Abstract
The in vitro susceptibility profile of 24 clinical isolates of non-Cryptococcus neoformans/non-Cryptococcus gattii Cryptococcus species was analysed. In addition, the susceptibility results of 98 other strains from seven different reports were reviewed. The latter included studies which used antifungal susceptibility testing reference procedures or commercial methods which exhibited high correlation rates with the reference procedures. A total of 122 isolates were analysed (57 Cryptococcus albidus, 39 Cryptococcus laurentii, ten Cryptococcus uniguttulatus, ten Cryptococcus humicola, four Cryptococcus curvatus, and two Cryptococcus luteolus). Amphotericin B was in vitro the most active compound against all species, while flucytosine and candins were inactive. Fluconazole exhibited a limited in vitro activity, particularly against C. albidus, C. uniguttulatus and C. laurentii. Voriconazole, itraconazole and posaconazole were active against most of isolates, but we found significant rates of decreased susceptibility. Identification and susceptibility testing of Cryptococcus spp. should be performed on a routine basis in view of their unpredictable susceptibility profiles.
Acknowledgements
L. Bernal-Martinez has a research Contract from REIPI (Red Española de Investigación de Patología Infecciosa, Project MPY 1022/07_1). M.V Castelli has a research contract from AECI (Agencia Española de Cooperación Internacional) a research contract from AECI (Agencia Española de Cooperación Internacional, 2007–08). A.C. Mesa Arango has a grant from program AlBan Asociación Grupo Santander from European Union A. C. Mesa has a grant from program AlBan Asociacio′n Grupo Santander from European Union (7941), and Oscar Zaragoza is a ‘Ramón y Cajal’ fellow.
Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.
This paper was first published online on Early Online on 23 February 2009.