TABLE 2.
In vitro antifungal susceptibility data for 217 clinical isolates of zygomycetous fungi
| Organism (no. of isolates tested) | Antifungal agent (breakpoint, μg/ml)a | MIC (μg/ml)
|
% Susceptible (no. of isolates tested)b | ||
|---|---|---|---|---|---|
| Range | 50% | 90% | |||
| Rhizopus sp. (101) | AMB (≤1) | 0.03-0.5 | 0.25 | 0.5 | 100 (86) |
| 5-FC (≤16) | >64 | NAc | NA | 0 (4) | |
| KTC (≤4) | 1-16 | 1 | NA | 83 (6) | |
| ITC (≤0.5) | 0.03->8 | 0.5 | 4 | 62 (50) | |
| FLC (≤32) | >64 | >64 | >64 | 0 (14) | |
| VRC (≤2) | 2->8 | 8 | >8 | 5 (54) | |
| POS (≤0.5) | 0.06-4 | 0.25 | 1 | 80 (66) | |
| CAS (≤2) | >16 | >16 | >16 | 0 (44) | |
| Rhizopus arrhizus (20) | AMB (≤1) | 0.06-0.5 | 0.25 | 0.25 | 100 (15) |
| 5-FC (≤16) | >64 | NA | NA | 0 (1) | |
| KTC (≤4) | 8 | NA | NA | 0 (1) | |
| ITC (≤0.5) | 0.25-2 | 0.5 | NA | 50 (6) | |
| FLC (≤32) | >64 | NA | NA | 0 (3) | |
| VRC (≤2) | 8->8 | >8 | NA | 0 (5) | |
| POS (≤0.5) | 0.03-1 | 0.25 | 1 | 64 (14) | |
| CAS (≤2) | >16 | >16 | NA | 0 (5) | |
| Rhizopus microsporus var. rhizopodiformis (12) | AMB (≤1) | 0.03-0.5 | 0.25 | 0.25 | 100 (10) |
| 5-FC (≤16) | >64 | NA | NA | 0 (1) | |
| KTC (≤4) | 2 | NA | NA | 0 (1) | |
| ITC (≤0.5) | 0.25-1 | 0.5 | NA | 60 (5) | |
| FLC (≤32) | >64 | NA | NA | 0 (4) | |
| VRC (≤2) | 4->8 | NA | NA | 0 (4) | |
| POS (≤0.5) | 0.25-2 | 0.25 | NA | 78 (9) | |
| CAS (≤2) | >16 | >16 | NA | 0 (7) | |
| Rhizopus microsporus var. microsporus (1) | AMB (≤1) | 0.25 | NA | NA | 100 (1) |
| 5-FC (≤16) | NTd | NA | NA | NT | |
| KTC (≤4) | NT | NA | NA | NT | |
| ITC (≤0.5) | 1 | NA | NA | 0 (1) | |
| FLC (≤32) | NT | NA | NA | NT | |
| VRC (≤2) | NT | NA | NA | NT | |
| POS (≤0.5) | NT | NA | NA | NT | |
| CAS (≤2) | NT | NA | NA | NT | |
| Mucor sp. (41) | AMB (≤1) | 0.125-4 | 0.25 | 0.5 | 94 (36) |
| 5-FC (≤16) | >64 | >64 | NA | 0 (5) | |
| KTC (≤4) | 2-16 | NA | NA | 33 (3) | |
| ITC (≤0.5) | 0.25->8 | 0.5 | >8 | 57 (14) | |
| FLC (≤32) | >64 | >64 | NA | 0 (6) | |
| VRC (≤2) | 4->8 | >8 | >8 | 0 (20) | |
| POS (≤0.5) | 0.06-2 | 0.5 | 2 | 70 (20) | |
| CAS (≤2) | >16 | >16 | >16 | 0 (15) | |
| Mucor circinelloides group (6) | AMB (≤1) | 0.06-0.5 | 0.25 | NA | 100 (5) |
| 5-FC (≤16) | >64 | NA | NA | 0 (1) | |
| KTC (≤4) | 16 | NA | NA | 0 (1) | |
| ITC (≤0.5) | 2->8 | NA | NA | 0 (4) | |
| FLC (≤32) | >64 | NA | NA | 0 (2) | |
| VRC (≤2) | >8 | NA | NA | 0 (3) | |
| POS (≤0.5) | 1-2 | NA | NA | 0 (3) | |
| CAS (≤2) | >16 | NA | NA | 0 (3) | |
| Rhizomucor sp. (5) | AMB (≤1) | 0.125-0.25 | 0.125 | NA | 100 (5) |
| 5-FC (≤16) | NT | NA | NA | NT | |
| KTC (≤4) | NT | NA | NA | NT | |
| ITC (≤0.5) | 0.125-1 | NA | NA | 67 (3) | |
| FLC (≤32) | >64 | NA | NA | 0 (2) | |
| VRC (≤2) | 8->8 | NA | NA | 0 (3) | |
| POS (≤0.5) | 0.06-1 | NA | NA | 67 (3) | |
| CAS (≤2) | >16 | NA | NA | 0 (1) | |
| Absidia sp. (3) | AMB (≤1) | 0.25-0.5 | NA | NA | 100 (2) |
| 5-FC (≤16) | NT | NA | NA | NT | |
| KTC (≤4) | NT | NA | NA | NT | |
| ITC (≤0.5) | 0.5-1 | NA | NA | 50 (2) | |
| FLC (≤32) | NT | NA | NA | NT | |
| VRC (≤2) | >8 | NA | NA | 0 (3) | |
| POS (≤0.5) | 0.125 | NA | NA | 100 (1) | |
| CAS (≤2) | >16 | NA | NA | 0 (3) | |
| Absidia corymbifera (9) | AMB (≤1) | 0.25-0.5 | 0.25 | NA | 100 (6) |
| 5-FC (≤16) | NT | NA | NA | NT | |
| KTC (≤4) | NT | NA | NA | MT | |
| ITC (≤0.5) | 0.125-0.5 | NA | NA | 100 (4) | |
| FLC (≤32) | NT | NA | NA | NT | |
| VRC (≤2) | 8->8 | NA | NA | 0 (3) | |
| POS (≤0.5) | 0.06-0.25 | NA | NA | 100 (4) | |
| CAS (≤2) | >16 | NA | NA | 0 (3) | |
| Cunninghamella sp. (13) | AMB (≤1) | 0.25-2 | 1 | NA | 63 (8) |
| 5-FC (≤16) | >64 | NA | NA | 0 (1) | |
| KTC (≤4) | >16 | NA | NA | 0 (1) | |
| ITC (≤0.5) | 0.125-4 | 1 | NA | 29 (7) | |
| FLC (≤32) | >64 | NA | NA | 0 (1) | |
| VRC (≤2) | 0.5->8 | >8 | >8 | 10 (10) | |
| POS (≤0.5) | 0.06-1 | 0.5 | NA | 75 (8) | |
| CAS (≤2) | >16 | NA | NA | 0 (5) | |
| Apophysomyces elegans (6) | AMB (≤1) | 0.03-1 | 0.125 | NA | 100 (6) |
| 5-FC (≤16) | NT | NA | NA | NT | |
| KTC (≤4) | NT | NA | NA | NT | |
| ITC (≤0.5) | 0.03-4 | 0.125 | NA | 80 (5) | |
| FLC (≤32) | >64 | NA | NA | 0 (1) | |
| VRC (≤2) | 0.125 | NA | NA | 100 (1) | |
| POS (≤0.5) | ≤0.016-1 | 0.03 | NA | 83 (6) | |
| CAS (≤2) | >16 | NA | NA | 0 (1) | |
a
AMB, amphotericin B; 5-FC,flucytosine; KTC, ketoconazole; ITC, itraconazole; FLC, fluconazole; VRC, voriconazole; POS, posaconazole; CAS, caspofungin. For all except caspofungin, suggested 24-h MIC breakpoints for polyene and azole susceptibility are shown. For caspofungin, the suggested 24-h MEC breakpoint for echinocandin susceptibility is shown. There are no CLSI established MIC/MEC breakpoints for any of the organism-drug combinations.
b
Boldface indicates in vitro activity for amphotericin B and posaconazole.
c
NA, not applicable.
d
NT, not tested.