Skip to main content
Antimicrobial Agents and Chemotherapy logoLink to Antimicrobial Agents and Chemotherapy
. 1993 Jun;37(6):1383–1386. doi: 10.1128/aac.37.6.1383

Susceptibilities of serial Cryptococcus neoformans isolates from patients with recurrent cryptococcal meningitis to amphotericin B and fluconazole.

A Casadevall 1, E D Spitzer 1, D Webb 1, M G Rinaldi 1
PMCID: PMC187974  PMID: 8328793

Abstract

Amphotericin B and fluconazole susceptibilities of 13 Cryptococcus neoformans isolates from five patients with recurrent cryptococcal meningitis were determined. For each patient, serial isolates showed no increase in antibiotic resistance relative to the initial isolate. For these patients, recurrent disease was not due to drug resistance but may reflect changes in immune function and/or poor compliance.

Full text

PDF

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bodey G. P. Azole antifungal agents. Clin Infect Dis. 1992 Mar;14 (Suppl 1):S161–S169. doi: 10.1093/clinids/14.supplement_1.s161. [DOI] [PubMed] [Google Scholar]
  2. Brajtburg J., Kobayashi D., Medoff G., Kobayashi G. S. Antifungal action of amphotericin B in combination with other polyene or imidazole antibiotics. J Infect Dis. 1982 Aug;146(2):138–146. doi: 10.1093/infdis/146.2.138. [DOI] [PubMed] [Google Scholar]
  3. Brajtburg J., Powderly W. G., Kobayashi G. S., Medoff G. Amphotericin B: current understanding of mechanisms of action. Antimicrob Agents Chemother. 1990 Feb;34(2):183–188. doi: 10.1128/aac.34.2.183. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Casadevall A., Freundlich L. F., Marsh L., Scharff M. D. Extensive allelic variation in Cryptococcus neoformans. J Clin Microbiol. 1992 May;30(5):1080–1084. doi: 10.1128/jcm.30.5.1080-1084.1992. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Eng R. H., Bishburg E., Smith S. M., Kapila R. Cryptococcal infections in patients with acquired immune deficiency syndrome. Am J Med. 1986 Jul;81(1):19–23. doi: 10.1016/0002-9343(86)90176-2. [DOI] [PubMed] [Google Scholar]
  6. Espinel-Ingroff A., Kerkering T. M., Goldson P. R., Shadomy S. Comparison study of broth macrodilution and microdilution antifungal susceptibility tests. J Clin Microbiol. 1991 Jun;29(6):1089–1094. doi: 10.1128/jcm.29.6.1089-1094.1991. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Fromtling R. A., Galgiani J. N., Pfaller M. A., Espinel-Ingroff A., Bartizal K. F., Bartlett M. S., Body B. A., Frey C., Hall G., Roberts G. D. Multicenter evaluation of a broth macrodilution antifungal susceptibility test for yeasts. Antimicrob Agents Chemother. 1993 Jan;37(1):39–45. doi: 10.1128/aac.37.1.39. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Ghannoum M. A., Ibrahim A. S., Fu Y., Shafiq M. C., Edwards J. E., Jr, Criddle R. S. Susceptibility testing of Cryptococcus neoformans: a microdilution technique. J Clin Microbiol. 1992 Nov;30(11):2881–2886. doi: 10.1128/jcm.30.11.2881-2886.1992. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Kovacs J. A., Kovacs A. A., Polis M., Wright W. C., Gill V. J., Tuazon C. U., Gelmann E. P., Lane H. C., Longfield R., Overturf G. Cryptococcosis in the acquired immunodeficiency syndrome. Ann Intern Med. 1985 Oct;103(4):533–538. doi: 10.7326/0003-4819-103-4-533. [DOI] [PubMed] [Google Scholar]
  10. Kwon-Chung K. J., Polacheck I., Bennett J. E. Improved diagnostic medium for separation of Cryptococcus neoformans var. neoformans (serotypes A and D) and Cryptococcus neoformans var. gattii (serotypes B and C). J Clin Microbiol. 1982 Mar;15(3):535–537. doi: 10.1128/jcm.15.3.535-537.1982. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Mukherjee J., Pirofski L. A., Scharff M. D., Casadevall A. Antibody-mediated protection in mice with lethal intracerebral Cryptococcus neoformans infection. Proc Natl Acad Sci U S A. 1993 Apr 15;90(8):3636–3640. doi: 10.1073/pnas.90.8.3636. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Mukherjee J., Scharff M. D., Casadevall A. Protective murine monoclonal antibodies to Cryptococcus neoformans. Infect Immun. 1992 Nov;60(11):4534–4541. doi: 10.1128/iai.60.11.4534-4541.1992. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Pfaller M. A., Dupont B., Kobayashi G. S., Müller J., Rinaldi M. G., Espinel-Ingroff A., Shadomy S., Troke P. F., Walsh T. J., Warnock D. W. Standardized susceptibility testing of fluconazole: an international collaborative study. Antimicrob Agents Chemother. 1992 Sep;36(9):1805–1809. doi: 10.1128/aac.36.9.1805. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Powderly W. G., Kobayashi G. S., Herzig G. P., Medoff G. Amphotericin B-resistant yeast infection in severely immunocompromised patients. Am J Med. 1988 May;84(5):826–832. doi: 10.1016/0002-9343(88)90059-9. [DOI] [PubMed] [Google Scholar]
  15. Powderly W. G. Therapy for cryptococcal meningitis in patients with AIDS. Clin Infect Dis. 1992 Mar;14 (Suppl 1):S54–S59. doi: 10.1093/clinids/14.supplement_1.s54. [DOI] [PubMed] [Google Scholar]
  16. Saag M. S., Dismukes W. E. Azole antifungal agents: emphasis on new triazoles. Antimicrob Agents Chemother. 1988 Jan;32(1):1–8. doi: 10.1128/aac.32.1.1. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Schacter L. P., Owellen R. J., Rathbun H. K., Buchanan B. Letter: Antagonism between miconazole and amphotericin B. Lancet. 1976 Aug 7;2(7980):318–318. doi: 10.1016/s0140-6736(76)90774-1. [DOI] [PubMed] [Google Scholar]
  18. Schaffner A., Frick P. G. The effect of ketoconazole on amphotericin B in a model of disseminated aspergillosis. J Infect Dis. 1985 May;151(5):902–910. doi: 10.1093/infdis/151.5.902. [DOI] [PubMed] [Google Scholar]
  19. Spitzer E. D., Spitzer S. G., Freundlich L. F., Casadevall A. Persistence of initial infection in recurrent Cryptococcus neoformans meningitis. Lancet. 1993 Mar 6;341(8845):595–596. doi: 10.1016/0140-6736(93)90354-j. [DOI] [PubMed] [Google Scholar]
  20. Sud I. J., Feingold D. S. Effect of ketoconazole on the fungicidal action of amphotericin B in Candida albicans. Antimicrob Agents Chemother. 1983 Jan;23(1):185–187. doi: 10.1128/aac.23.1.185. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Sud I. J., Feingold D. S. Mechanisms of action of the antimycotic imidazoles. J Invest Dermatol. 1981 Jun;76(6):438–441. doi: 10.1111/1523-1747.ep12521036. [DOI] [PubMed] [Google Scholar]
  22. Sugar A. M., Saunders C. Oral fluconazole as suppressive therapy of disseminated cryptococcosis in patients with acquired immunodeficiency syndrome. Am J Med. 1988 Oct;85(4):481–489. doi: 10.1016/s0002-9343(88)80082-2. [DOI] [PubMed] [Google Scholar]
  23. Zuger A., Louie E., Holzman R. S., Simberkoff M. S., Rahal J. J. Cryptococcal disease in patients with the acquired immunodeficiency syndrome. Diagnostic features and outcome of treatment. Ann Intern Med. 1986 Feb;104(2):234–240. doi: 10.7326/0003-4819-104-2-234. [DOI] [PubMed] [Google Scholar]
  24. Zuger A., Schuster M., Simberkoff M. S., Rahal J. J., Holzman R. S. Maintenance amphotericin B for cryptococcal meningitis in the acquired immunodeficiency syndrome (AIDS). Ann Intern Med. 1988 Oct 1;109(7):592–593. doi: 10.7326/0003-4819-109-7-592. [DOI] [PubMed] [Google Scholar]

Articles from Antimicrobial Agents and Chemotherapy are provided here courtesy of American Society for Microbiology (ASM)

RESOURCES