Skip Navigation


JAC Advance Access originally published online on September 30, 2003
This Article
Right arrow Full Text Freely available
Right arrow FREE Full Text (PDF) Freely available
Right arrow All Versions of this Article:
52/5/873    most recent
dkg434v1
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrow Search for citing articles in:
ISI Web of Science (12)
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Paterson, P. J.
Right arrow Articles by Kibbler, C. C.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Paterson, P. J.
Right arrow Articles by Kibbler, C. C.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?


Journal of Antimicrobial Chemotherapy (2003) 52, 873-876
© 2003 The British Society for Antimicrobial Chemotherapy

Treatment failure in invasive aspergillosis: susceptibility of deep tissue isolates following treatment with amphotericin B

P. J. Paterson1,2, S. Seaton1, H. G. Prentice2 and C. C. Kibbler1,*

Departments of 1 Microbiology and 2 Haematology, Royal Free and University College Medical School, Royal Free Campus and Royal Free Hospital, Pond Street, London NW3 2QG, UK

Received 4 June 2003; returned 16 July 2003; revised 1 August 2003; accepted 1 August 2003

Objectives: To determine whether treatment failure in invasive aspergillosis (IA) is the result of resistance of Aspergillus spp. isolates to amphotericin B.

Methods: Six Aspergillus fumigatus and six Aspergillus flavus isolates cultured from deep tissue biopsies in 11 patients with haematological malignancies during 1991–1998 were tested. A method based on the NCCLS M38-A broth microdilution method, with colorimetric determination of MICs, was used to determine the MICs of amphotericin B and itraconazole.

Results: All A. fumigatus isolates were susceptible to amphotericin B (MIC 0.25–0.5 mg/L), as were three A. flavus isolates (MIC 1 mg/L), but three were less susceptible (MIC 2 mg/L). All isolates were susceptible to itraconazole (MIC 0.125–0.25 mg/L). All patients had been treated with amphotericin B, having received a median of 12 days of treatment when the tissue was obtained.

Conclusion: The difficulty in treating IA may not be because of the susceptibility of the isolates, but because of poor penetration of antifungal agents into infected tissue. Aspergillus spp. invade blood vessels causing thrombosis and tissue infarction, and therefore it may be difficult for antifungal drugs to exceed MICs in infected tissues. This highlights the need for different treatment strategies, such as surgery and the administration of cytokines.

Keywords: NCCLS, antifungals, MICs, Aspergillus

* Corresponding author. Tel: +44-020-779-40500; Fax: +44-020-783-02179; E-mail: kibbler{at}rfc.ucl.ac.uk


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
 J Antimicrob ChemotherHome page
K. Allinson, H. Kolve, H. G. Gumbinger, H. J. Vormoor, K. Ehlert, and A. H. Groll
Secondary antifungal prophylaxis in paediatric allogeneic haematopoietic stem cell recipients
J. Antimicrob. Chemother., March 1, 2008; 61(3): 734 - 742.
[Abstract] [Full Text] [PDF]

Home page
 MicrobiologyHome page
M. T. Hedayati, A. C. Pasqualotto, P. A. Warn, P. Bowyer, and D. W. Denning
Aspergillus flavus: human pathogen, allergen and mycotoxin producer
Microbiology, June 1, 2007; 153(6): 1677 - 1692.
[Abstract] [Full Text] [PDF]

Home page
 J Med MicrobiolHome page
R. S. Jayshree, M. Shafiulla, J. George, J. K. David, P. P. Bapsy, and A. Chakrabarti
Microscopic, cultural and molecular evidence of disseminated invasive aspergillosis involving the lungs and the gastrointestinal tract.
J. Med. Microbiol., July 1, 2006; 55(Pt 7): 961 - 964.
[Abstract] [Full Text] [PDF]

Home page
 Antimicrob. Agents Chemother.Home page
B. J. Hoeben, D. S. Burgess, J. T. McConville, L. K. Najvar, R. L. Talbert, J. I. Peters, N. P. Wiederhold, B. L. Frei, J. R. Graybill, R. Bocanegra, et al.
In vivo efficacy of aerosolized nanostructured itraconazole formulations for prevention of invasive pulmonary aspergillosis.
Antimicrob. Agents Chemother., April 1, 2006; 50(4): 1552 - 1554.
[Abstract] [Full Text] [PDF]

Home page
 Infect. Immun.Home page
M. S. Lionakis, J. Lahdenranta, J. Sun, W. Liu, R. E. Lewis, N. D. Albert, R. Pasqualini, W. Arap, and D. P. Kontoyiannis
Development of a Ligand-Directed Approach To Study the Pathogenesis of Invasive Aspergillosis
Infect. Immun., November 1, 2005; 73(11): 7747 - 7758.
[Abstract] [Full Text] [PDF]

Home page
 Clin. Microbiol. Rev.Home page
N. Singh and D. L. Paterson
Aspergillus Infections in Transplant Recipients
Clin. Microbiol. Rev., January 1, 2005; 18(1): 44 - 69.
[Abstract] [Full Text] [PDF]

Home page
 Antimicrob. Agents Chemother.Home page
J. R. Graybill, S. Hernandez, R. Bocanegra, and L. K. Najvar
Antifungal Therapy of Murine Aspergillus terreus Infection
Antimicrob. Agents Chemother., October 1, 2004; 48(10): 3715 - 3719.
[Abstract] [Full Text] [PDF]


Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.