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In Vitro Antifungal Susceptibility of <Emphasis Type="Italic">Neoscytalidium dimidiatum</Emphasis> Clinical Isolates from Malaysia
Authors:Jasper Elvin James  Jacinta Santhanam  Mei Chen Lee  Choon Xian Wong  Parameswari Sabaratnam  Hamidah Yusoff  Mohd Nizam Tzar  Mohd Fuat Abdul Razak
Institution:1.Biomedical Science Programme, Faculty of Health Sciences,Universiti Kebangsaan Malaysia,Kuala Lumpur,Malaysia;2.Bacteriology Unit,Institute for Medical Research,Kuala Lumpur,Malaysia;3.Department of Medical Microbiology and Immunology,Universiti Kebangsaan Malaysia Medical Centre,Cheras,Malaysia
Abstract:Neoscytalidium dimidiatum is an opportunistic fungus causing cutaneous infections mostly, which are difficult to treat due to antifungal resistance. In Malaysia, N. dimidiatum is associated with skin and nail infections, especially in the elderly. These infections may be mistaken for dermatophyte infections due to similar clinical appearance. In this study, Neoscytalidium isolates from cutaneous specimens, identified using morphological and molecular methods (28 Neoscytalidium dimidiatum and 1 Neoscytalidium sp.), were evaluated for susceptibility towards antifungal agents using the CLSI broth microdilution (M38-A2) and Etest methods. Amphotericin B, voriconazole, miconazole and clotrimazole showed high in vitro activity against all isolates with MIC ranging from 0.0313 to 1 µg/mL. Susceptibility towards fluconazole and itraconazole was noted in up to 10% of isolates, while ketoconazole was inactive against all isolates. Clinical breakpoints for antifungal drugs are not yet available for most filamentous fungi, including Neoscytalidium species. However, the results indicate that clinical isolates of N. dimidiatum in Malaysia were sensitive towards miconazole, clotrimazole, voriconazole and amphotericin B, in vitro.
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