Please use this identifier to cite or link to this item: http://repositorio.unicamp.br/jspui/handle/REPOSIP/326722
Type: Artigo
Title: Evaluation Of Antifungal Combination Against Cryptococcus Spp.
Author: Reichert-Lima
Franqueline; Busso-Lopes
Ariane F.; Lyra
Luzia; Peron
Isabela Haddad; Taguchi
Hideaki; Mikami
Yuzuru; Kamei
Katsuiko; Moretti
Maria Luiza; Schreiber
Angelica Z.
Abstract: The second cause of death among systemic mycoses, cryptococcosis treatment represents a challenge since that 5-flucytosine is not currently available in Brazil. Looking for alternatives, this study evaluated antifungal agents, alone and combined, correlating susceptibility to genotypes. Eighty Cryptococcus clinical isolates were genotyped by URA5 gene restriction fragment length polymorphism. Antifungal susceptibility was assessed following CLSI-M27A3 for amphotericin (AMB), 5-flucytosine (5FC), fluconazole (FCZ), voriconazole (VRZ), itraconazole (ITZ) and terbinafine (TRB). Drug interaction chequerboard assay evaluated: AMB + 5FC, AMB + FCZ, AMB + TRB and FCZ + TRB. Molecular typing divided isolates into 14 C. deuterogattii (VGII) and C. neoformans isolates were found to belong to genotype VNI (n = 62) and VNII (n = 4). C. neoformans VNII was significantly less susceptible than VNI (P = 0.0407) to AMB; C. deuterogattii was significantly less susceptible than VNI and VNII to VRZ (P < 0.0001). C. deuterogattii was less susceptible than C. neoformans VNI for FCZ (P = 0.0170), ITZ (P < 0.0001) and TRB (P = 0.0090). The combination FCZ + TRB showed 95.16% of synergistic effect against C. neoformans genotype VNI isolates and all combinations showed 100% of synergism against genotype VNII isolates, suggesting the relevance of cryptococcal genotyping as it is widely known that the various genotypes (now species) have significant impact in antifungal susceptibilities and clinical outcome. In difficult-to-treat cryptococcosis, terbinafine and different antifungal combinations might be alternatives to 5FC.
Subject: Cryptococcus Neoformans
Cryptococcus Gattii
Cryptococcus Deuterogattii
Rflp
Combined Antifungal Agents
Editor: Wiley-Blackwell
Hoboken
Rights: fechado
Identifier DOI: 10.1111/myc.12510
Address: http://onlinelibrary.wiley.com/doi/10.1111/myc.12510/abstract
Date Issue: 2016
Appears in Collections:Unicamp - Artigos e Outros Documentos

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