Does Systemic Methotrexate Therapy Induce Azole Resistance among Endogenous <i>Candida</i> Strains?

Background: Research confirms that <i>Candida</i> spp. incubated with methotrexate develop multi-drug resistance to azoles, but it is not clear whether this phenomenon occurs in vivo in patients treated with cytostatics. The aim of the study was to assess whether systemic methotrexate th...

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Autores principales:	Dawid Żyrek, Joanna Nowicka, Magdalena Pajączkowska, Ewa Morgiel
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	<i>Candida</i> cross-resistance methotrexate fluconazole Therapeutics. Pharmacology RM1-950
Acceso en línea:	https://doaj.org/article/2e8b0da00464485dbf8b0b20901005fd
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spelling	oai:doaj.org-article:2e8b0da00464485dbf8b0b20901005fd2021-11-25T16:22:23ZDoes Systemic Methotrexate Therapy Induce Azole Resistance among Endogenous <i>Candida</i> Strains?10.3390/antibiotics101113022079-6382https://doaj.org/article/2e8b0da00464485dbf8b0b20901005fd2021-10-01T00:00:00Zhttps://www.mdpi.com/2079-6382/10/11/1302https://doaj.org/toc/2079-6382Background: Research confirms that <i>Candida</i> spp. incubated with methotrexate develop multi-drug resistance to azoles, but it is not clear whether this phenomenon occurs in vivo in patients treated with cytostatics. The aim of the study was to assess whether systemic methotrexate therapy induces resistance to azoles among endogenous <i>Candida</i> strains in patients with rheumatological diseases. Methods: The test group consisted of 52 rheumatological patients on methotrexate therapy, who have never been exposed to fluconazole. The control group was composed of 49 individuals who have never been exposed to either methotrexate or fluconazole. Oral swab and clinical information were obtained from each participant. The acquired material was cultured, then each strain was isolated and identified (MALDI TOF). Subsequently, minimal inhibitory concentration (MIC) for fluconazole was determined. Results: MIC values ranged from <0.125 to 64 µg/mL with the most common result <0.125 µg/mL. Samples obtained from 4 patients of the test group and 2 patients of the control group contained strains resistant to fluconazole. Conclusions: Despite slightly higher incidence of fluconazole-resistant strains among patients on systemic methotrexate therapy, we found no solid evidence to support the hypothesis that methotrexate induces resistance to azoles among endogenous <i>Candida</i> strains in patients with rheumatological diseases.Dawid ŻyrekJoanna NowickaMagdalena PajączkowskaEwa MorgielMDPI AGarticle<i>Candida</i>cross-resistancemethotrexatefluconazoleTherapeutics. PharmacologyRM1-950ENAntibiotics, Vol 10, Iss 1302, p 1302 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	<i>Candida</i> cross-resistance methotrexate fluconazole Therapeutics. Pharmacology RM1-950
spellingShingle	<i>Candida</i> cross-resistance methotrexate fluconazole Therapeutics. Pharmacology RM1-950 Dawid Żyrek Joanna Nowicka Magdalena Pajączkowska Ewa Morgiel Does Systemic Methotrexate Therapy Induce Azole Resistance among Endogenous <i>Candida</i> Strains?
description	Background: Research confirms that <i>Candida</i> spp. incubated with methotrexate develop multi-drug resistance to azoles, but it is not clear whether this phenomenon occurs in vivo in patients treated with cytostatics. The aim of the study was to assess whether systemic methotrexate therapy induces resistance to azoles among endogenous <i>Candida</i> strains in patients with rheumatological diseases. Methods: The test group consisted of 52 rheumatological patients on methotrexate therapy, who have never been exposed to fluconazole. The control group was composed of 49 individuals who have never been exposed to either methotrexate or fluconazole. Oral swab and clinical information were obtained from each participant. The acquired material was cultured, then each strain was isolated and identified (MALDI TOF). Subsequently, minimal inhibitory concentration (MIC) for fluconazole was determined. Results: MIC values ranged from <0.125 to 64 µg/mL with the most common result <0.125 µg/mL. Samples obtained from 4 patients of the test group and 2 patients of the control group contained strains resistant to fluconazole. Conclusions: Despite slightly higher incidence of fluconazole-resistant strains among patients on systemic methotrexate therapy, we found no solid evidence to support the hypothesis that methotrexate induces resistance to azoles among endogenous <i>Candida</i> strains in patients with rheumatological diseases.
format	article
author	Dawid Żyrek Joanna Nowicka Magdalena Pajączkowska Ewa Morgiel
author_facet	Dawid Żyrek Joanna Nowicka Magdalena Pajączkowska Ewa Morgiel
author_sort	Dawid Żyrek
title	Does Systemic Methotrexate Therapy Induce Azole Resistance among Endogenous <i>Candida</i> Strains?
title_short	Does Systemic Methotrexate Therapy Induce Azole Resistance among Endogenous <i>Candida</i> Strains?
title_full	Does Systemic Methotrexate Therapy Induce Azole Resistance among Endogenous <i>Candida</i> Strains?
title_fullStr	Does Systemic Methotrexate Therapy Induce Azole Resistance among Endogenous <i>Candida</i> Strains?
title_full_unstemmed	Does Systemic Methotrexate Therapy Induce Azole Resistance among Endogenous <i>Candida</i> Strains?
title_sort	does systemic methotrexate therapy induce azole resistance among endogenous <i>candida</i> strains?
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/2e8b0da00464485dbf8b0b20901005fd
work_keys_str_mv	AT dawidzyrek doessystemicmethotrexatetherapyinduceazoleresistanceamongendogenousicandidaistrains AT joannanowicka doessystemicmethotrexatetherapyinduceazoleresistanceamongendogenousicandidaistrains AT magdalenapajaczkowska doessystemicmethotrexatetherapyinduceazoleresistanceamongendogenousicandidaistrains AT ewamorgiel doessystemicmethotrexatetherapyinduceazoleresistanceamongendogenousicandidaistrains
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Does Systemic Methotrexate Therapy Induce Azole Resistance among Endogenous <i>Candida</i> Strains?

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