Abstract
The number of reports of Malassezia furfur bloodstream infections is constantly increasing and there is a need for more simple antifungal susceptibility methods for their management. In this study, a total of 39 M. furfur isolates collected from hospitalized patients with fungemia were screened for antifungal susceptibility to azole and amphotericin B (AmB) using Clinical and Laboratory Standards Institute broth microdilution (CLSI BMD) and E-test in Sabouraud dextrose agar + 1% Tween80 (SDAt) and mDixon agar (DIX). Essential agreement (EA) and discrepancies between the two methods were evaluated after 48 h and 72 h reading times. Itraconazole (ITZ) and posaconazole (POS) displayed the lowest MIC values whereas fluconazole (FLZ) and AmB the highest, regardless of the methods and the reading time. The EA between BMD was >95% for FLZ and voriconazole (VOR) regardless of the media in the E-tests and reading time. The EA between BMD with E-test for AmB was >97% only when E-test in SDAt was used. The EA between BMD and E-test for ITZ and POS varied according to the media in E-test procedures and the reading time and was higher than 66.6% (POS) or 72% (ITZ) only when SABt was used. Substantial discrepancies for ITZ and POS were >5.1% regardless of the media and the reading time. This study suggests that the E-test in SABt represents an alternative method to CLSI BMD to evaluate the susceptibility of M. furfur to FLZ, VOR and AmB and not for ITZ and POS.
Highlights
Malassezia furfur is a lyphophilic commensal organism of human and animal skin that may become pathogenic under the influence of predisposing factors leading to cases of dermatitis in immunocompetent patients as well as bloodstream infections (BSI) in immunocompromised host [1,2,3].Clinical manifestations induced by M. furfur include skin disorders in humans and animals and fungemia in humans [2,3]
The results in repeated experiments obtained with CLSI and E-test were the same or ±1 log2 dilution from the initial results
The MIC values of azoles and amphotericin B (AmB) were higher when tested with E-test in DIX or Sabouraud dextrose agar + 1% Tween80 (SDAt) than those registered by using CLSI BMD (Tables 1 and 2)
Summary
Malassezia furfur is a lyphophilic commensal organism of human and animal skin that may become pathogenic under the influence of predisposing factors leading to cases of dermatitis in immunocompetent patients as well as bloodstream infections (BSI) in immunocompromised host [1,2,3]. Clinical manifestations induced by M. furfur include skin disorders in humans and animals and fungemia in humans [2,3]. The number of human and animal skin infections by Malassezia spp. as well as the occurrence of M. furfur BSI increased. For the treatment of Malassezia-related infections, azoles and the polyene amphotericin B (AmB) are frequently employed both in humans and in animals. Topical antifungal agents (mainly azoles) are adequate for the management of localized skin lesions, while systemic itraconazole (ITZ) or fluconazole (FLZ) for severe skin diseases [3].
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
