Abstract
Coccidioidomycosis is a systemic fungal infection endemic in Southwestern United States, Mexico, Central and South America. The causal agents are Coccidioides immitis and C. posadasii. A large number of cases of coccidioidomycosis in New York State residents were identified. We compared susceptibility profiles of these isolates and of C. immitis isolates from California using mycelial phase inoculum and CLSI (NCCLS) M38–A broth microdilution protocol. Minimum fungicidal concentrations (MFC) were also determined. Results indicated that geometric mean MICs of amphotericin B (AMB, 0.06 µg/ml), fluconazole (FLC, 8.0 µg/ml), itraconazole (ITC, 0.07 µg/ml), ketoconazole (KTC, 0.04 µg/ml), voriconazole (VRC, 0.04 µg/ml), posaconazole (PSC, 0.17 µg/ml) and caspofungin (CSP, 0.15 µg/ml) were in susceptible range as per breakpoints published for pathogenic Candida species. However, geometric MFC for FLC was relatively higher (52.4 µg/ml). Also, no significant difference in MIC and MFC values was evident for C. immitis and C. posadasii isolates. In conclusion, current methods for antifungal susceptibility testing yield reproducible profiles for Coccidioides species, which appear to be highly susceptible to most antifungal agents.
References
Eulalio KD, de Macedo RL, Cavalcanti MA, Martins LM, Lazera MS, Wanke B. Coccidioides immitis isolated from armadillos (Dasypus novemcinctus) in the state of Piaui, northeast Brazil. Mycopathologia 2001;149:57–61.
Fisher MC, Koenig GL, White TJ, Taylor JW. Molecular and phenotypic description of Coccidioides posadasii sp. Nov., previously recognized as the non-California population of Coccidioides immitis. Mycologia 2002;94:73–84.
Dixon DM. Coccidioides immitis as a select agent of bioterrorism. J Appl Microbiol 2001;91:602–5.
Park BJ, Sigel K, Vaz V, Komatsu K, McRill C, Phelen M, Colman T, Comrie AC, Warnock DW, Hajjeh RA. An epidemic of coccidioidomycosis in Arizona associated with climatic changes, 1998–2001. J Infect Dis 2005;191:1981–7.
Chaturvedi V, Ramani R, Gromadzki S, Rodeghier B, Chang HG, Morse DL. Coccidioidomycosis in New York State. Emerg Infect Dis 2000;6:25–9.
Chuang A, Thomas R, Hoffman RS. Disseminated coccidioidomycosis in an immunocompetent person living in New York City. J Urban Health 2005;82:339–45.
Long JB, Brett AS, Horvath JA. Coccidioidomycosis diagnosed in South Carolina. South Med J 2005;98:930–2.
Youssef SS, Ramu V, Sarubbi FA. Unusual case of pyopneumothorax in Tennessee. South Med J 2005;98:1139–41.
Chowfin A, Tight R. Female genital coccidioidomycosis (FGC), Addison’s disease and sigmoid loop abscess due to Coccidioides immitis; case report and review of literature on FGC. Mycopathologia 1999;145:121–6.
Anstead GM, Corcoran G, Lewis J, Berg D, Graybill JR. Refractory coccidioidomycosis treated with posaconazole. Clin Infect Dis 2005;40:1770–6.
Deresinski SC. Coccidioidomycosis: efficacy of new agents and future prospects. Curr Opin Infect Dis 2001;14:693–6.
Galgiani JN, Catanzaro A, Cloud GA, Johnson RH, Williams PL, Mirels LF, Nassar F, Lutz JE, Stevens DA, Sharkey PK, Singh VR, Larsen RA, Delgado KL, Flanigan C, Rinaldi MG. Comparison of oral fluconazole and itraconazole for progressive, nonmeningeal coccidioidomycosis. A randomized, double-blind trial. Mycoses study group. Ann Intern Med 2000;133:676–86.
Cordeiro RA, Brilhante RS, Rocha MF, Fechine MA, Costa AK, Camargo ZP, Sidrim JJ. In vitro activities of caspofungin, amphotericin B and azoles against Coccidioides posadasii strains from Northeast, Brazil. Mycopathologia 2006;161:21–26.
Gonzalez GM, Fothergill AW, Sutton DA, Rinaldi MG, Loebenberg D. In vitro activities of new and established triazoles against opportunistic filamentous and dimorphic fungi. Med Mycol 2005;43:281–4.
Gonzalez GM, Tijerina R, Najvar LK, Bocanegra R, Rinaldi M, Loebenberg D, Graybill JR. In vitro and in vivo activities of posaconazole against Coccidioides immitis. Antimicrob Agents Chemother 2002;46:1352–6.
Gonzalez GM, Tijerina R, Najvar LK, Bocanegra R, Luther M, Rinaldi MG, Graybill JR. Correlation between antifungal susceptibilities of Coccidioides immitis in vitro and antifungal treatment with caspofungin in a mouse model. Antimicrob Agents Chemother 2001;45:1854–9.
Li RK, Ciblak MA, Nordoff N, Pasarell L, Warnock DW, McGinnis MR. In vitro activities of voriconazole, itraconazole, and amphotericin B against Blastomyces dermatitidis, Coccidioides immitis, and Histoplasma capsulatum. Antimicrob Agents Chemother 2000;44:1734–6.
National Committee for Clinical Laboratory Standards. Reference method for broth dilution antifungal susceptibility testing of conidium-forming filamentous fungi; approved standard, M-38A, vol. 18 no. 3. Wayne: National Committee for Clinical Laboratory Standards; 2002.
Barry AL, Pfaller MA, Brown SD, Espinel-Ingroff A, Ghannoum MA, Knapp C, Rennie RP, Rex JH, Rinaldi MG. Quality control limits for broth microdilution susceptibility tests of ten antifungal agents. J Clin Microbiol 2000;38:3457–9.
Guinea J, Pelaez T, Alcala L, Bouza E. Comparison of sensititre yeastone with the NCCLS M38-A microdilution method to determine the activity of amphotericin B, voriconazole, and itraconazole against clinical isolates of Aspergillus fumigatus. Diagn Microbiol Infect Dis 2006;56:53–5.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Ramani, R., Chaturvedi, V. Antifungal susceptibility profiles of Coccidioides immitis and Coccidioides posadasii from endemic and non-endemic areas. Mycopathologia 163, 315–319 (2007). https://doi.org/10.1007/s11046-007-9018-7
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11046-007-9018-7