Increasing in vitro resistance to fluconazole in Cryptococcus neoformans Cambodian isolates: April 2000 to March 2002

Sar, Borann; Monchy, Didier; Vann, Mich; Keo, Chantary; Sarthou, Jean Louis; Buisson, Y.

doi:10.1093/jac/dkh361

Cited by 94 publications

(61 citation statements)

References 8 publications

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“…In this study, the MIC 50 and MIC 90 values for fluconazole were 4-8 mg/L; however, higher values (2-128 mg/L) have been reported for isolates of C. neoformans VNI [46].…”

Section: Discussioncontrasting

confidence: 56%

Molecular typing and in vitro antifungal susceptibility of Cryptococcus spp from patients in Midwest Brazil

Favalessa

Paula

Dutra

et al. 2014

J Infect Dev Ctries

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Introduction: Cryptococcosis is a systemic fungal infection that affects humans and animals, mainly due to Cryptococcus neoformans and Cryptococcus gattii. Following the epidemic of acquired immunodeficiency syndrome (AIDS), fungal infections by C. neoformans have become more common among immunocompromised patients. Cryptococcus gattii has primarily been isolated as a primary pathogen in healthy hosts and occurs endemically in northern and northeastern Brazil. We to perform genotypic characterization and determine the in vitro susceptibility profile to antifungal drugs of the Cryptococcus species complex isolated from HIV-positive and HIV-negative patients attended at university hospitals in Cuiabá, MT, in the Midwestern region of Brazil. Methodology: Micromorphological features, chemotyping with canavanine-glycine-bromothymol blue (CGB) agar and genotyping by URA5-RFLP were used to identify the species. The antifungal drugs tested were amphotericin B, fluconazole, flucytosine, itraconazole and voriconazole. Minimum inhibitory concentrations (MICs) were determined according to the CLSI methodology M27-A3. Results: Analysis of samples yelded C. neoformans AFLP1/VNI (17/27, 63.0%) and C. gattii AFLP6/VGII (10/27, 37.0%). The MICs ranges for the antifungal drugs were: amphotericin B (0.5-1 mg/L), fluconazole (1-16 mg/L), flucytosine (1-16 mg/L), itraconazole (0.25-0.12 mg/L) and voriconazole (0.06-0.5 mg/L). Isolates of C. neoformans AFLP1/VNI were predominant in patients with HIV/AIDS, and C. gattii VGII in HIV-negative patients. The genotypes identified were susceptible to the antifungal drugs tested. Conclusion: It is worth emphasizing that AFLP6/VGII is a predominant genotype affecting HIV-negative individuals in Cuiabá. These findings serve as a guide concerning the molecular epidemiology of C. neoformans and C. gattii in the State of Mato Grosso.

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“…In this study, the MIC 50 and MIC 90 values for fluconazole were 4-8 mg/L; however, higher values (2-128 mg/L) have been reported for isolates of C. neoformans VNI [46].…”

Section: Discussioncontrasting

confidence: 56%

Molecular typing and in vitro antifungal susceptibility of Cryptococcus spp from patients in Midwest Brazil

Favalessa

Paula

Dutra

et al. 2014

J Infect Dev Ctries

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“…Studies by Brandt et al (11), Davey et al (17), Klepser and Pfaller (25), and Yildiran et al (48) provide in vitro antifungal susceptibility data generated by National Committee for Clinical Laboratory Standards (NCCLS) reference MIC methods (30), indicating that in vitro resistance to commonly used antifungal agents (i.e., amphotericin B, flucytosine, fluconazole, and itraconazole) remains uncommon among C. neoformans and has not increased with time in the last decade in the United States and in the United Kingdom. In contrast, Sar et al (44) report an increase in resistance to fluconazole from 2.5% to 14% between 2001 and 2002 in a hospital in Cambodia. Both Archibald et al (6) and Datta et al (16) stress the need for expanded international surveillance of antifungal susceptibility of cryptococcal isolates; however, the published literature thus far is limited to small studies of limited geographic scope conducted over rather short periods of time (2, 6, 12-14, 16, 18, 41, 44).…”

mentioning

confidence: 89%

“…Most of these reports involve resistance to fluconazole emerging in the setting of meningitis in AIDS patients after long treatments or prophylaxis with fluconazole (7,8,34). Recent reports from Cambodia (12,44) and from India (16) have raised the concern of a more widespread increase in fluconazole resistance among C. neoformans, suggesting the need for greater vigilance and more-widespread surveillance.…”

mentioning

confidence: 99%

Global Trends in the Antifungal Susceptibility of Cryptococcus neoformans (1990 to 2004)

Pfaller

Messer²,

Boyken³

et al. 2005

J Clin Microbiol

189

119

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“…Globally, it is estimated that approximately 957,900 cases of cryptococcal meningitis occur each year, resulting in more than 600,000 deaths (Sar et al, 2004). Neurological dysfunction as the first manifestation of AIDS has been found in 10-20% of symptomatic HIV infections (Botha and Wessels, 1999).…”

Section: Resultsmentioning

confidence: 99%

A 28 Years Old Woman with Severe Headache and Few Episodes of Vomiting: A Case Report

Nakhayi¹

2010

American Journal of Infectious Diseases

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Problem statement: Cryptococcosis neoformans is commonest central nervous system infection in individuals infected with HIV. Most of the patients infected with Cryptococcus neoformans present with headache and visual changes. Approach: A 28 year old woman presented to Emergency Department (ED) with a chief complaint of headache, fever and vomiting and developed seizures during the first hour of admission. Firstly, diagnosed as cryptococcal meningitis, then, because of having a low White Blood Cell count (WBC) and low Total Lymphocyte Count (TLC) she was checked for HIV Ab and P24 Ag. Results: A diagnosis of HIV was made then her family members were checked for HIV and they were also HIV positive. Patient was discharged with a two month course of Fluconazole and after completion of antifungal treatment, Antiretroviral Treatment (HAART) was started. Conclusion: This case indicated that Cryptococcosis neoformans may develop in Immune-deficient patients, so complete laboratory workup and high index of suspicion to HIV should be under diagnosis.

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Increasing in vitro resistance to fluconazole in Cryptococcus neoformans Cambodian isolates: April 2000 to March 2002

Cited by 94 publications

References 8 publications

Molecular typing and in vitro antifungal susceptibility of Cryptococcus spp from patients in Midwest Brazil

Molecular typing and in vitro antifungal susceptibility of Cryptococcus spp from patients in Midwest Brazil

Global Trends in the Antifungal Susceptibility of Cryptococcus neoformans (1990 to 2004)

A 28 Years Old Woman with Severe Headache and Few Episodes of Vomiting: A Case Report

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