{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T01:27:50Z","timestamp":1792805270557,"version":"4.5.0"},"reference-count":48,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2022,9,13]],"date-time":"2022-09-13T00:00:00Z","timestamp":1663027200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Ministry of Higher Education and Scientific Research"},{"name":"University of Monastir","id":[{"id":"https:\/\/ror.org\/00nhtcg76","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JoF"],"abstract":"<jats:p>Malassezia yeasts have recently gained medical importance as emerging pathogens associated with a wide range of dermatological and systemic infections. Since standardized methods for in vitro antifungal susceptibility testing have not yet been established for Malassezia spp., related diseases are always treated empirically. As a result, a high rate of recurrence and decreased antifungal susceptibility have appeared. Thus, the aims of the study were to assess and analyze the in vitro susceptibility of Malassezia isolated from pityriasis versicolor (PV) lesions and healthy controls. A total of 58 Malassezia strains isolated from PV patients and healthy controls were tested. In vitro antifungal susceptibility testing was conducted using the CLSI broth microdilution with some modifications. Candida spp. criteria established in accordance with CLSI guidelines were used for data interpretation. Ketoconazole and posaconazole seemed to be the most effective molecules against Malassezia species. However, considerable percentages of itraconazole, fluconazole, and amphotericin B \u2018\u2018resistant\u2019\u2019 strains (27.6%, 29.3%, and 43.1%, respectively) were revealed in this study. Malassezia furfur, M. sympodialis, and M. globosa showed different susceptibility profiles to the drugs tested. These results emphasize the importance of accurately identifying and evaluating the antifungal susceptibility of Malassezia species in order to guide a specific and effective treatment regimen.<\/jats:p>","DOI":"10.3390\/jof8090959","type":"journal-article","created":{"date-parts":[[2022,9,13]],"date-time":"2022-09-13T22:37:28Z","timestamp":1663108648000},"page":"959","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["In Vitro Assessment of Azole and Amphotericin B Susceptibilities of Malassezia spp. Isolated from Healthy and Lesioned Skin"],"prefix":"10.3390","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7041-6373","authenticated-orcid":false,"given":"Wissal","family":"Chebil","sequence":"first","affiliation":[{"name":"Laboratory of Medical and Molecular Parasitology-Mycology (LR12ES08), Department of Clinical Biology B, Faculty of Pharmacy, University of Monastir, Monastir 5000, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Najoua","family":"Haouas","sequence":"additional","affiliation":[{"name":"Laboratory of Medical and Molecular Parasitology-Mycology (LR12ES08), Department of Clinical Biology B, Faculty of Pharmacy, University of Monastir, Monastir 5000, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elja","family":"Eskes","sequence":"additional","affiliation":[{"name":"Laboratory of Molecular Cell Biology, Institute of Botany and Microbiology, Department of Biology, Faculty of Sciences, KU Leuven, Heverlee, 3001 Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1181-1090","authenticated-orcid":false,"given":"Paul","family":"Vandecruys","sequence":"additional","affiliation":[{"name":"Laboratory of Molecular Cell Biology, Institute of Botany and Microbiology, Department of Biology, Faculty of Sciences, KU Leuven, Heverlee, 3001 Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sameh","family":"Belgacem","sequence":"additional","affiliation":[{"name":"Laboratory of Parasitology-Mycology, Fattouma Bourguiba University Hospital, Monastir 5000, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6684-5167","authenticated-orcid":false,"given":"Hichem","family":"Belhadj Ali","sequence":"additional","affiliation":[{"name":"Dermatology Department, Fattouma Bourguiba University Hospital, Monastir 5000, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hamouda","family":"Babba","sequence":"additional","affiliation":[{"name":"Laboratory of Medical and Molecular Parasitology-Mycology (LR12ES08), Department of Clinical Biology B, Faculty of Pharmacy, University of Monastir, Monastir 5000, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1542-897X","authenticated-orcid":false,"given":"Patrick","family":"Van Dijck","sequence":"additional","affiliation":[{"name":"Laboratory of Molecular Cell Biology, Institute of Botany and Microbiology, Department of Biology, Faculty of Sciences, KU Leuven, Heverlee, 3001 Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,9,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"S10","DOI":"10.1093\/mmy\/myx134","article-title":"Malassezia ecology, pathophysiology, and treatment","volume":"56","author":"Theelen","year":"2018","journal-title":"Med. Mycol."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Jagielski, T., Rup, E., Zi\u00f3\u0142kowska, A., Roeske, K., Macura, A.B., and Bielecki, J. (2014). Distribution of Malassezia species on the skin of patients with atopic dermatitis, psoriasis, and healthy volunteers assessed by conventional and molecular identification methods. BMC Dermatol., 14.","DOI":"10.1186\/1471-5945-14-3"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1097\/01.qco.0000216624.21069.61","article-title":"Malassezia yeasts and pityriasis versicolor","volume":"19","author":"Florencio","year":"2006","journal-title":"Curr. Opin. Infect. Dis."},{"key":"ref_4","first-page":"274","article-title":"Distribution of Malassezia species in patients with different dermatological disorders and healthy individuals","volume":"24","year":"2016","journal-title":"Acta Dermatovenerol. Croat."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"101246","DOI":"10.1016\/j.mycmed.2022.101246","article-title":"Epidemiology of Pityriasis versicolor in Tunisia: Clinical features and characterization of Malassezia species","volume":"32","author":"Chebil","year":"2022","journal-title":"J. Mycol. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1093\/mmy\/myaa087","article-title":"Conventional therapy and new antifungal drugs against Malassezia infections","volume":"59","author":"Rhimi","year":"2021","journal-title":"Med. Mycol."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Abdillah, A., and Ranque, S. (2021). Chronic diseases assciated with Malassezia yeast. J. Fungi, 7.","DOI":"10.20944\/preprints202109.0416.v1"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"889694","DOI":"10.3389\/fmicb.2022.889694","article-title":"Fungal microbiota dysbiosis and ecological alterations in gastric cancer","volume":"13","author":"Yang","year":"2022","journal-title":"Front. Microbiol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"e155786","DOI":"10.1172\/JCI155786","article-title":"Fungal microbiome in inflammatory bowel disease: A critical assessment","volume":"132","author":"Underhill","year":"2022","journal-title":"J. Clin. Invest."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1016\/j.vetmic.2011.04.027","article-title":"In vitro susceptibility of fluconazole-susceptible and -resistant isolates of Malassezia pachydermatis against azoles","volume":"152","author":"Jesus","year":"2011","journal-title":"Vet. Microbiol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"536","DOI":"10.1016\/j.vetmic.2012.04.034","article-title":"Assessment of the antifungal susceptibility of Malassezia pachydermatis in various media using a CLSI protocol","volume":"159","author":"Cafarchia","year":"2012","journal-title":"Vet. Microbiol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1185","DOI":"10.1016\/S0025-7125(05)70410-7","article-title":"Pigmentary diseases","volume":"82","author":"Kim","year":"1998","journal-title":"Med. Clin. N. Am."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1937","DOI":"10.4014\/jmb.1810.10019","article-title":"Genomic tandem quadruplication is associated with ketoconazole resistance in Malassezia pachydermatis","volume":"28","author":"Kim","year":"2018","journal-title":"J. Microbiol. Biotechnol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1007\/s11046-014-9788-7","article-title":"Skin colonization by Malassezia spp. in hospitalized neonates and infants in a tertiary care centre in North India","volume":"178","author":"Gupta","year":"2014","journal-title":"Mycopathologia"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"466","DOI":"10.1097\/PAT.0000000000000139","article-title":"Malassezia pachydermatis fungaemia in an adult on posaconazole prophylaxis for acute myeloid leukaemia","volume":"46","author":"Choudhury","year":"2014","journal-title":"Pathology"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1093\/mmy\/myt004","article-title":"Bloodstream infections by Malassezia and Candida species in critical care","volume":"52","author":"Iatta","year":"2014","journal-title":"Med. Mycol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1278","DOI":"10.1111\/1346-8138.14653","article-title":"Malassezia infections with systemic involvement: Figures and facts","volume":"45","author":"Pedrosa","year":"2018","journal-title":"J. Dermatol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"E3","DOI":"10.1097\/ANC.0000000000000640","article-title":"Malassezia furfur emergance and candidemia trends in a neonatal intensive care unit during 10 years: The experience of fluconazole prophylaxis in a single hospital","volume":"20","author":"Chen","year":"2020","journal-title":"Adv. Neonatal. Care"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"641","DOI":"10.1093\/mmy\/myu010","article-title":"Antifungal susceptibility of Malassezia furfur, Malassezia sympodialis, and Malassezia globosa to azole drugs and amphortericin B evaluated using a broth microdilution method","volume":"52","author":"Rojas","year":"2014","journal-title":"Med. Mycol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"743","DOI":"10.1093\/mmy\/myv049","article-title":"Azole susceptibility of Malassezia pachydermatis and Malassezia furfur and tentative epidemiological cut-off values","volume":"53","author":"Cafarchia","year":"2015","journal-title":"Med. Mycol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1467","DOI":"10.1099\/jmm.0.078709-0","article-title":"In vitro antifungal susceptibility of Malassezia furfur from bloodstream infections","volume":"63 Pt 11","author":"Iatta","year":"2014","journal-title":"J. Med. Microbiol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1007\/BF00399623","article-title":"The genus Malassezia with description of four new species","volume":"69","author":"Midgley","year":"1996","journal-title":"Antonie Leeuwenhoek"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1007\/s11046-013-9704-6","article-title":"Identification of Malassezia species from pityriasis versicolor lesions with a new multiplex PCR method","volume":"177","author":"Vuran","year":"2014","journal-title":"Mycopathologia"},{"key":"ref_24","unstructured":"(2008). Reference Method for Broth Dilution Antifungal Susceptibility Testing of Yeast; Approved Standard-Third Edition (Standard No. CLSI document M27-A3)."},{"key":"ref_25","unstructured":"(2012). Reference Method for Broth Dilution Antifungal Susceptibility Testing of Yeasts. Fourth Informational Supplement (Standard No. CLSI document M27-S4)."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"3170","DOI":"10.1128\/JCM.00942-09","article-title":"In vitro activity of seven systemically active antifungal agents against a large global collection of rare Candida species as determined by CLSI broth microdilution methods","volume":"47","author":"Diekema","year":"2009","journal-title":"J. Clin. Microbiol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"571","DOI":"10.1111\/myc.12076","article-title":"In vitro antifungal activity of topical and systemic antifungal drugs against Malassezia species","volume":"56","author":"Rojas","year":"2013","journal-title":"Mycoses"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Rhimi, W., Inyang Aneke, C., Mosca, A., Otranto, D., and Cafarchia, C. (2020). In vitro azole and amphotericin B susceptibilities of Malasezia furfur from bloodstream infections using E-test and CLSI broth microdilution methods. Antibiotics, 9.","DOI":"10.3390\/antibiotics9060361"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1883","DOI":"10.1128\/JCM.00338-17","article-title":"Antifungal susceptibility testing of Malassezia spp. with an optimized colorimetric broth microdilution method","volume":"55","author":"Leong","year":"2017","journal-title":"J. Clin. Microbiol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1111\/myc.12556","article-title":"Antifungal susceptibility testing of Malassezia yeast: Comparison of two different methodologies","volume":"60","author":"Rojas","year":"2017","journal-title":"Mycoses"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1016\/j.vetmic.2012.05.012","article-title":"Biofilm formation of Malassezia pachydermatis from dogs","volume":"160","author":"Figueredo","year":"2012","journal-title":"Vet. Microbiol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"863","DOI":"10.3109\/13693786.2013.805440","article-title":"Antifungal susceptibility of Malassezia pachydermatis biofilm","volume":"51","author":"Figueredo","year":"2013","journal-title":"Med. Mycol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1016\/j.vetmic.2011.09.008","article-title":"In vitro antifungal susceptibility of Malassezia pachydermatis from dogs with and without skin lesions","volume":"155","author":"Cafarchia","year":"2012","journal-title":"Vet. Microbiol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"288","DOI":"10.1016\/j.vetmic.2010.10.010","article-title":"An azole-resistant isolate of Malassezia pachydermatis","volume":"149","author":"Nijima","year":"2011","journal-title":"Vet. Microbiol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1016\/j.mmcr.2014.04.004","article-title":"Malasseizia pachydermatis fungemia in a preterm neonate resistant to fluconazole and flucytosine","volume":"5","author":"Ahmad","year":"2014","journal-title":"Med. Mycol. Case Rep."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1016\/j.mmcr.2018.12.004","article-title":"Azole resistance of Malassezia pachydermatis causing treatment failure in a dog","volume":"23","author":"Angileri","year":"2018","journal-title":"Med. Mycol. Case Rep."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"53","DOI":"10.3314\/mmj.21-00013","article-title":"Rapid molecular detection of antifungal-resistant strains of Malassezia pachydermatis","volume":"63","author":"Kano","year":"2022","journal-title":"Med. Mycol. J."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"191","DOI":"10.3389\/fcimb.2020.00191","article-title":"genomic mutiplication and drug efflux influence ketoconazole resistance in Malassezia restricta","volume":"10","author":"Park","year":"2020","journal-title":"Front. Cell. Infect. Microbiol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"e01975-20","DOI":"10.1128\/AAC.01975-20","article-title":"Azole resistance mechanisms in pathogenic M. furfur","volume":"65","author":"Leong","year":"2021","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"467","DOI":"10.1128\/AAC.44.2.467-469.2000","article-title":"In vitro activities of ketoconazole, econazole, miconazole, and Melaleuca alternifolia (tea tree) oil against Malassezia species","volume":"44","author":"Hammer","year":"2000","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"3589","DOI":"10.1128\/JCM.42.8.3589-3593.2004","article-title":"Use of fatty acid RPMI 1640 media for testing susceptibilities of eight Malassezia species to the new triazole posaconazole and to six established antifungal agents by a modified NCCLS M27-A microdilution method and Etest","volume":"42","author":"Velegraki","year":"2004","journal-title":"J. Clin. Microbiol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"3429","DOI":"10.1128\/JCM.00989-06","article-title":"A modified Christensen\u2019s urea and CLSI broth microdilution method for testing susceptibilities of six Malassezia species to voriconazole, itraconazole, and ketoconazole","volume":"44","year":"2006","journal-title":"J. Clin. Microbiol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1016\/j.ijantimicag.2006.09.016","article-title":"Antifungal activiities of azole agents against the Malassezia species","volume":"29","author":"Miranda","year":"2007","journal-title":"Int. J. Antimicrob. Agents"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"795","DOI":"10.3109\/13693786.2012.674219","article-title":"In vitro evaluation of Malassezia pachydermatis susceptibility to azole compounds using E-test and CLSI micrdilution methods","volume":"50","author":"Cafarchia","year":"2012","journal-title":"Med. Mycol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"2185","DOI":"10.1128\/AAC.44.8.2185-2186.2000","article-title":"Susceptibility testing of I species using the urea broth microdilution method","volume":"44","author":"Nakamura","year":"2000","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"myac048","DOI":"10.1093\/mmy\/myac048","article-title":"Malassezia species: The need to establish epidemiological cutoff values","volume":"60","author":"Rojas","year":"2022","journal-title":"Med. Mycol."},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Espinel-Ingroff, A. (2022). Commercial methods for antifungal susceptibility testing of yeasts: Strengths and limitations as predictors of resistance. J. Fungi, 8.","DOI":"10.3390\/jof8030309"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"3800","DOI":"10.1128\/JCM.05047-11","article-title":"Triazole and echinocandin MIC distributions with epidemiological cutoff values for differentiation of wild-type strains from non-wild-type strains of six uncommon species of Candida","volume":"49","author":"Pfaller","year":"2011","journal-title":"J. Clin. Microbiol."}],"container-title":["Journal of Fungi"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2309-608X\/8\/9\/959\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:30:50Z","timestamp":1760142650000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2309-608X\/8\/9\/959"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9,13]]},"references-count":48,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2022,9]]}},"alternative-id":["jof8090959"],"URL":"https:\/\/doi.org\/10.3390\/jof8090959","relation":{},"ISSN":["2309-608X"],"issn-type":[{"value":"2309-608X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,9,13]]}}}