RESUMEN
OBJECTIVES: Actinomycetoma is a chronic granulomatous disease affecting skin, subcutaneous tissue, fascia, muscle and bones. With increasing resistance against commonly used treatment regimens, susceptibility testing is urgently needed. METHODS: We developed an in vitro susceptibility assay for Actinomadura madurae, one of the common causative agents of actinomycetoma, employing resazurin for endpoint reading. Using this assay, reproducible MICs were determined for the most commonly used antibacterial agents for actinomycetoma treatment. The tested antibacterial agents included trimethoprim/sulfamethoxazole, amikacin, streptomycin, amoxicillin, ceftriaxone, gentamicin, ciprofloxacin, doxycycline, imipenem, linezolid, penicillin G and rifampicin. RESULTS: Following the clinical breakpoints as stated by CLSI, 100% of the tested strains were susceptible to trimethoprim/sulfamethoxazole (MIC 0.03/0.59-1/19â mg/L), amikacin (MIC 0.0078-0.25â mg/L), doxycycline (MIC <0.25-1â mg/L) and linezolid (MIC <0.25-2â mg/L), 90% to ciprofloxacin (MIC <0.25-2â mg/L), 80% to ceftriaxone (MIC <0.5 to >64â mg/L) and imipenem (MIC <0.25-32â mg/L) and only 20% to amoxicillin (MIC <0.5 to >64â mg/L) and rifampicin (MIC 0.5 to >32â mg/L). CONCLUSIONS: Determinations of MICs by visual readings of colour changes versus spectrophotometric readings were comparable. This convenient visual reading has the advantage of feasible implementation in endemic settings.
Asunto(s)
Amicacina , Micetoma , Humanos , Linezolid/farmacología , Doxiciclina , Ceftriaxona , Rifampin , Micetoma/tratamiento farmacológico , Antibacterianos/farmacología , Antibacterianos/uso terapéutico , Amoxicilina , Combinación Trimetoprim y Sulfametoxazol , Imipenem , Ciprofloxacina , Ifosfamida , Pruebas de Sensibilidad MicrobianaRESUMEN
We present an in vitro susceptibility assay for Madurella mycetomatis hyphae using resazurin for endpoint reading. Using this assay, reproducible MICs were obtained for amphotericin B, itraconazole, voriconazole, posaconazole, terbinafine, and micafungin. Results were comparable with those of a 2,3-bis-(2-methoxy-4-nitro-5-sulfophenyl)-2H-tetrazolium-5-carboxanilide salt (XTT)-based susceptibility assay. The lowest MICs were obtained for itraconazole and posaconazole (MIC50, 0.016 µg/ml) followed by voriconazole (MIC50, 0.063 µg/ml). Amphotericin B, micafungin, and terbinafine appeared much less effective.