In vitro inhibitory activity of sertraline against clinical isolates of Sporothrix schenckii / Actividad inhibitoria in vitro de la sertralina frente a aislamientos clínicos de Sporothrix schenckii

Background: Sertraline (SRT) is an antidepressant that has proven its activity in vitro against Cryptococcus, Coccidioides, Trichosporon and other fungi. Disseminated sporotrichosis, although rare, has a high mortality and its treatment is difficult and prolonged, often relying in combining two or more antifungals. Aims: In our study we evaluate the antifungal activity of SRT, alone and in combination with itraconazole (ITC), voriconazole (VRC) and amphotericin B (AMB), against 15 clinical isolates of Sporothrix schenckii. Methods: We used the broth microdilution method as described by the CLSI to test the susceptibility to antifungals, and the checkerboard microdilution method to evaluate drug interactions. Results: The minimum inhibitory concentration (MIC) with SRT was in the range of 4-8μg/ml, while for AMB, VRC and ITC were 0.5-4μg/ml, 0.5-8μg/ml and 0.125-2μg/ml, respectively. In addition, SRT showed synergy with ITC in one strain, mainly additivity with VRC, and indifference with AMB in others. Conclusions: The MIC values with SRT for the isolates studied show the potential role of this drug as an adjuvant in the treatment of sporotrichosis, especially in disseminated or complicated cases

Antecedentes: La sertralina (SRT) es un antidepresivo que ha demostrado actividad in vitro contra Cryptococcus, Coccidioides, Trichosporon y otros hongos. La esporotricosis diseminada, aunque rara, tiene una mortalidad elevada y su tratamiento es complicado, requiriendo, a menudo, la combinación de dos o más antifúngicos. Objetivos: En este estudio evaluamos la actividad antifúngica de SRT, sola y en combinación con itraconazol (ITC), voriconazol (VRC) y anfotericina B (AMB), frente a 15 aislamientos clínicos de Sporothrix schenckii. Métodos: Se usó la técnica de microdilución en caldo para evaluar la sensibilidad a los antifúngicos y el método de tablero de damas para las interacciones entre estos fármacos. Resultados: La concentración mínima inhibitoria (CMI) de SRT estuvo en el rango de 4-8μg/ml, mientras que para AMB, VRC e ITC fue de 0,5-4 μg/ml, 0,5-8 μg/ml y 0,125-2 μg/ml, respectivamente. La SRT mostró sinergia con ITC frente a una cepa, efecto aditivo principalmente con VRC, e indiferencia con AMB. Conclusiones: Los valores de la CMI de SRT para los aislamientos ensayados son indicativos del potencial de este fármaco como adyuvante en el tratamiento de la esporotricosis, especialmente en casos complicados o de enfermedad diseminada

In vitro inhibitory activity of sertraline against clinical isolates of Sporothrix schenckii.

BACKGROUND: Sertraline (SRT) is an antidepressant that has proven its activity in vitro against Cryptococcus, Coccidioides, Trichosporon and other fungi. Disseminated sporotrichosis, although rare, has a high mortality and its treatment is difficult and prolonged, often relying in combining two or more antifungals. AIMS: In our study we evaluate the antifungal activity of SRT, alone and in combination with itraconazole (ITC), voriconazole (VRC) and amphotericin B (AMB), against 15 clinical isolates of Sporothrix schenckii. METHODS: We used the broth microdilution method as described by the CLSI to test the susceptibility to antifungals, and the checkerboard microdilution method to evaluate drug interactions. RESULTS: The minimum inhibitory concentration (MIC) with SRT was in the range of 4-8µg/ml, while for AMB, VRC and ITC were 0.5-4µg/ml, 0.5-8µg/ml and 0.125-2µg/ml, respectively. In addition, SRT showed synergy with ITC in one strain, mainly additivity with VRC, and indifference with AMB in others. CONCLUSIONS: The MIC values with SRT for the isolates studied show the potential role of this drug as an adjuvant in the treatment of sporotrichosis, especially in disseminated or complicated cases.

Rapid spread of an ongoing outbreak of Zika virus disease in pregnant women in a Mexican hospital

Abstract In the first nine weeks of implementation of a Zika Virus Preparedness Plan in a Mexican Public Hospital, we cared for 221 pregnant women with any signal or symptom suggesting Zika virus infection and 99 (44.8%) patients were found to be positive for Zika virus.The median age of patients was 25.3 years (range 13-49). Symptoms in PCR-positive patients were rash (91.4%) followed by headache (53.1%), myalgia (46.9%), arthralgia (45.7%), pruritus (35.8%), retroocular pain (29.6%), conjunctivitis (21%), and fever (21%). The women's epidemiologic exposure history indicates local transmission and a community outbreak.

Rapid spread of an ongoing outbreak of Zika virus disease in pregnant women in a Mexican hospital.

In the first nine weeks of implementation of a Zika Virus Preparedness Plan in a Mexican Public Hospital, we cared for 221 pregnant women with any signal or symptom suggesting Zika virus infection and 99 (44.8%) patients were found to be positive for Zika virus. The median age of patients was 25.3 years (range 13-49). Symptoms in PCR-positive patients were rash (91.4%) followed by headache (53.1%), myalgia (46.9%), arthralgia (45.7%), pruritus (35.8%), retroocular pain (29.6%), conjunctivitis (21%), and fever (21%). The women's epidemiologic exposure history indicates local transmission and a community outbreak.