In vitro antifungal susceptibility profiles of Cryptococcus species isolated from HIV-associated cryptococcal meningitis patients in Zimbabwe.
Cryptococcus neoformans is the leading cause of cryptococcosis 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 2.67mg/L for C. neoformans AFLP1/VNI, 1.38 and 1.53mg/L for C. neoformans AFLP1A/VNB/VNII and AFLP1B/VNII, and 1.85 and 0.68mg/L for Cryptococcus 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 wild-type MIC phenotype of all antifungal agents. This study demonstrates a favorable 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.
Department of Chemical Pathology, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe; Department of Medical Microbiology, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe; Department of Medical Microbiology and Infectious Diseases, Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands. Electronic address: tknyazika@gmail.com.
Tinashe K
TK
Nyazika
Department of Medical Microbiology and Infectious Diseases, Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands; Postgraduate Program in Microbiology, Parasitology and Pathology, Biological Sciences, Department of Basic Pathology, Federal University of Parana, Curitiba, Brazil.
Patricia F
PF
Herkert
Department of Medical Microbiology and Infectious Diseases, Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands.
Ferry
F
Hagen
Research Support Centre, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe.
Kudzanai
K
Mateveke
Department of Medical Microbiology, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe.
Valerie J
VJ
Robertson
Department of Medical Microbiology and Infectious Diseases, Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands; Department of Medical Microbiology, Radboud University Medical Centre, Nijmegen, The Netherlands.
Jacques F
JF
Meis
D000293:Adolescent; D000328:Adult; D000935:Antifungal Agents / Q000494:pharmacology*; D015331:Cohort Studies; D003455:Cryptococcus neoformans / Q000187:drug effects* / Q000302:isolation & purification*; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D008297:Male; D016919:Meningitis, Cryptococcal / Q000382:microbiology*; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D055815:Young Adult; D015030:Zimbabwe
D000935:Antifungal Agents
Antifungal susceptibility testing; Cryptococcus gattii; Cryptococcus neoformans; Cryptococcus tetragattii; Zimbabwe