activity of manogepix and comparators against infrequently encountered yeast and mold isolates from the SENTRY Surveillance Program (2017-2022).

Manogepix is a potent new antifungal agent targeting the fungal Gwt1 enzyme. Manogepix has previously demonstrated potent activity against clinical isolates of both (except ) and species. This study determined the activity of manogepix and comparators against a large collection of infrequently encountered yeast and molds. Manogepix demonstrated potent activity against infrequently encountered yeasts exhibiting elevated MIC values to other drug classes, including spp. (MIC, 0.008/0.12 mg/L), () (MIC, 0.03/0.06 mg/L), (MIC, 0.016-0.06 mg/L), (MIC, 0.016 mg/L), and (MIC, 0.03/0.12 mg/L). Similarly, manogepix was active against infrequently encountered mold isolates and strains exhibiting elevated MIC/MEC values to echinocandins, azoles, and amphotericin B, including (MEC, 0.004 mg/L), spp. (MEC, 0.016/0.06 mg/L), () species complex (MEC, 0.016/0.03 mg/L), (MEC, 0.03/0.06 mg/L), (MEC, 0.008 mg/L), spp. (MEC, ≤0.008/0.016 mg/L), (MEC, 0.06 mg/L), (MEC range, 0.016-0.12 mg/L), and spp. (MEC, 0.03/0.06 mg/L). Manogepix demonstrated potent activity against a majority of the infrequently encountered yeast and mold isolates tested including strains with elevated MIC/MEC values to other drug classes. Additional clinical development of manogepix (fosmanogepix) in difficult-to-treat, resistant fungal infections is warranted.