In vitro susceptibility of cryptococcus neoformans clinical isolates from Egypt to seven antifungal drugs
Arab Journal of Laboratory Medicine [The]. 2004; 30 (3): 505-516
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Objective: to assess the in vitro susceptibility of clinical isolates of Cryptococcus neoformans from Al-Sharkia Governorate, Egypt to seven antifungal drugs; fluconazole, miconazole, itraconazole, ketoconazole, flucytosine, nystatin and amphotericin B
Materials and Methods: a total of 59 samples of CSF and vaginal discharges, in addition to 20 oral swabs were obtained and cultured on Saburaud dextrose agar supplemented with 0.5% chloramphenicol, Esculin-based agar and PCR was carried out for confirmation and discrimination of C. neoformans. Broth and colorimetric microdilution methods were used to test the in vitro susceptibility of the C. neoformans isolates to antifungal drugs
Results: the in vitro susceptibility of 29 clinical isolates of Cryptococcus neoformans to fluconazole, miconazole, itraconazole, ketoconazole, flucytosine, nystatin and amphotericin B was tested by broth and colonmetric microdilution methods. The yeast cells were grown well in Bacto-antibiotic medium 3 and RPMI 1640 medium buffered by MOPS to pH 7 and supplemented with 1.5 % glucose. The isolates mostly showed uniform patterns of susceptibility to the used antifungal agents. The required MICs to inhibit 50 and 90% of the isolates showed high ranges for 5-flucytosine [0.5-8 mg/L], nystatin [0.2-8.25 mg/L], fluconazole [0.5-16 mg/L], and miconazole [0.2-12.5 mg/L]. However, amphotericin B [0.5-1 mg/L], ketoconazole and itraconazole [0.016-0.25 mg/L] revealed lower MICs ranges for the clinical yeast isolates in both methods used. Only three isolates exhibited resistance [four-fold or greater rise in the MICs] to the tested antifungal drugs. The resistant isolates showed MICs of fluconazole, miconazole, itraconazole and ketoconazole of about 40-120 mg/L, 6-60 mg/L for nystatin, 4-30 mg/L for 5-flucytosine and 5-8 mg/L for amphotericin B. The combination of fluconazole plus flucytosine showed higher synergy and fungicidal activity than that of fluconazole plus amphotericin B and then the use of each antifungal alone
Conclusion: isolation and identification of C. neoformans may be considered as one of the causative agents of vaginal, oral and meningis infections, particularly in neonates. Fluconazol alone or in combination with flucytosine could be used for the treatment
Materials and Methods: a total of 59 samples of CSF and vaginal discharges, in addition to 20 oral swabs were obtained and cultured on Saburaud dextrose agar supplemented with 0.5% chloramphenicol, Esculin-based agar and PCR was carried out for confirmation and discrimination of C. neoformans. Broth and colorimetric microdilution methods were used to test the in vitro susceptibility of the C. neoformans isolates to antifungal drugs
Results: the in vitro susceptibility of 29 clinical isolates of Cryptococcus neoformans to fluconazole, miconazole, itraconazole, ketoconazole, flucytosine, nystatin and amphotericin B was tested by broth and colonmetric microdilution methods. The yeast cells were grown well in Bacto-antibiotic medium 3 and RPMI 1640 medium buffered by MOPS to pH 7 and supplemented with 1.5 % glucose. The isolates mostly showed uniform patterns of susceptibility to the used antifungal agents. The required MICs to inhibit 50 and 90% of the isolates showed high ranges for 5-flucytosine [0.5-8 mg/L], nystatin [0.2-8.25 mg/L], fluconazole [0.5-16 mg/L], and miconazole [0.2-12.5 mg/L]. However, amphotericin B [0.5-1 mg/L], ketoconazole and itraconazole [0.016-0.25 mg/L] revealed lower MICs ranges for the clinical yeast isolates in both methods used. Only three isolates exhibited resistance [four-fold or greater rise in the MICs] to the tested antifungal drugs. The resistant isolates showed MICs of fluconazole, miconazole, itraconazole and ketoconazole of about 40-120 mg/L, 6-60 mg/L for nystatin, 4-30 mg/L for 5-flucytosine and 5-8 mg/L for amphotericin B. The combination of fluconazole plus flucytosine showed higher synergy and fungicidal activity than that of fluconazole plus amphotericin B and then the use of each antifungal alone
Conclusion: isolation and identification of C. neoformans may be considered as one of the causative agents of vaginal, oral and meningis infections, particularly in neonates. Fluconazol alone or in combination with flucytosine could be used for the treatment
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IMEMR
Idioma:
En
Revista:
Arab J. Lab. Med.
Ano de publicação:
2004