In Vitro Susceptibility to Voriconazole of 566 Clinical Isolates of Cryptococcus neoformans from Africa and the United States.

M.A. PFALLER, S.A. MESSER, M. GHANNOUM, M. TUMBERLAND, E.K. MBIDDE, M.E. BRANDT, R.A. HAJJEH

Abstract: 

Among the community acquired opportunistic fungal pathogens, perhaps the most important and certainly the most common agent of serious infection is Cryptococcus neoformans. A rare disease prior to the onset of the HIV epidemic, cryptococcosis is one of the most common life-threatening infections in AIDS patients and it is now the most common cause of meningitis at many large hospitals caring for AIDS patients. Current therapy with amphotericin B is complicated by toxicity. Although fluconazole and itraconazole are better tolerated, concerns of resistance and decreased efficacy exist. Thus, there is a need for continued evaluation of alternative agents against C. neoformans var. neoformans. Voriconazole is a new monotriazole antifungal agent which has potent activity against Candida, Cryptococcus, and Aspergillus species. We investigated the in vitro activity of voriconazole (Vori) compared to those of fluconazole (Flu) and itraconazole (Itz) against 566 clinical isolates of C. neoformans from Africa (164) and the U.S. (402). Isolates were obtained from CSF (362), blood (139) and miscellaneous sites (65). MICs for all antifungal drugs were determined by NCCLS methodology using RPMI 1640 test medium. Vori was quite active against C. neoformans isolates from Africa (MIC_{90}, 0.25 mug/ml) and the U.S. (MIC_{90}, 0.12 mug/ml). Vori was more active than either Itz (MIC_{90}, 0.5 mug/ml) or Flu (MIC_{90}, 8.0 - 16 mug/ml) against both African and U.S. isolates. Isolates inhibited by >= 16 mug/ml of Flu were inhibited by
1998

abstract No: 

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Full conference title: 

38th Interscience Conference on Antimicrobial Agents and Chemotherapy
    • ICAAC 38th