title: In vitro susceptibilities of cerebrospinal fluid isolates of Cryptococcus neoformans collected during a ten-year period against fluconazole, voriconazole and posaconazole (SCH56592).
abstract: We investigated the in vitro susceptibilities of 213 cerebrospinal fluid isolates of Cryptococcus neoformans isolated from 192 patients through a 10-year period, 1990-99, against fluconazole, voriconazole and posaconazole (SCH56592) by using the NCCLS (National Committee for Clinical Laboratory Standards) macrodilution method, M27-A. The overall MICs50 and MICs90 of fluconazole, voriconazole and posaconazole were found to be 2 and 8 micro g ml-1, <or=0.125 micro g ml-1 (both), and <or=0.015 and 0.06 micro g ml-1, respectively. The MIC ranges, MICs50, and MICs90 of three triazoles were also determined according to the defined year category (1990-94, 1995, 1996, 1997 and 1998-99). The MICs50 and MICs90 of each triazole remained almost unchanged and did not exhibit any sign of an upward shift during a decade (1990-99). However, a tendency for development of possible cross-resistance between the three triazoles was observed only in 1996. Meanwhile, the individual relapsing isolates (n:21) from 20 patients exhibited same, higher or, suprisingly, lower MICs, particularly against fluconazole and posaconazole.
authors.affiliation: Department of Pathology, University of Texas Health Science Center, San Antonio, Texas, USA.sinasit@gata.edu.tr
authors.forename: S T
authors.initials: ST
authors.lastname: Yildiran
authors.forename: A W
authors.initials: AW
authors.lastname: Fothergill
authors.forename: D A
authors.initials: DA
authors.lastname: Sutton
authors.forename: M G
authors.initials: MG
authors.lastname: Rinaldi
mesh_terms: D000935:Antifungal Agents / Q000494:pharmacology*; D002555:Cerebrospinal Fluid / Q000382:microbiology*; D003453:Cryptococcosis / Q000134:cerebrospinal fluid* / Q000188:drug therapy / Q000382:microbiology; D003455:Cryptococcus neoformans / Q000187:drug effects*; D004352:Drug Resistance, Microbial; D015725:Fluconazole / Q000494:pharmacology; D006801:Humans; D066298:In Vitro Techniques; D008826:Microbial Sensitivity Tests; D011743:Pyrimidines / Q000494:pharmacology; D014230:Triazoles / Q000494:pharmacology*; D065819:Voriconazole
chemical_list: D000935:Antifungal Agents; D011743:Pyrimidines; D014230:Triazoles; C101425:posaconazole; D015725:Fluconazole; D065819:Voriconazole