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


Lalitha, P; Shapiro, BL; Srinivasan, M; Prajna, NV; Acharya, NR; Fothergill, AW; Ruiz, J; Chidambaram, JD; Maxey, KJ; Hong, KC; McLeod, SD; Lietman, TM; (2007) Antimicrobial susceptibility of Fusarium, Aspergillus, and other filamentous fungi isolated from keratitis. Archives of ophthalmology, 125 (6). pp. 789-93. ISSN 0003-9950 DOI: 10.1001/archopht.125.6.789

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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.

Item Type: Article
Faculty and Department: Faculty of Infectious and Tropical Diseases > Dept of Clinical Research
Research Centre: Antimicrobial Resistance Centre (AMR)
PubMed ID: 17562990
Web of Science ID: 247143600009
URI: http://researchonline.lshtm.ac.uk/id/eprint/834598

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