Pre-Exposure to Isavuconazole Increases the Virulence of Mucorales but not Aspergillus fumigatus in a Drosophila melanogaster Infection Model [Clinical Therapeutics]

Breakthrough mucormycosis in patients receiving isavuconazole prophylaxis or therapy has been reported. We compared the impact of isavuconazole and voriconazole exposure on the virulence of clinical isolates of Aspergillus fumigatus and different Mucorales species in a Drosophila melanogaster infection model. In contrast to A. fumigatus, a hyper-virulent phenotype was found in all tested Mucorales upon pre-exposure to either voriconazole or isavuconazole. These findings may contribute to the explanation of breakthrough mucormycosis in isavuconazole-treated patients.

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