PDF(Pubmed)
Abstract：
Several prolonged and significant outbreaks of dermatophytosis caused by Trichophyton indotineae, a new emerging terbinafine-resistant species, have been ongoing in India in recent years, and have since spread to various countries outside Asia. Miltefosine, an alkylphosphocholine, is the most recently approved drug for the treatment of both visceral and cutaneous leishmaniasis. Miltefosine in vitro activity against terbinafine-resistant and susceptible T. mentagrophytes/T. interdigitale species complex, including T. indotineae, is limited. The current study aimed to assess miltefosine\'s in vitro activity against dermatophyte isolates, which are the most common causes of dermatophytosis. Miltefosine, terbinafine, butenafine, tolnaftate, and itraconazole susceptibility testing was performed using Clinical and Laboratory Standards Institute broth microdilution methods (CLSI M38-A3) against 40 terbinafine-resistant T. indotineae isolates and 40 terbinafine-susceptible T. mentagrophytes/T. interdigitale species complex isolates. Miltefosine had MIC ranges of 0.063-0.5 µg/mL and 0.125-0.25 µg/mL against both terbinafine-resistant and susceptible isolates. In terbinafine-resistant isolates, the MIC50 and MIC90 were 0.125 µg/mL and 0.25 µg/mL, respectively, and 0.25 µg/mL in susceptible isolates. Miltefosine had statistically significant differences in MIC results when compared to other antifungal agents (p-value 0.05) in terbinafine-resistant strains. Accordingly, the findings suggest that miltefosine has a potential activity for treating infections caused by terbinafine-resistant T. indotineae. However, further studies are needed to determine how well this in vitro activity translates into in vivo efficacy.
摘要：
由吲哚毛癣菌引起的皮肤癣菌病的几次长期和重大爆发，一种新出现的特比萘芬抗性物种，近年来一直在印度进行，此后传播到亚洲以外的各个国家。米替福辛,烷基磷酸胆碱，是最近批准的用于治疗内脏和皮肤利什曼病的药物。米替福辛对特比萘芬抗性和易感T.数码间物种复合体，包括T.indotineae,是有限的。本研究旨在评估米替福辛对皮肤癣菌分离物的体外活性，这是皮肤癣菌病最常见的原因。米替福辛,特比萘芬,布替萘芬,Tolnaftate,使用临床和实验室标准研究所的肉汤微量稀释方法（CLSIM38-A3）对40种耐特比萘芬的吲哚虫分离株和40种特比萘芬敏感的T.mentagrosphytes/T.进行了伊曲康唑敏感性测试。数码间物种复杂的分离株。米替福辛对特比萘芬耐药和易感分离株的MIC范围为0.063-0.5µg/mL和0.125-0.25µg/mL。在特比萘芬耐药的分离株中，MIC50和MIC90分别为0.125µg/mL和0.25µg/mL，分别,在易感分离株中和0.25µg/mL。与特比萘芬耐药菌株中的其他抗真菌剂相比，米替福辛的MIC结果具有统计学上的显着差异（p值0.05）。因此，研究结果表明，米替福辛具有治疗特比萘芬耐药T.indotineae引起的感染的潜在活性。然而,需要进一步的研究来确定这种体外活性转化为体内功效的程度。
