This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrowReprints and Permissions
Right arrow Copyright Information
Right arrow Books from ASM Press
Right arrow MicrobeWorld
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Pfaller, M. A.
Right arrow Articles by Diekema, D. J.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Pfaller, M. A.
Right arrow Articles by Diekema, D. J.

 Previous Article  |  Next Article 

Journal of Clinical Microbiology, May 2005, p. 2163-2167, Vol. 43, No. 5
0095-1137/05/$08.00+0     doi:10.1128/JCM.43.5.2163-2167.2005
Copyright © 2005, American Society for Microbiology. All Rights Reserved.

Global Trends in the Antifungal Susceptibility of Cryptococcus neoformans (1990 to 2004)

M. A. Pfaller,1,2* S. A. Messer,1 L. Boyken,1 C. Rice,1 S. Tendolkar,1 R. J. Hollis,1 G. V. Doern,1 and D. J. Diekema1,3

Departments of Pathology,1 Medicine, Roy J. and Lucille A. Carver College of Medicine,3 Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa 522422

Received 23 November 2004/ Returned for modification 29 December 2004/ Accepted 4 January 2005

The antifungal susceptibilities of 1,811 clinical isolates of Cryptococcus neoformans obtained from 100 laboratories in 5 geographic regions worldwide between 1990 and 2004 were determined. The MICs of amphotericin B, flucytosine, fluconazole, voriconazole, posaconazole, and ravuconazole were determined by the National Committee for Clinical Laboratory Standards broth microdilution method. Isolates were submitted to a central reference laboratory (University of Iowa) from study centers in Africa (5 centers, 395 isolates), Europe (14 centers, 102 isolates), Latin America (14 centers, 82 isolates), the Pacific region (7 centers, 50 isolates), and North America (60 centers, 1,182 isolates). Resistance to amphotericin B, flucytosine, and fluconazole was ≤1% overall. Susceptibility to flucytosine (MIC, ≤4 µg/ml) ranged from 35% in North America to 68% in Latin America. Similarly, only 75% of isolates from North America were susceptible to fluconazole (MIC, ≤8 µg/ml) compared to 94 to 100% in the other regions. Isolates remained highly susceptible to amphotericin B (99% susceptibility at a MIC of ≤1 µg/ml) over the entire 15-year period. Susceptibility to flucytosine (MIC, ≤4 µg/ml) increased from 34% in 1990 to 1994 to 66% in 2000 to 2004. Susceptibility to fluconazole (MIC, ≤8 µg/ml) increased from 72% in 1990 to 1994 to 96% in 2000 to 2004. Voriconazole, posaconazole, and ravuconazole all were very active (99% of isolates susceptible at MIC of ≤1 µg/ml) against this geographically diverse collection of isolates. We conclude that in vitro resistance to antifungal agents used in the treatment of cryptococcosis remains uncommon among isolates of C. neoformans from five broad geographic regions and has not increased over a 15-year period.

* Corresponding author. Mailing address: Medical Microbiology Division, C606 GH, Department of Pathology, University of Iowa College of Medicine, Iowa City, IA 52242. Phone: (319) 384-9566. Fax: (319) 356-4916. E-mail: michael-pfaller{at}uiowa.edu.

Journal of Clinical Microbiology, May 2005, p. 2163-2167, Vol. 43, No. 5
0095-1137/05/$08.00+0     doi:10.1128/JCM.43.5.2163-2167.2005
Copyright © 2005, American Society for Microbiology. All Rights Reserved.



This article has been cited by other articles:

  • Carbonara, S., Regazzi, M., Ciraci, E., Villani, P., Stano, F., Cusato, M., Heichen, M., Monno, L. (2009). Long-Term Efficacy and Safety of TDM-Assisted Combination of Voriconazole plus Efavirenz in an AIDS Patient with Cryptococcosis and Liver Cirrhosis. The Annals of Pharmacotherapy 43: 978-984 [Abstract] [Full Text]  
  • Cannon, R. D., Lamping, E., Holmes, A. R., Niimi, K., Baret, P. V., Keniya, M. V., Tanabe, K., Niimi, M., Goffeau, A., Monk, B. C. (2009). Efflux-Mediated Antifungal Drug Resistance. Clin. Microbiol. Rev. 22: 291-321 [Abstract] [Full Text]  
  • Thompson, G. R. III, Wiederhold, N. P., Fothergill, A. W., Vallor, A. C., Wickes, B. L., Patterson, T. F. (2009). Antifungal Susceptibilities among Different Serotypes of Cryptococcus gattii and Cryptococcus neoformans. Antimicrob. Agents Chemother. 53: 309-311 [Abstract] [Full Text]  
  • Pfaller, M. A., Diekema, D. J., Gibbs, D. L., Newell, V. A., Bijie, H., Dzierzanowska, D., Klimko, N. N., Letscher-Bru, V., Lisalova, M., Muehlethaler, K., Rennison, C., Zaidi, M., the Global Antifungal Surveillance Group, (2009). Results from the ARTEMIS DISK Global Antifungal Surveillance Study, 1997 to 2007: 10.5-Year Analysis of Susceptibilities of Noncandidal Yeast Species to Fluconazole and Voriconazole Determined by CLSI Standardized Disk Diffusion Testing. J. Clin. Microbiol. 47: 117-123 [Abstract] [Full Text]  
  • Rachwalski, E. J, Wieczorkiewicz, J. T, Scheetz, M. H (2008). Posaconazole: An Oral Triazole with an Extended Spectrum of Activity. The Annals of Pharmacotherapy 42: 1429-1438 [Abstract] [Full Text]  
  • Torres-Rodriguez, J. M., Alvarado-Ramirez, E., Murciano, F., Sellart, M. (2008). MICs and minimum fungicidal concentrations of posaconazole, voriconazole and fluconazole for Cryptococcus neoformans and Cryptococcus gattii. J Antimicrob Chemother 62: 205-206 [Full Text]  
  • Cowen, L. E., Steinbach, W. J. (2008). Stress, Drugs, and Evolution: the Role of Cellular Signaling in Fungal Drug Resistance. Eukaryot Cell 7: 747-764 [Full Text]  
  • Pasqualotto, A. C., Denning, D. W. (2008). New and emerging treatments for fungal infections. J Antimicrob Chemother 61: i19-i30 [Abstract] [Full Text]  
  • Khan, Z. U., Randhawa, H. S., Kowshik, T., Chowdhary, A., Chandy, R. (2007). Antifungal susceptibility of Cryptococcus neoformans and Cryptococcus gattii isolates from decayed wood of trunk hollows of Ficus religiosa and Syzygium cumini trees in north-western India. J Antimicrob Chemother 60: 312-316 [Abstract] [Full Text]  
  • Schwarz, P., Janbon, G., Dromer, F., Lortholary, O., Dannaoui, E. (2007). Combination of Amphotericin B with Flucytosine Is Active In Vitro against Flucytosine-Resistant Isolates of Cryptococcus neoformans. Antimicrob. Agents Chemother. 51: 383-385 [Abstract] [Full Text]  
  • Espinel-Ingroff, A. (2006). Comparison of Three Commercial Assays and a Modified Disk Diffusion Assay with Two Broth Microdilution Reference Assays for Testing Zygomycetes, Aspergillus spp., Candida spp., and Cryptococcus neoformans with Posaconazole and Amphotericin B. J. Clin. Microbiol. 44: 3616-3622 [Abstract] [Full Text]  
  • Schwarz, P., Dromer, F., Lortholary, O., Dannaoui, E. (2006). Efficacy of Amphotericin B in Combination with Flucytosine against Flucytosine-Susceptible or Flucytosine-Resistant Isolates of Cryptococcus neoformans during Disseminated Murine Cryptococcosis. Antimicrob. Agents Chemother. 50: 113-120 [Abstract] [Full Text]  
  • Pfaller, M. A., Diekema, D. J., Rinaldi, M. G., Barnes, R., Hu, B., Veselov, A. V., Tiraboschi, N., Nagy, E., Gibbs, D. L., the Global Antifungal Surveillance Group, (2005). Results from the ARTEMIS DISK Global Antifungal Surveillance Study: a 6.5-Year Analysis of Susceptibilities of Candida and Other Yeast Species to Fluconazole and Voriconazole by Standardized Disk Diffusion Testing. J. Clin. Microbiol. 43: 5848-5859 [Abstract] [Full Text]  
  • Perkins, A., Gomez-Lopez, A., Mellado, E., Rodriguez-Tudela, J. L., Cuenca-Estrella, M. (2005). Rates of antifungal resistance among Spanish clinical isolates of Cryptococcus neoformans var. neoformans. J Antimicrob Chemother 56: 1144-1147 [Abstract] [Full Text]  
  • Pfaller, M. A., Boyken, L., Messer, S. A., Tendolkar, S., Hollis, R. J., Diekema, D. J. (2005). Comparison of Results of Voriconazole Disk Diffusion Testing for Candida Species with Results from a Central Reference Laboratory in the ARTEMIS Global Antifungal Surveillance Program. J. Clin. Microbiol. 43: 5208-5213 [Abstract] [Full Text]  
  • Pfaller, M. A., Boyken, L., Hollis, R. J., Messer, S. A., Tendolkar, S., Diekema, D. J. (2005). In Vitro Susceptibilities of Clinical Isolates of Candida Species, Cryptococcus neoformans, and Aspergillus Species to Itraconazole: Global Survey of 9,359 Isolates Tested by Clinical and Laboratory Standards Institute Broth Microdilution Methods. J. Clin. Microbiol. 43: 3807-3810 [Abstract] [Full Text]  


Copyright © 2009 by the American Society for Microbiology.   For an alternate route to Journals.ASM.org, visit: http://intl-journals.asm.org | More Info»