Revista medico-chirurgicala a Societatii de Medici si Naturalisti din Iasi · 2008
[Cryptococcus meningitis, five years of experience and literature review].
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Dorneanu Olivia, Filip Olga, Miftode Egidia, Radu Irina, Nicolau Cristina, Damian Ioana, Luca V
Аннотация
UNLABELLED: The aim of this study was to determine the distribution and antifungal susceptibility profile of Cryptococcus spp. isolated from patients in northeast Romania.
MATERIAL AND METHOD: Fungi isolated from blood and cerebrospinal fluid (CSF) cultures were identified by ID32C strips (bioMerieux, France). Susceptibility testing was performed using ATB FUNGUS2 strips (bioMerieux, France).
RESULTS: A total of 20 significant strains have been isolated. Overall, Cryptococcus neoformans was the most frequent isolate (95%). We mention the first Cryptococcus albidus meningitis in Romania (strain with multiple resistance). All cryptococci tested were susceptible to amphotericin B with minimal inhibitory concentration (MIC) =1 microg/mL; 90% strains were susceptible to flucytosine. Resistance to fluconazole and itraconazole was observed in 2 and 1 case, respectively. Most of the patients had an associated infection, tuberculosis in 37.5% cases. Despite appropriate therapy 4 patients died (21%).
CONCLUSION: First choice induction therapy with amphotericin B plus flucytosine followed by fluconazole is highly recommended since resistance to antifungal agents is still very low.
MATERIAL AND METHOD: Fungi isolated from blood and cerebrospinal fluid (CSF) cultures were identified by ID32C strips (bioMerieux, France). Susceptibility testing was performed using ATB FUNGUS2 strips (bioMerieux, France).
RESULTS: A total of 20 significant strains have been isolated. Overall, Cryptococcus neoformans was the most frequent isolate (95%). We mention the first Cryptococcus albidus meningitis in Romania (strain with multiple resistance). All cryptococci tested were susceptible to amphotericin B with minimal inhibitory concentration (MIC) =1 microg/mL; 90% strains were susceptible to flucytosine. Resistance to fluconazole and itraconazole was observed in 2 and 1 case, respectively. Most of the patients had an associated infection, tuberculosis in 37.5% cases. Despite appropriate therapy 4 patients died (21%).
CONCLUSION: First choice induction therapy with amphotericin B plus flucytosine followed by fluconazole is highly recommended since resistance to antifungal agents is still very low.
Предметные рубрики MeSH
AdolescentAdultAmphotericin BAntifungal AgentsCryptococcus neoformansDrug Resistance, FungalDrug Therapy, CombinationFemaleFluconazoleHIV InfectionsHumansImmunocompromised HostItraconazoleMaleMeningitis, CryptococcalMiddle AgedRetrospective StudiesRomaniaSurvival AnalysisTreatment OutcomeTuberculosis, Pulmonary