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JAC Advance Access published online on November 9, 2005
Journal of Antimicrobial Chemotherapy, 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
Received July 26, 2005
Revised September 27, 2005
Accepted October 3, 2005

Brief report

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

Alexander Perkins 1, Alicia Gomez-Lopez 1, Emilia Mellado 1, Juan L. Rodriguez-Tudela 1, and Manuel Cuenca-Estrella 1*

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

* To whom correspondence should be addressed.
Manuel Cuenca-Estrella, E-mail: mcuenca-estrella{at}isciii.es


  Abstract

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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