Killing kinetics of anidulafungin, caspofungin and micafungin against Candida parapsilosis species complex: Evaluation of the fungicidal activity

En esta publicación en la Revista Iberoamericana de Micología mostramos la alta eficacia de las equinocandinas, anidulafungina, caspofungina y micafungina contra los aislamientos clínicos de Candida parapsilosis, Candida metapsilosis y Candida orthopsilosis, especies emergentes de Candida. Es un estudio que hemos realizado en la Facultad de Medicina y Enfermería de la Universidad del País Vasco (UPV/EHU), Sandra Gil-Alonso, Nerea Jauregizar, Elena Eraso y Guillermo Quindós. Hemos contado con la inestimable ayuda de Emilia Cantón del Hospital Universitario y Politécnico La Fe (Valencia).

Este es el resumen:

Candida parapsilosis, Candida metapsilosis and Candida orthopsilosis are emerging as relevant causes of candidemia. Moreover, they show differences in their antifungal susceptibility and virulence. The echinocandins are different in terms of in vitro antifungal activity against Candida. Time-kill (TK) curves represent an excellent approach to evaluate the fungicidal activity of antifungal drugs.

AIMS:

To compare the fungicidal activities of anidulafungin, caspofungin and micafungin against C. parapsilosis species complex by TK curves.

METHODS:

Antifungal activities of three echinocandins against C. parapsilosis, C. metapsilosis and C. orthopsilosis were studied by TK curves. Drug concentrations assayed were 0.25, 2 and 8μg/ml. CFU/ml were determined at 0, 2, 4, 6, 24 and 48h.

RESULTS:

Killing activities of echinocandins were species-, isolates- and concentration-dependent. Anidulafungin reached the fungicidad endpoint for 6 out of 7 isolates (86%); it required between 13.34 and 29.67h to reach this endpoint for the three species studied, but more than 48h were needed against one isolate of C. orthopsilosis (8μg/ml). Caspofungin fungicidal endpoint was only achieved with 8μg/ml against one isolate of C. metapsilosis after 30.12h (1 out of 7 isolates; 14%). Micafungin fungicidal endpoint was reached in 12.74-28.38h (8μg/ml) against one isolate each of C. parapsilosis and C. orthopsilosis, and against both C. metapsilosis isolates (4 out of 7 isolates; 57%).

CONCLUSIONS:

C. metapsilosis was the most susceptible species to echinocandins, followed by C. orthopsilosis and C. parapsilosis. Anidulafungin was the most active echinocandin against C. parapsilosis complex.

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