AUTHOR=Quindós Guillermo , Miranda-Cadena Katherine , San-Millán Rosario , Borroto-Esoda Katyna , Cantón Emilia , Linares-Sicilia María José , Hamprecht Axel , Montesinos Isabel , Tortorano Anna Maria , Prigitano Anna , Vidal-García Matxalen , Marcos-Arias Cristina , Guridi Andrea , Sanchez-Reus Ferran , Machuca-Bárcena Jesús , Rodríguez-Iglesias Manuel Antonio , Martín-Mazuelos Estrella , Castro-Méndez Carmen , López-Soria Leyre , Ruiz-Gaitán Alba , Fernandez-Rivero Marcelo , Lorenzo Damaris , Capilla Javier , Rezusta Antonio , Pemán Javier , Guarro Josep , Pereira Joana , Pais Célia , Romeo Orazio , Ezpeleta Guillermo , Jauregizar Nerea , Angulo David , Eraso Elena 

TITLE=In Vitro Antifungal Activity of Ibrexafungerp (SCY-078) Against Contemporary Blood Isolates From Medically Relevant Species of Candida: A European Study

JOURNAL=Frontiers in Cellular and Infection Microbiology

VOLUME=12

YEAR=2022

URL=https://www.frontiersin.org/journals/cellular-and-infection-microbiology/articles/10.3389/fcimb.2022.906563

DOI=10.3389/fcimb.2022.906563

ISSN=2235-2988

ABSTRACT=<sec><title>Background</title><p>Ibrexafungerp (SCY-078) is the newest oral and intravenous antifungal drug with broad activity, currently undergoing clinical trials for invasive candidiasis.</p></sec><sec><title>Objective</title><p>The aim of this study was to assess the <italic>in vitro</italic> activity of ibrexafungerp and comparators against a collection of 434 European blood isolates of <italic>Candida</italic>.</p></sec><sec><title>Methods</title><p>Ibrexafungerp, caspofungin, fluconazole, and micafungin minimum inhibitory concentrations (MICs) were collected from 12 European laboratories for 434 blood isolates, including 163 <italic>Candida albicans</italic>, 108 <italic>Candida parapsilosis</italic>, 60 <italic>Candida glabrata</italic>, 40 <italic>Candida tropicalis</italic>, 29 <italic>Candida krusei</italic>, 20 <italic>Candida orthopsilosis</italic>, 6 <italic>Candida guilliermondii</italic>, 2 <italic>Candida famata</italic>, 2 <italic>Candida lusitaniae</italic>, and 1 isolate each of <italic>Candida bracarensis, Candida catenulata</italic>, <italic>Candida dubliniensis</italic>, and <italic>Candida kefyr</italic>. MICs were determined by the EUCAST broth microdilution method, and isolates were classified according to recommended clinical breakpoints and epidemiological cutoffs. Additionally, 22 <italic>Candida auris</italic> from different clinical specimens were evaluated.</p></sec><sec><title>Results</title><p>Ibrexafungerp MICs ranged from 0.016 to ≥8 mg/L. The lowest ibrexafungerp MICs were observed for <italic>C. albicans</italic> (geometric MIC 0.062 mg/L, MIC range 0.016–0.5 mg/L) and the highest ibrexafungerp MICs were observed for <italic>C. tropicalis</italic> (geometric MIC 0.517 mg/L, MIC range 0.06–≥8 mg/L). Modal MICs/MIC<sub>50</sub>s (mg/L) against <italic>Candida</italic> spp. were 0.125/0.06 for <italic>C. albicans</italic>, 0.5/0.5 for <italic>C. parapsilosis</italic>, 0.25/0.25 for <italic>C. glabrata</italic>, 0.5/0.5 for <italic>C. tropicalis</italic>, 1/1 for <italic>C. krusei</italic>, 4/2 for <italic>C. orthopsilosis</italic>, and 0.5/0.5 for <italic>C. auris</italic>. Ibrexafungerp showed activity against fluconazole- and echinocandin-resistant isolates. If adopting wild-type upper limits, a non-wild-type phenotype for ibrexafungerp was only observed for 16/434 (3.7%) isolates: 11 (4.6%) <italic>C. parapsilosis</italic>, 4 (5%) <italic>C. glabrata</italic>, and 1 (2.5%) <italic>C. tropicalis</italic>.</p></sec><sec><title>Conclusion</title><p>Ibrexafungerp showed a potent <italic>in vitro</italic> activity against <italic>Candida</italic>.</p></sec>