title: Susceptibility profile and epidemiological cut-off values of Cryptococcus neoformans species complex from Argentina.
abstract: Epidemiological cut-off values (ECVs) based on minimal inhibitory concentration (MIC) distribution have been recently proposed for some antifungal drug/Cryptococcus neoformans combinations. However, these ECVs vary according to the species studied, being serotypes and the geographical origin of strains, variables to be considered. The aims were to define the wild-type (WT) population of the C. neoformans species complex (C. neoformans) isolated from patients living in Argentina, and to propose ECVs for six antifungal drugs. A total of 707 unique C. neoformans isolates obtained from HIV patients suffering cryptococcal meningitis were studied. The MIC of amphotericin B, flucytosine, fluconazole, itraconazole, voriconazole and posaconazole was determined according to the EDef 7.2 (EUCAST) reference document. The MIC distribution, MIC50 , MIC90 and ECV for each of these drugs were calculated. The highest ECV, which included ≥95% of the WT population modelled, was observed for flucytosine and fluconazole (32 μg ml(-1) each). For amphotericin B, itraconazole, voriconazole and posaconazole, the ECVs were: 0.5, 0.5, 0.5 and 0.06 μg ml(-1) respectively. The ECVs determined in this study may aid in identifying the C. neoformans strains circulating in Argentina with decreased susceptibility to the antifungal drugs tested.
authors: Instituto Nacional de Enfermedades Infecciosas "Dr. C. G. Malbrán", Buenos Aires, Argentina.
authors: Susana
authors: S
authors: Córdoba
authors: Instituto Nacional de Enfermedades Infecciosas "Dr. C. G. Malbrán", Buenos Aires, Argentina.
authors: Maria G
authors: MG
authors: Isla
authors: Instituto Nacional de Enfermedades Infecciosas "Dr. C. G. Malbrán", Buenos Aires, Argentina.
authors: Wanda
authors: W
authors: Szusz
authors: Instituto Nacional de Enfermedades Infecciosas "Dr. C. G. Malbrán", Buenos Aires, Argentina.
authors: Walter
authors: W
authors: Vivot
authors: Cátedra de Cálculo Estadístico y Biometría, Facultad de Ciencias Agrarias y Forestales, Buenos Aires, Argentina.
authors: Rodrigo
authors: R
authors: Altamirano
authors: Instituto Nacional de Enfermedades Infecciosas "Dr. C. G. Malbrán", Buenos Aires, Argentina.
authors: Graciela
authors: G
authors: Davel
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000382:microbiology* / Q000401:mortality; D000666:Amphotericin B / Q000494:pharmacology; D000935:Antifungal Agents / Q000494:pharmacology*; D001118:Argentina / Q000453:epidemiology; D003453:Cryptococcosis / Q000453:epidemiology* / Q000382:microbiology*; D003455:Cryptococcus neoformans / Q000187:drug effects* / Q000302:isolation & purification; D025141:Drug Resistance, Fungal; D004812:Epidemiologic Methods; D015725:Fluconazole / Q000494:pharmacology; D005437:Flucytosine / Q000494:pharmacology; D015658:HIV Infections / Q000382:microbiology; D006801:Humans; D017964:Itraconazole / Q000494:pharmacology; D016919:Meningitis, Cryptococcal / Q000382:microbiology*; D008826:Microbial Sensitivity Tests; D014230:Triazoles / Q000494:pharmacology; D065819:Voriconazole / Q000494:pharmacology
chemical_list: D000935:Antifungal Agents; D014230:Triazoles; D017964:Itraconazole; C101425:posaconazole; D000666:Amphotericin B; D015725:Fluconazole; D005437:Flucytosine; D065819:Voriconazole
keywords: Argentina; Cryptococcus neoformans; HIV; antifungal drugs; epidemiological cut-off value