title: Rates of antifungal resistance among Spanish clinical isolates of Cryptococcus neoformans var. neoformans.
abstract: OBJECTIVE
  Activities in vitro of six antifungal agents were tested against a collection of 317 Cryptococcus neoformans var. neoformans clinical isolates.
  
  
  METHODS
  The procedure described in document 7.1 by the European Committee on Antibiotic Susceptibility Testing with minor modifications was employed.
  
  
  RESULTS
  Amphotericin B, itraconazole, voriconazole and ravuconazole exhibited a potent activity with geometric mean (GM) MICs under 0.26 mg/L. The GM MIC of flucytosine was 7.33 mg/L and that of fluconazole was 4.16 mg/L. The rates of antifungal resistance were 5.3% for amphotericin B, 0.9% for voriconazole and 3.1% for ravuconazole. Fifteen point eight per cent of strains had itraconazole MICs > or = 1 mg/L, and 46% of strains had flucytosine MICs > or = 8 mg/L. Fluconazole susceptibility (MIC < or = 8 mg/L) stood at 53.4%.
  
  
  CONCLUSIONS
  The percentage of fluconazole susceptibility was significantly lower than that in other surveys. Cross-resistance to itraconazole was common (33.8%) but almost the whole collection was susceptible to voriconazole and ravuconazole. These results should be confirmed with prospective and population-based surveillance programmes.
authors.affiliation: Servicio de Micología, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Ctra Majadahonda-Pozuelo Km 2. 28220 Majadahonda (Madrid), Spain.
authors.forename: Alexander
authors.initials: A
authors.lastname: Perkins
authors.forename: Alicia
authors.initials: A
authors.lastname: Gomez-Lopez
authors.forename: Emilia
authors.initials: E
authors.lastname: Mellado
authors.forename: Juan L
authors.initials: JL
authors.lastname: Rodriguez-Tudela
authors.forename: Manuel
authors.initials: M
authors.lastname: Cuenca-Estrella
mesh_terms: D000935:Antifungal Agents / Q000494:pharmacology*; D003453:Cryptococcosis / Q000382:microbiology*; D003455:Cryptococcus neoformans / Q000187:drug effects* / Q000302:isolation & purification; D025141:Drug Resistance, Fungal; D006761:Hospitals; D006801:Humans; D008826:Microbial Sensitivity Tests; D013030:Spain
chemical_list: D000935:Antifungal Agents