Luliconazole, a New Antifungal, vs Amphotericin B, Voriconazole, Posaconazole and Caspofungin against Clinical and Environmental Aspergillus Nigri Complex

Black Aspergilli are, the most causes of aspergillosis and Aspergillus niger and A. tubingensis are two more frequently isolates. Although, amphotericin B was a gold standard for the treatment of invasive fungal infection for several decades, it replaced by several new antifungals. Furthermore, a novel antifungal, luliconazole, appears to offer the potential for improved therapy for aspergillosis. The aim of the present study was to compare the effect of a novel antifungal agent, luliconazole, with classical antifungal against clinical and environmental strains of black Aspergilli. Sixty seven strains of black Aspergilli were identified using morphological and molecular tests (β-Tubulin gene). Antifungal susceptibility test was applied according to CLSI M38 A2. The results were reported as MIC range, MIC 50 , MIC 90 and MIC GM . In the present study, A. niger was the common isolate followed by, A. tubingensis and 54.1% (clinical) and 30% (environmental) of isolates were resistant to caspofungin. The highest resistant rate was found in amphotericin B for both clinical (86.5%) and environmental (96.7%) strains. Clinical strains of Aspergillus were more sensitive to voriconazole (86.7%) than environmental strains (70.3%). On the other hand, 83.8% of clinical and 70% of environmental isolates were resistant to posaconazole, respectively. It is found that the lowest MIC range, MIC 50 , MIC 90 , and MIC GM was attributed to luliconazole in clinical strains. In conclusion, luliconazole vs. routine antifungal is a potent antifungal for A. niger complex in vitro. The MIC range, MIC 50 , MIC 90 and MIC GM of luliconazole against black Aspergilli were the lowest among the representative tested antifungals.