Antifungal susceptibilities of Cryptococcus species complex isolates from AIDS and non-AIDS patients in Southeast China

Li, Meng; Liao, Yong; Chen, Min; Pan, Weihua; Weng, Lixing

doi:10.1590/s1413-86702012000200012

Cited by 6 publications

(5 citation statements)

References 15 publications

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“…Studies conducted in several parts of the world have shown low MIC 50 and MIC 90 values for fluconazole against C. neoformans VNI [43][44][45]. 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: 58%

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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Section: Discussioncontrasting

confidence: 58%

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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“…High MIC values (≥64 μg/ml) have been reported for fluconazole against C. gattii ( Sar et al, 2004 ; Tay et al, 2006 ; Soares et al, 2008 ; Lia et al, 2012 ), in contrast to this study, where we determined MIC values of ≤ 16 μg/ml. It is worth mentioning that MIC ≥16 μg/ml is believed to be the resistance cutoff for fluconazole; this value was observed from a single C. gattii ( C. deuterogattii ) isolate in this study.…”

Section: Discussioncontrasting

confidence: 98%

“…Studies conducted previously have shown low MIC 50 and MIC 90 values for fluconazole against C. neoformans ( Datta et al, 2003 ; Tay et al, 2006 ; Lia et al, 2012 ). In this study, the MIC 50 and MIC 90 values for fluconazole were 2–4 μg/ml; however, higher MIC 50 and MIC 90 values (4–8 and 2–128 μg/ml) have been reported for C. neoformans isolates ( Sar et al, 2004 ; Favalessa et al, 2014 ).…”

Section: Discussionmentioning

confidence: 90%

In vitro Antifungal Susceptibility Profiles of Cryptococcus neoformans var. grubii and Cryptococcus gattii Clinical Isolates in Guangxi, Southern China

Al-Odaini

et al. 2021

Front. Microbiol.

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This study analyzed the in vitro drug sensitivity of Cryptococcus spp. from Guangxi, Southern China. One hundred three strains of Cryptococcus were recovered from 86 patients; 14 were HIV positive and 72 were HIV negative. Ninety-two strains were identified as Cryptococcus neoformans var. grubii, while 11 strains were identified as Cryptococcus gattii (5 C. gattii sensu stricto and 6 Cryptococcus deuterogattii). The recovered strains were tested against commonly used antifungal drugs (fluconazole, amphotericin B, 5-fluorocytosine, itraconazole, and voriconazole) and to novel antifungal drugs (posaconazole and isavuconazole) using CLSI M27-A4 method. The results showed that all isolates were susceptible to most antifungal drugs, of which the minimum inhibitory concentration (MIC) ranges were as follows: 0.05–4 μg/ml for fluconazole, 0.25–1 μg/ml for amphotericin B; 0.0625–2 μg/ml for 5-fluorocytosine, 0.0625–0.25 μg/ml for itraconazole, 0.0078–0.25 μg/ml for voriconazole, 0.0313–0.5 μg/ml for posaconazole, 0.0020–0.125 μg/ml for isavuconazole for C. neoformans var. grubii isolates, and 1–16 μg/ml for fluconazole, 0.125–1 μg/ml for 5-fluorocytosine, 0.25–1 μg/ml for amphotericin B, 0.0625–0.25 μg/ml for itraconazole, 0.0156–0.125 μg/ml for voriconazole, 0.0156–0.25 μg/ml for posaconazole, and 0.0078–0.125 μg/ml for isavuconazole for C. gattii isolates. Furthermore, some C. neoformans var. grubii isolates were found to be susceptible-dose dependent to 5-fluorocytosine and itraconazole. In addition, a reduction in the potency of fluconazole against C. gattii is possible. We observed no statistical differences in susceptibility of C. neoformans var. grubii and C. gattii in the tested strains. Continuous observation of antifungal susceptibility of Cryptococcus isolates is recommended to monitor the emergence of resistant strains.

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“…Ergosterol is an essential element for several aspects of fungal physiology 8 , which makes difficult for the cell to produce mutations related to resistance 9 . Most strains of the main fungal pathogens for humans have the inhibition of growth in vitro when exposed to concentrations from 0.05 to 1.0 µg/mL 10 . It means that strains presenting the minimal inhibitory concentrations (MIC) above this interval are considered potentially resistant.…”

Section: Mechanisms Of Resistancementioning

confidence: 99%

Nephrotoxicity and fungal resistance associated with Amphotericin B

Berto

Dalzochio²

2021

Saúde e meio ambient.: rev. interdisciplin.

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Introduction: Amphotericin B (AB) is the drug of choice for the treatment of several systemic fungal infections. Despite of its effectiveness and minimum relation to the resistance, AB is toxic to animal cells, in particular to the kidney cells. Objective: To address the aspects of resistance, nephrotoxicity and biomarkers available for the early detection of kidney disease caused by AB. Method: The bibliographic search was performed in online databases. Papers published between 2008-2019, were selected for further analysis and inclusion in the present review. Results: The search resulted in 42 eligible papers which the main findings were: (i) the frequency of resistance to AB appears to be substantial, however, some species should be carefully studied given their diminished susceptibility; (ii) regarding nephrotoxicity, new techniques and methods have promisingly been implemented; and (iii) a novel generation of biomarkers for kidney injury is more specific and sensitive. Conclusion: The adoption of conjugated drug delivery systems is a consistent alternative to minimize nephrotoxicity and fungal resistance. Considering the biomarkers, it is more likely that, instead of a punctual assessment of a single biomarker, a set of biomarkers provides a more thorough comprehension of the aspects related to AB-induced kidney injury. Nonetheless, more clinical studies are necessary for further implementation of such biomarkers in the clinical routine. Keywords: Amphotericin B. Nephrotoxicity. Acute Kidney Injury. Biomarkers.

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Antifungal susceptibilities of Cryptococcus species complex isolates from AIDS and non-AIDS patients in Southeast China

Cited by 6 publications

References 15 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

In vitro Antifungal Susceptibility Profiles of Cryptococcus neoformans var. grubii and Cryptococcus gattii Clinical Isolates in Guangxi, Southern China

Nephrotoxicity and fungal resistance associated with Amphotericin B

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