Antimicrobial susceptibility of Fusarium, Aspergillus, and other filamentous fungi isolated from keratitis.

Authors

Lalitha P, Shapiro BL, Srinivasan M, et al.

Institution

Aravind Eye Hospital and PG Institute of Ophthalmology, Madurai, India.

Source

Arch Ophthalmol 2007 Jun; 125(6) :789-93.

Abstract

OBJECTIVE
To characterize the susceptibility of filamentous fungi isolated from keratitis to amphotericin B, natamycin, caspofungin acetate, itraconazole, voriconazole, and posaconazole.
METHODS
Ninety isolates from fungal keratitis cases at Aravind Eye Hospital in South India were tested using macrobroth dilution for susceptibility to amphotericin B, natamycin, caspofungin, itraconazole, voriconazole, and posaconazole. The minimum inhibitory concentration (MIC) median and 90th percentile were determined.
RESULTS
The 90 isolates included 41 Aspergillus species, 38 Fusarium species, and 11 others. The triazoles and caspofungin had the lowest MICs against Aspergillus species; voriconazole, amphotericin B, and posaconazole had the lowest MICs against Fusarium species, and none of the Fusarium species were inhibited by itraconazole or caspofungin. Amphotericin B had significantly lower MICs compared with natamycin, but after correcting for the typical prescription dose, natamycin was superior.
CONCLUSION
No single agent was universally most effective, but voriconazole and other triazoles demonstrated the broadest spectrum. Itraconazole and caspofungin were not effective against Fusarium species.
CLINICAL RELEVANCE
Fungal ulcers are commonly treated empirically; drugs are typically selected without regard to susceptibility data. The nonocular infectious disease literature suggests modern fungal susceptibility methods are clinically relevant, but ocular studies are limited. Our results suggest antifungal therapy might be tailored to individual organisms.

Mesh

Amphotericin B
Antifungal Agents
Aspergillus
Corneal Ulcer
Echinocandins
Eye Infections, Fungal
Fusarium
Humans
Itraconazole
Microbial Sensitivity Tests
Natamycin
Peptides, Cyclic
Prospective Studies
Pyrimidines
Triazoles

Language

eng

Pub Type(s)

Comparative Study Journal Article Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't

PubMed ID

17562990

Content Manager

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