Combination of amphotericin B and flucytosine against neurotropic species of melanized fungi causing Primary cerebral phaeohyphomycosis

S. Deng; W. Pan; W. Liao; G. S. De Hoog; A. H G Gerrits Van Den Ende; R. G. Vitale; H. Rafati; M. Ilkit; A. H. Van Der Lee; A. J M M Rijs; P. E. Verweij; S. Seyedmousavi

doi:10.1128/AAC.02526-15

Combination of amphotericin B and flucytosine against neurotropic species of melanized fungi causing Primary cerebral phaeohyphomycosis

S. Deng, W. Pan, W. Liao, G. S. De Hoog, A. H G Gerrits Van Den Ende, R. G. Vitale, H. Rafati, M. Ilkit, A. H. Van Der Lee, A. J M M Rijs, P. E. Verweij, S. Seyedmousavi

Research output: Contribution to journal/periodical › Article › Scientific › peer-review

21 Citations (Scopus)

Abstract

Primary central nervous system phaeohyphomycosis is a fatal fungal infection due mainly to the neurotropic melanized fungi Cladophialophora bantiana , Rhinocladiella mackenziei , and Exophiala dermatitidis. Despite the combination of surgery with antifungal treatment, the prognosis continues to be poor, with mortality rates ranging from 50 to 70%. Therefore, a search for a more-appropriate therapeutic approach is urgently needed. Our in vitro studies showed that with the combination of amphotericin B and flucytosine against these species, the median fractional inhibitory concentration (FIC) indices for strains ranged from 0.25 to 0.38, indicating synergy. By use of Bliss independence analysis, a significant degree of synergy was confirmed for all strains, with the sum ΔE ranging from 90.2 to 698.61%. No antagonism was observed. These results indicate that amphotericin B, in combination with flucytosine, may have a role in the treatment of primary cerebral infections caused by melanized fungi belonging to the order Chaetothyriales . Further in vivo studies and clinical investigations to elucidate and confirm these observations are warranted.

Original language	English
Pages (from-to)	2346-2351
Number of pages	6
Journal	Antimicrobial Agents and Chemotherapy
Volume	60
Issue number	4
DOIs	https://doi.org/10.1128/AAC.02526-15
Publication status	Published - 01 Apr 2016

Access to Document

10.1128/AAC.02526-15

http://www.mendeley.com/research/combination-amphotericin-b-flucytosine-against-neurotropic-species-melanized-fungi-causing-primary-c

Cite this

Deng, S., Pan, W., Liao, W., De Hoog, G. S., Van Den Ende, A. H. G. G., Vitale, R. G., Rafati, H., Ilkit, M., Van Der Lee, A. H., Rijs, A. J. M. M., Verweij, P. E., & Seyedmousavi, S. (2016). Combination of amphotericin B and flucytosine against neurotropic species of melanized fungi causing Primary cerebral phaeohyphomycosis. Antimicrobial Agents and Chemotherapy, 60(4), 2346-2351. https://doi.org/10.1128/AAC.02526-15

@article{7a5777c7a37f44a8b695e6e4fb606094,

title = "Combination of amphotericin B and flucytosine against neurotropic species of melanized fungi causing Primary cerebral phaeohyphomycosis",

abstract = " Primary central nervous system phaeohyphomycosis is a fatal fungal infection due mainly to the neurotropic melanized fungi Cladophialophora bantiana , Rhinocladiella mackenziei , and Exophiala dermatitidis. Despite the combination of surgery with antifungal treatment, the prognosis continues to be poor, with mortality rates ranging from 50 to 70%. Therefore, a search for a more-appropriate therapeutic approach is urgently needed. Our in vitro studies showed that with the combination of amphotericin B and flucytosine against these species, the median fractional inhibitory concentration (FIC) indices for strains ranged from 0.25 to 0.38, indicating synergy. By use of Bliss independence analysis, a significant degree of synergy was confirmed for all strains, with the sum ΔE ranging from 90.2 to 698.61%. No antagonism was observed. These results indicate that amphotericin B, in combination with flucytosine, may have a role in the treatment of primary cerebral infections caused by melanized fungi belonging to the order Chaetothyriales . Further in vivo studies and clinical investigations to elucidate and confirm these observations are warranted. ",

author = "S. Deng and W. Pan and W. Liao and {De Hoog}, {G. S.} and {Van Den Ende}, {A. H G Gerrits} and Vitale, {R. G.} and H. Rafati and M. Ilkit and {Van Der Lee}, {A. H.} and Rijs, {A. J M M} and Verweij, {P. E.} and S. Seyedmousavi",

year = "2016",

month = apr,

day = "1",

doi = "10.1128/AAC.02526-15",

language = "English",

volume = "60",

pages = "2346--2351",

journal = "Antimicrobial Agents and Chemotherapy",

issn = "0066-4804",

publisher = "American Society for Microbiology",

number = "4",

}

Deng, S, Pan, W, Liao, W, De Hoog, GS, Van Den Ende, AHGG, Vitale, RG, Rafati, H, Ilkit, M, Van Der Lee, AH, Rijs, AJMM, Verweij, PE & Seyedmousavi, S 2016, 'Combination of amphotericin B and flucytosine against neurotropic species of melanized fungi causing Primary cerebral phaeohyphomycosis', Antimicrobial Agents and Chemotherapy, vol. 60, no. 4, pp. 2346-2351. https://doi.org/10.1128/AAC.02526-15

TY - JOUR

T1 - Combination of amphotericin B and flucytosine against neurotropic species of melanized fungi causing Primary cerebral phaeohyphomycosis

AU - Deng, S.

AU - Pan, W.

AU - Liao, W.

AU - De Hoog, G. S.

AU - Van Den Ende, A. H G Gerrits

AU - Vitale, R. G.

AU - Rafati, H.

AU - Ilkit, M.

AU - Van Der Lee, A. H.

AU - Rijs, A. J M M

AU - Verweij, P. E.

AU - Seyedmousavi, S.

PY - 2016/4/1

Y1 - 2016/4/1

N2 - Primary central nervous system phaeohyphomycosis is a fatal fungal infection due mainly to the neurotropic melanized fungi Cladophialophora bantiana , Rhinocladiella mackenziei , and Exophiala dermatitidis. Despite the combination of surgery with antifungal treatment, the prognosis continues to be poor, with mortality rates ranging from 50 to 70%. Therefore, a search for a more-appropriate therapeutic approach is urgently needed. Our in vitro studies showed that with the combination of amphotericin B and flucytosine against these species, the median fractional inhibitory concentration (FIC) indices for strains ranged from 0.25 to 0.38, indicating synergy. By use of Bliss independence analysis, a significant degree of synergy was confirmed for all strains, with the sum ΔE ranging from 90.2 to 698.61%. No antagonism was observed. These results indicate that amphotericin B, in combination with flucytosine, may have a role in the treatment of primary cerebral infections caused by melanized fungi belonging to the order Chaetothyriales . Further in vivo studies and clinical investigations to elucidate and confirm these observations are warranted.

AB - Primary central nervous system phaeohyphomycosis is a fatal fungal infection due mainly to the neurotropic melanized fungi Cladophialophora bantiana , Rhinocladiella mackenziei , and Exophiala dermatitidis. Despite the combination of surgery with antifungal treatment, the prognosis continues to be poor, with mortality rates ranging from 50 to 70%. Therefore, a search for a more-appropriate therapeutic approach is urgently needed. Our in vitro studies showed that with the combination of amphotericin B and flucytosine against these species, the median fractional inhibitory concentration (FIC) indices for strains ranged from 0.25 to 0.38, indicating synergy. By use of Bliss independence analysis, a significant degree of synergy was confirmed for all strains, with the sum ΔE ranging from 90.2 to 698.61%. No antagonism was observed. These results indicate that amphotericin B, in combination with flucytosine, may have a role in the treatment of primary cerebral infections caused by melanized fungi belonging to the order Chaetothyriales . Further in vivo studies and clinical investigations to elucidate and confirm these observations are warranted.

U2 - 10.1128/AAC.02526-15

DO - 10.1128/AAC.02526-15

M3 - Article

C2 - 26833164

SN - 0066-4804

VL - 60

SP - 2346

EP - 2351

JO - Antimicrobial Agents and Chemotherapy

JF - Antimicrobial Agents and Chemotherapy

IS - 4

ER -

Combination of amphotericin B and flucytosine against neurotropic species of melanized fungi causing Primary cerebral phaeohyphomycosis

Abstract

Access to Document

Fingerprint

Cite this