Iranian Journal of Pathology

The In vitro Effect of Nanoliposomal Amphotericin B Against Rhizopus arrhizus Isolated From COVID-19-Associated Mucormycosis Patients

Document Type : Original Research

Authors

Ali Ahmadi 1, 2
Sayed Jamal Hashemi 1, 3
Seyed Mahdi Rezayat 4
Roshanak Daei Ghazvini 1
Mahmoud Reza Jaafari 5, 6
Jamileh Esmaeili 4
Fatemeh Saiedmohammadi 7
Farzaneh Afshari 8
Laura Alcazar-Fuoli 9
Alireza Abdollahi 10
Sadegh Khodavaisy 1

1 Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran

2 Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran

3 Food Microbiology Research Center, Tehran University of Medical Sciences, Tehran, Iran

4 Department of Pharmacology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran

5 Department of Pharmaceutical Nanotechnology, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran.

6 Nanotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran

7 Department of Pharmacology and Toxicology, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran

8 Cancer Immunology Project (CIP), Universal Scientific Education & Research Network (USERN), Tehran, Iran

9 Mycology Reference Laboratory, National Centre for Microbiology, Instituto de Salud Carlos III, Madrid, Spain

10 Department of Pathology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran

https://doi.org/10.30699/ijp.2024.2033626.3320
Abstract
Background & Objective: Rhizopus arrhizus, a major contributor to COVID-19-associated mucormycosis (CAM) globally. Nanoliposomal amphotericin B (NLAmB) presents a promising approach due to its enhanced drug delivery and reduced side effects. This study aimed to assess the in vitro antifungal susceptibility of NLAmB against R. arrhizus isolated from CAM patients.
Methods: Thirty-nine R. arrhizus isolated from CAM patients were identified through phenotypic characterization, MALDI-TOF, and the internal transcribed spacer rDNA region (ITS) sequencing approaches. Antifungal susceptibility testing (AFST) for NLAmB, amphotericin B (AmB), posaconazole (PSC), and isavuconazole (ISC) was conducted through broth microdilution methods according to the European Committee on Antimicrobial Susceptibility Testing (EUCAST) standard E.DEF 9.4. Results were analyzed for MIC ranges, MIC50, MIC90, and distributions.
Results: NLAmB demonstrated superior in vitro efficacy against R. arrhizus (MIC50/90, 0.063/0.25 μg/ml) compared to AmB, PSC, and ISC. PSC exhibited notable activity (MIC range: ≤0.031 - ≥16 μg/ml).
Conclusion: The study emphasized NLAmB's sustained activity, making it a potential alternative to LAmB. Further exploration and clinical correlation are warranted to validate NLAmB in CAM treatment.

Highlights

  • COVID-19 has affected the antifungal susceptibility test (AFST) pattern of Rhizopus arrhizus.
  • Poor clinical results in mucormycosis can be attributed to a lack of identification and AFST.
  • Nanoliposomal Amphotericin B could be an appropriate alternative to liposomal Amphotericin B.

Keywords

Nanoparticle Drug Delivery System
Liposome
Amphotericin B
Rhizopus oryzae
COVID-19
Mucormycosis

Subjects

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Iranian Journal of Pathology
Volume 20, Issue 1
Winter 2025
Pages 84-89

  • Receive Date 24 June 2024
  • Revise Date 24 April 2024
  • Accept Date 19 July 2024

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