We amplified, cloned, and sequenced the -tubulin gene of Vittaforma corneae, a microsporidium causing human infections. The -tubulin gene sequence has a substitution at Glu 198 (with glutamine), which is one of six amino acids reported to be associated with benzimidazole sensitivity. Benzimidazoles were assayed for antimicrosporidial activity and showed poor parasite inhibition.Microsporidia are obligate intracellular protozoan parasites that have emerged as major opportunistic human pathogens since the onset of the AIDS pandemic (6, 11). Vittaforma corneae is responsible for keratitis in otherwise healthy persons (2, 9, 10, 18), but disseminated infections have occurred in human immunodeficiency virus-infected patients as well (3). V. corneae was first described as Nosema corneum in a stromal biopsy from a non-human immunodeficiency virus-infected man who suffered from central disciform keratitis for 18 months (2). The parasite was cultivated in cell culture and identified as a new species, N. corneum (19). Infection with this organism was subsequently established in athymic mice (20), and new taxonomically significant features found warranted placing this organism within a new genus, Vittaforma, as V. corneae (21). In the second reported case of V. corneae infection, dual microsporidial infection was detected in a patient with AIDS-Encephalitozoon hellem in the sinonasal aspirate and V. corneae in the urine (3), indicating that V. corneae is capable of dissemination and survival in deep tissues, at least in an immunocompromised host. Three further cases involving V. corneae infection of the corneal stroma of immunocompetent patients were published (9,10,18). In addition to these confirmed cases, there is molecular evidence (obtained by PCR) for Vittaforma infections as a cause of keratitis in India (15 cases) (12) and of enteritis in Portugal (25 cases) (23).Benzimidazoles are widely used as anthelmintic drugs in veterinary and human medicine and have been used as antifungal agents in agriculture. Albendazole is one of the most commonly used drugs for treating microsporidiosis in humans (5). Infections with Encephalitozoon spp. respond especially well to therapy with albendazole, whereas infections with Enterocytozoon bieneusi do not respond to albendazole, and the sequence of the -tubulin gene of E. bieneusi suggests that this species is resistant to albendazole (1,5). No clinical data about the response of Vittaforma infections to albendazole are available, and molecular data on the -tubulin gene are not available for this species either. We therefore tested the susceptibility of V. corneae to different benzimidazoles in vitro and amplified, cloned, and sequenced the -tubulin gene of V. corneae.MRC-5 cells were seeded on 24-well culture plates at a concentration of 5 ϫ 10 5 /ml in minimal essential medium and incubated overnight to confluence. Confluent monolayers of cells were inoculated with 2 ϫ 10 6 microsporidian spores (V. corneae and E. cuniculi as a control). Three hours later, noninternalized sp...