In vitro antifungal susceptibility profiles of Cryptococcus species isolated from HIV-associated cryptococcal meningitis patients in Zimbabwe

Abstract Cryptococcus neoformans is the leading cause of cryptocococcosis in HIV-infected subjects worldwide. Treatment of cryptococcosis is based on amphotericin B, flucytosine and fluconazole. In Zimbabwe, little is known about antifungal susceptibility of Cryptococcus . Sixty-eight genotyped Cryp...

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Published in:Diagnostic microbiology and infectious disease 2016-11, Vol.86 (3), p.289-292
Main Authors: Nyazika, Tinashe K, Herkert, Patricia F, Hagen, Ferry, Mateveke, Kudzayi, Robertson, Valerie J, Meis, Jacques F
Format: Article
Language:English
Subjects:
Adolescent
Adult
Antifungal Agents - pharmacology
Antifungal susceptibility testing
Cohort Studies
Cryptococcus gattii
Cryptococcus neoformans
Cryptococcus neoformans - drug effects
Cryptococcus neoformans - isolation & purification
Cryptococcus tetragattii
Female
HIV Infections - complications
Humans
Infectious Disease
Internal Medicine
Lentivirus
Male
Meningitis, Cryptococcal - microbiology
Microbial Sensitivity Tests
Middle Aged
Retroviridae
Young Adult
Zimbabwe
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Summary:Abstract Cryptococcus neoformans is the leading cause of cryptocococcosis in HIV-infected subjects worldwide. Treatment of cryptococcosis is based on amphotericin B, flucytosine and fluconazole. In Zimbabwe, little is known about antifungal susceptibility of Cryptococcus . Sixty-eight genotyped Cryptococcus isolates were tested for antifungal profiles. Amphotericin B, isavuconazole and voriconazole showed higher activity than other triazoles. Fluconazole and flucytosine were less effective, with geometric mean MICs of 2.24 and 2.67 mg L−1 for C. neoformans AFLP1/VNI, 1.38 and 1.53 mg L−1 for C. neoformans AFLP1A/VNB/VNII and AFLP1B/VNII, and 1.85 and 0.68 mg L−1 for C. tetragattii , respectively. A significant difference between flucytosine geometric mean MICs of C. neoformans and C. tetragattii was observed ( P = 0.0002). The majority of isolates ( n = 66/68; 97.1%) had a wildtype MIC phenotype of all antifungal agents. This study demonstrates a favourable situation with respect to the tested antifungals agents. Continued surveillance of antifungal susceptibility profiles is important due to the high burden of cryptococcosis in Africa.
ISSN:0732-8893
1879-0070
DOI:10.1016/j.diagmicrobio.2016.08.004