai

  3. Department of Clinical Laboratory, Guangzhou Eighth People’s Hospital, Guangzhou Medical University, Guangzhou, Guangdong Province, 510060, People’s Republic of China

    W.-S. Chen & W.-N. Song

  4. Department of Medical Ultrasonics, Guangzhou First People’s Hospital, Guangzhou, Guangdong Province, 510060, People’s Republic of China

    Y. He

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  1. H.-L. Lei
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Correspondence to X.-P. Tang.

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Ethical statement and informed consent

This study was approved by the institutional review board of Guangzhou Eighth People’s Hospital, which contained only sub-cultured clinical T. marneffei isolates and all patient information were anonymised. Informed consent was not required in this work.

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Lei, HL., Li, LH., Chen, WS. et al. Susceptibility profile of echinocandins, azoles and amphotericin B against yeast phase of Talaromyces marneffei isolated from HIV-infected patients in Guangdong, China. Eur J Clin Microbiol Infect Dis 37, 1099–1102 (2018). https://doi.org/10.1007/s10096-018-3222-x

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  • DOI: https://doi.org/10.1007/s10096-018-3222-x

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