Title
Correlation of susceptibility of Cryptococcus neoformans to amphotericin B with clinical outcome
Date Issued
01 December 2011
Access level
open access
Resource Type
journal article
Author(s)
Larsen R.A.
Bauer M.
Pitisuttithum P.
Sanchez A.
Tansuphaswadikul S.
Wuthiekanun V.
Peacock S.J.
Simpson A.J.H.
Fothergill A.W.
Rinaldi M.G.
Thomas A.M.
Altomstone R.
Day N.P.J.
White N.J.
Publisher(s)
American Society for Microbiology
Abstract
Testing of Cryptococcus neoformans for susceptibility to antifungal drugs by standard microtiter methods has not been shown to correlate with clinical outcomes. This report describes a modified quantitative broth macrodilution susceptibility method showing a correlation with both the patient's quantitative biological response in the cerebrospinal fluid (CSF) and the survival of 85 patients treated with amphotericin B (AMB). The Spearman rank correlation between the quantitative in vitro measure of susceptibility and the quantitative measure of the number of organisms in the patient's CSF was 0.37 (P < 0.01; 95% confidence interval [95% CI], 0.20, 0.60) for the first susceptibility test replicate and 0.46 (P < 0.001; 95% CI, 0.21, 0.62) for the second susceptibility test replicate. The median in vitro estimated response (defined as the fungal burden after AMB treatment) at 1.5 mg/liter AMB for patients alive at day 14 was 5 CFU (95% CI, 3, 8), compared to 57 CFU (95% CI, 4, 832) for those who died before day 14. These exploratory results suggest that patients whose isolates show a quantitative in vitro susceptibility response below 10 CFU/ml were more likely to survive beyond day 14. Copyright © 2011, American Society for Microbiology. All Rights Reserved.
Start page
5624
End page
5630
Volume
55
Issue
12
Language
English
OCDE Knowledge area
Medicina tropical
Enfermedades infecciosas
PatologÃa
Scopus EID
2-s2.0-81555221156
PubMed ID
Source
Antimicrobial Agents and Chemotherapy
ISSN of the container
0066-4804
Sponsor(s)
National Institute of Allergy and Infectious Diseases R01AI070091 NIAID
Sources of information:
Directorio de Producción CientÃfica
Scopus