Efficacies of fluconazole, caspofungin, and amphotericin B in Candida glabrata-infected p47phox-/- knockout mice

Antimicrob Agents Chemother. 2002 May;46(5):1240-5. doi: 10.1128/AAC.46.5.1240-1245.2002.

Abstract

Candida glabrata is the second leading cause of adult candidemia, resulting in high mortality. Amphotericin B is considered the treatment of choice, while the efficacy of fluconazole is controversial and caspofungin efficacy is unknown. To ascertain drug efficacy in vivo, the utility of a murine model of C. glabrata infection was investigated. C. glabrata was found to cause progressive, lethal infection when injected intravenously into C57BL/6 mice with reduced oxidative microbicidal capacity due to knockout of the p47(phox) gene. Spleen and kidney organ CFU counts were determined in groups of mice 2 days after the mice completed 6 days of daily intraperitoneal drug treatment, which began on the day of infection. Daily injections of fluconazole at 80 mg/kg did not reduce spleen or kidney CFU counts after infection with C. glabrata strains having in vitro fluconazole MICs of 2, 32, or 256 microg/ml compared to saline-treated controls. However, this fluconazole regimen reduced spleen CFU counts in mice infected with Candida albicans, an infection that is known to be responsive to fluconazole. Caspofungin at 5 mg/kg and amphotericin B at 5 mg/kg were both effective in reducing fungal burden in spleens and kidneys of C. glabrata-infected mice. Ten mice treated for 6 days with caspofungin at 1 mg/kg survived for 15 days, though all 10 saline-injected mice died or were so ill that they had to be sacrificed by 96 h postinfection. This murine model provided evidence of the efficacy of amphotericin B and caspofungin but not of fluconazole against C. glabrata infection.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Amphotericin B / pharmacology
  • Amphotericin B / therapeutic use*
  • Animals
  • Antifungal Agents / pharmacology
  • Antifungal Agents / therapeutic use*
  • Candida / drug effects*
  • Candida / pathogenicity
  • Candidiasis / drug therapy*
  • Candidiasis / microbiology
  • Disease Models, Animal
  • Female
  • Fluconazole / pharmacology
  • Fluconazole / therapeutic use*
  • Humans
  • Interferon-gamma / genetics
  • Mice
  • Mice, Inbred C57BL
  • Mice, Knockout
  • NADPH Oxidases
  • Phosphoproteins / genetics*
  • Treatment Outcome
  • Virulence

Substances

  • Antifungal Agents
  • Phosphoproteins
  • Amphotericin B
  • Interferon-gamma
  • Fluconazole
  • NADPH Oxidases
  • neutrophil cytosolic factor 1