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Virulence Attributes and Antifungal Susceptibility Profile of Opportunistic Fungi Isolated from Ophthalmic Infections

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Abstract

Investigations of both virulence factors and antifungal susceptibility profiles are crucial for understanding the pathogenesis and prognosis of ophthalmic mycoses. In this study, we investigated the in vitro antifungal susceptibility of amphotericin B (AMB), voriconazole (VRC), and natamycin (NAT) against a set of 50 fungal isolates obtained from patients with ocular mycoses using the Clinical and Laboratory Standards Institute broth microdilution method. In addition, putative virulence factor, such as secretory phospholipases and proteinases, and biofilm formation activity were analyzed. The geometric means (GMs) of the minimum inhibitory concentrations (MICs) of the antifungals across all isolates were the following (in increasing order): VRC (0.70 μg/mL), AMB (0.81 μg/mL), and NAT (1.05 μg/mL). The highest activity against 14 Aspergillus strains was exhibited by VRC (GM MIC: 0.10 μg/mL), followed by AMB and NAT (GM MICs: 0.21 and 0.27 μg/mL), respectively. However, for 12 Fusarium spp., the GM MIC of VRC (2.66) was higher than those of NAT and AMB (GM MICs 1.3 and 0.8 μg/mL, respectively). Proteinase and phospholipase activity were observed in 30 % and 42 % of the isolates, respectively, whereas only 8 % of the isolates were able to produce biofilms. Phospholipase activity was observed in all Fusarium isolates, but not in any of the Aspergillus isolates. In contrast, biofilm-forming capability was detected in 25 % of the Fusarium isolates, but none of the Aspergillus isolates. The differences in the MICs of AMB, VRC, and NAT, biofilm-forming ability and proteinase and phospholipase activities among the isolates were not significant (p > 0.05). Overall, our study suggests no significant correlation between the antifungal susceptibility profiles and virulence attributes of ocular fungal isolates.

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Acknowledgments

Ocular fungal isolates were provided by Havva Gül Özdemir from the CBS-KNAW Fungal Biodiversity Centre, Utrecht, The Netherlands.

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Author notes

  1. Seyedmojtaba Seyedmousavi

    Present address: Laboratory of Clinical Infectious Diseases, National Institute of Allergy and Infectious Diseases (NIAID), National Institute of Health (NIH), Bethesda, MD, USA

Authors and Affiliations

  1. Division of Mycology, Department of Microbiology, Cerrahpaşa Faculty of Medicine, Istanbul University, 34098, Istanbul, Turkey

    Hafize Sav, Rabiye Altınbas & Nuri Kiraz

  2. Division of Ophthalmology, Medicosocial Health Center, University of Çukurova, Adana, Turkey

    Havva Gül Ozdemir

  3. Division of Mycology, Department of Microbiology, Faculty of Medicine, University of Çukurova, Adana, Turkey

    Macit Ilkit

  4. Department of Medical Microbiology and Infectious Diseases, Erasmus MC, Rotterdam, The Netherlands

    Seyedmojtaba Seyedmousavi

  5. Department of Medical Microbiology, Radboud UMC, Nijmegen, The Netherlands

    Seyedmojtaba Seyedmousavi

  6. Invasive Fungi Research Center, Mazandaran University of Medical Sciences, Sari, Iran

    Seyedmojtaba Seyedmousavi

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  1. Hafize Sav
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Correspondence to Hafize Sav.

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Conflict of interest

S.S. has received research and travel grants from Astellas Pharma B.V. and a travel grant from Gilead Sciences. All other authors have no conflicts of interests.

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Sav, H., Ozdemir, H.G., Altınbas, R. et al. Virulence Attributes and Antifungal Susceptibility Profile of Opportunistic Fungi Isolated from Ophthalmic Infections. Mycopathologia 181, 653–661 (2016). https://doi.org/10.1007/s11046-016-0018-3

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