Publication: Antifungal drug susceptibility of Cryptococcus neoformans from clinical sources in Nairobi, Kenya
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2006
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Blackwell Publishing Ltd
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Abstract
The serotypes and mating types of 80 clinical isolates of Cryptococcus neoformans from
Kenya were studied and subjected to broth microdilution susceptibility testing to
amphotericin B (AMP), flucytosin, fluconazole (FLC), itraconazole (ITC) and miconazole
(MCZ). The isolates included C. neoformans var. grubii – 75 of 80 (serotype A; 93.7%),
C. neoformans var. neoformans – three of 80 (3.8%) and C. neoformans var. gattii – two
(serotype B; 2.5%). Mating experiment confirmed all the isolates to be a-mating type.
Seventy-eight (97.5%) of the isolates had minimum inhibitory concentration (MIC) of
£0.5 lg ml)1 to AMP and at 1 lg ml)1
, 100% of the isolates were inhibited. Flucytosin
resistance was observed in 21% with MIC in which 90% of the isolates were inhibited
(MIC 90 ) of 64 lg ml)1 . Only 23.8% of the strains were susceptible to FLC with 65%
susceptible dose-dependent (SDD) and 11.2% resistant. Itraconazole susceptibility was
61.3% while the rest were either SDD or resistant. The MIC90 for ITC and MCZ were 0.5
and 2 lg ml)1 respectively.
The study reports the serotypes, mating types and highlights the existence of azoles
resistance in C. neoformans in Nairobi which calls for antifungal drug resistance
surveillance as prophylactic use of FLC increases because of human immunodeficiency
virus/acquired immunodeficiency syndrome (HIV/AIDS) epidemic in sub-Saharan
Afric