Results Obtained with Various Antifungal Susceptibility Testing Methods Do Not Predict Early Clinical Outcome in Patients with Cryptococcosis
| Autor: | A. Michel-Nguyen, M. Arpin, M. Abdul, Olivier Lortholary, A. Favel, Marie-Antoinette Piens, Françoise Dromer, Eric Dannaoui |
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| Rok vydání: | 2006 |
| Předmět: |
Male
Serotype Antifungal Agents Flucytosine HIV Infections Microbial Sensitivity Tests Microbiology Predictive Value of Tests Amphotericin B medicine Humans Pharmacology (medical) Fluconazole Etest Pharmacology Cryptococcus neoformans AIDS-Related Opportunistic Infections biology Broth microdilution Cryptococcosis Prognosis bacterial infections and mycoses biology.organism_classification medicine.disease Treatment Outcome Infectious Diseases Susceptibility Female medicine.drug |
| Zdroj: | Antimicrobial Agents and Chemotherapy. 50:2464-2470 |
| ISSN: | 1098-6596 0066-4804 |
| DOI: | 10.1128/aac.01520-05 |
| Popis: | The in vitro susceptibilities of Cryptococcus neoformans isolates from consecutive human immunodeficiency virus-positive and -negative patients to the antifungal agents fluconazole, amphotericin B, and flucytosine were determined by different techniques, including the CLSI method, Etest, and broth microdilution in yeast nitrogen base (YNB) medium, during a multicenter prospective study in France. The relationship between the in vitro data and the clinical outcome 2 weeks after the initiation of antifungal therapy was assessed. In addition, the correlation between the strain serotype and the in vitro activities of the antifungals was determined, and the susceptibility results obtained with the different techniques were also compared. Thirty-seven patients received a combination of amphotericin B with flucytosine as first-line therapy, 22 were treated with amphotericin B alone, and 15 received fluconazole alone. Whatever the antifungal tested, there was no trend toward higher MICs for strains isolated from patients who failed to respond to a given therapy compared to those from patients who did not with either the CLSI method, Etest, or broth microdilution in YNB medium. The MICs obtained by the CLSI or Etest method were significantly lower for serotype D strains than for serotype A strains for both fluconazole and amphotericin B, while flucytosine MICs were not different according to serotype. These findings suggest that the in vitro antifungal susceptibility of C. neoformans , as determined with the techniques used, is not able to predict the early clinical outcome in patients with cryptococcosis. |
| Databáze: | OpenAIRE |
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