Assay of cytomegalovirus susceptibility to ganciclovir in renal and heart transplant recipients.
Ganciclovir (GCV) prophylaxis or pre-emptive therapy significantly reduce the rate of cytomegalovirus (CMV) disease and viremia, but increase the potential for emergence of ganciclovir-resistant CMV strains. The inhibitor concentration at 50% (IC(50)) of GCV from 156 CMV isolates from 59 renal or heart transplant recipients was calculated by means of a rapid phenotypic susceptibility assay. Twenty-seven strains were from 14 patients undergoing GCV therapy. The IC(50) was higher in patients under the prophylaxis regimen. One CMV strain, from a heart transplant recipient, became GCV-resistant after 1 month of therapy (IC(50)=13.7 micromol/l). These data, together with clinical and virological markers, suggested that a switch to foscarnet was necessary, and good evolution was observed. Thus, assay of CMV susceptibility to GCV could be helpful in clinical management.
de Oña Navarro
María
M
Virology Section, Hospital Central de Asturias, C/Celestino Villamil, s/n, 33006 Oviedo, Asturias, Spain. mona@hcas.insalud.es
Melón
Santiago
S
Méndez
Susana
S
Iglesias
Beatriz
B
Palacio
Ana
A
Bernardo
María J
MJ
Rodriguez-Lambert
José L
JL
Gómez
Ernesto
E
D000998:Antiviral Agents / Q000494:pharmacology*; D003587:Cytomegalovirus / Q000187:drug effects* / Q000235:genetics; D004352:Drug Resistance, Microbial; D015774:Ganciclovir / Q000494:pharmacology*; D016027:Heart Transplantation; D006801:Humans; D016030:Kidney Transplantation; D008826:Microbial Sensitivity Tests; D010641:Phenotype
D000998:Antiviral Agents; D015774:Ganciclovir