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Nitroxoline activity in antifungal-resistant Candida species isolated from the urinary tract in vitro

By on May 26, 2022 0

Drug-resistant fungal infections were becoming more common around the world, but only a few new antifungals were being produced. The old antibacterial nitroxoline was used to treat bacterial urinary tract infections (UTIs) by mouth. The study evaluated the activity of nitroxoline in vitro in a yeast collection from the German National Reference Center for Invasive Fungal Infections. Broth microdilution (BMD) and disk diffusion (DD) assessed sensitivity. Approximately 45 Candida isolates from the urinary tract were included in the collection. EUCAST BMD was used to determine the MICs of amphotericin, anidulafungin and azoles. Antifungal resistance was common among the isolates in the collection; for example, the MIC50/90 of fluconazole was 16/ more than 64 mg/L; however, the MIC50/90 of nitroxoline was 2/2 mg/L (MIC range 0.25 to 4 mg/L), which is at least two dilutions below the EUCAST breakpoint for urinary tract infections uncomplicated defined for E. coli (susceptible ≤ 16 mg/L). Regardless of resistance to other drugs, nitroxoline had strong activity. As BMD was time consuming, three different agars were used to test DD as an alternative. On all plates, nitroxoline discs produced large zones of inhibition (≥ 19 mm). However, the correlation between MICs and zone diameters was modest, with CLSI recommended agar for antifungal DD having the strongest correlation (Pearson’s r = 0.52). Finally, nitroxoline was extremely sensitive to isolates of many Candida species, suggesting that it could be a potent antibiotic for the treatment of candiduria caused by multidrug-resistant yeasts.

Source:journals.asm.org/doi/10.1128/aac.02265-21

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