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JAC Advance Access originally published online on November 9, 2005
Journal of Antimicrobial Chemotherapy 2005 56(6):1144-1147; doi:10.1093/jac/dki393
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© The Author 2005. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Rates of antifungal resistance among Spanish clinical isolates of Cryptococcus neoformans var. neoformans

Alexander Perkins, Alicia Gomez-Lopez, Emilia Mellado, Juan L. Rodriguez-Tudela and Manuel Cuenca-Estrella*

Servicio de Micología, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Ctra Majadahonda-Pozuelo Km 2. 28220 Majadahonda (Madrid), Spain

Received 26 July 2005; returned 13 September 2005; revised 27 September 2005; accepted 3 October 2005

* Corresponding author. Tel: +34-91-5097961; Fax: +34-91-5097966; E-mail: mcuenca-estrella{at}isciii.es

Objectives: Activities in vitro of six antifungal agents were tested against a collection of 317 Cryptococcus neoformans var. neoformans clinical isolates.

Methods: The procedure described in document 7.1 by the European Committee on Antibiotic Susceptibility Testing with minor modifications was employed.

Results: Amphotericin B, itraconazole, voriconazole and ravuconazole exhibited a potent activity with geometric mean (GM) MICs under 0.26 mg/L. The GM MIC of flucytosine was 7.33 mg/L and that of fluconazole was 4.16 mg/L. The rates of antifungal resistance were 5.3% for amphotericin B, 0.9% for voriconazole and 3.1% for ravuconazole. Fifteen point eight per cent of strains had itraconazole MICs ≥1 mg/L, and 46% of strains had flucytosine MICs ≥8 mg/L. Fluconazole susceptibility (MIC ≤8 mg/L) stood at 53.4%.

Conclusions: The percentage of fluconazole susceptibility was significantly lower than that in other surveys. Cross-resistance to itraconazole was common (33.8%) but almost the whole collection was susceptible to voriconazole and ravuconazole. These results should be confirmed with prospective and population-based surveillance programmes.

Keywords: fluconazole resistance , EUCAST , surveillance programmes


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