, Volume 184, Issue 1, pp 35–43 | Cite as

In Vitro Interactions of Amphotericin B Combined with Non-antifungal Agents Against Rhodotorula mucilaginosa Strains

  • Tatiana Borba SpaderEmail author
  • Mauricio Ramírez-Castrillón
  • Patricia Valente
  • Sydney Hartz Alves
  • Luiz Carlos Severo
Original Paper


Rhodotorula species are emerging as opportunistic pathogens, causing catheter-associated fungemia in patients with compromised immunity. R. mucilaginosa is considered the most common species involved in human infections. Correct identification and susceptibility testing of Rhodotorula isolates recovered from the blood stream or central nervous system are essential to determine the best management of this unusual infection. The antifungal susceptibility tests showed that Rhodotorula was susceptible to low concentrations of amphotericin B (AMB) but was less susceptible to voriconazole. Combinations of AMB plus several non-antifungal medications were evaluated against 35 susceptible (Rm AMB-S) and resistant (Rm AMB-R) clinical Rhodotorula isolates using the broth microdilution checkerboard technique. We showed that in vitro exposure to increasing concentrations of AMB changed the susceptibility profile to these strains, which were named the Rm AMB-R group. The most synergistic interactions were AMB + simvastatin, followed by AMB + amlodipine and AMB + warfarin. Synergism and antagonism were observed in both groups for the combination AMB + cyclosporine A. AMB combined with a fluoroquinolone (AMB + levofloxacin) also demonstrated antagonism for the Rm AMB-S strains, but a high percentage of synergistic interactions was observed for the Rm AMB-R group. A combination drug approach can provide a different strategy to treat infections caused by AMB-resistant R. mucilaginosa.


Rhodotorula mucilaginosa Combination test Synergism Resistance Amphotericin B 



This study was supported by CNPq (the National Council for Scientific and Technological Development of Brazil), ID 026/15.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Data Genuinity

The authors declare that the data/results of the manuscript do not constitute plagiarism and have not been published elsewhere.

Human and Animal Rights

This article does not contain any studies on human and animal performed by any of the authors.


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Copyright information

© Springer Nature B.V. 2019

Authors and Affiliations

  1. 1.Laboratório de Patologia e MicologiaHospital Santa Casa de Misericórdia de Porto AlegrePorto AlegreBrazil
  2. 2.Departamento de Microbiologia, Imunologia e ParasitologiaUniversidade Federal do Rio Grande do Sul (UFRGS)Porto AlegreBrazil
  3. 3.Research group in Microbiology, Industry and Environment (GIMIA/CICBA), Universidad Santiago de CaliCaliColombia
  4. 4.Laboratório de Pesquisas Micológicas (LAPEMI), Departamento de Microbiologia e ParasitologiaUniversidade Federal de Santa Maria (UFSM)Santa MariaBrazil

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