In vitro susceptibility of isolated Cryptococcus strains to fluconazole and voriconazole

[摘要] INTRODUCTION: invasive fungal infections have increased as a result of medical advances in the sphere of transplantation, cancer treatment, autoimmune diseases and AIDS fundamentally. Cryptococcus disease, infrequent before, holds the third place in the incidence of severe mycosis in AIDS patients and it is also the most lethal. Up to the present, there exist few reports on the development of Cryptococcus resistance to antifungal products, however, it is foreseen that wide use of fluconazole might encourage the emergence of less susceptible strains.OBJECTIVES: given the importance of surveillance of antifungal susceptibility and of the evaluation of new therapeutical options, in vitro action of fluconazole and voriconazole on a high number of isolated Cryptococcus strains was determined through Etest method on clinical and environmental samples.METHODS: in vitro susceptibility to fluconazole and voriconazole of 159 Cryptococcus strains (117 from clinical samples and 42 from environmental sources of Central and Western regions in Cuba) was determined through Etest method.RESULTS: the studied isolates showed low MIC values, mainly susceptibility to voriconazole. Ranges, geometric means and modes were 0.031-128, 4.631 y 3 mg/mL for fluconazole and 0.003-8, 0.02 y 0.016 mg/mL for voriconazole, respectively. Although MIC values were generally higher than those of environmental isolates, there were no statistically significant differences (p= 0.05) among strains according to their origin (clinical/environmental) or to their geographical location.CONCLUSIONS: this paper points out the importance of continuing this type of study for the detection of resistance to the most used drugs in anticryptococcus disease therapy as well as in the search of new strategies to treat this infection.

[学科分类] 传染病学

[关键词] : Cryptococcus;in vitro susceptibility;fluconazole;voriconazole;Etest