Antimicrobial susceptibility of Fusarium, Aspergillus, and other filamentous fungi isolated from keratitis
Antimicrobial susceptibility of Fusarium, Aspergillus, and other filamentous fungi isolated from keratitis
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DOI：
10.1001/archopht.125.6.789
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发表时间：
2007-06-01
影响因子：
--
通讯作者：
Lietman, Thomas M.
中科院分区：
文献类型：
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作者：
Lalitha, Prajna;Shapiro, Brett L.;Lietman, Thomas M.
目的：描述从角膜炎中分离的丝状真菌对阿替霉素B、纳他霉素、醋酸卡泊芬净、伊曲康唑、伏立康唑和泊沙康唑的敏感性。方法：在印度南部的Aravind眼科医院，使用大量肉汤稀释法对阿替霉素B、纳他霉素、卡泊芬净、伊曲康唑、伏立康唑和泊沙康唑的敏感性进行了测试。结果：90株分离菌中曲霉菌41株，镰刀菌38株，其它11株。三唑类和卡泊芬净对曲霉菌属的MIC最低;伏立康唑、阿替霉素B和泊沙康唑对镰刀菌属的MIC最低，伊曲康唑或卡泊芬净对镰刀菌属无抑制作用。两性霉素B有显着较低的MIC相比，纳他霉素，但校正后的典型处方剂量，纳他霉素是上级。结论：没有单一的代理是普遍最有效的，但伏立康唑和其他三唑类药物表现出最广泛的频谱。伊曲康唑和卡泊芬净对镰刀菌species.Clinical Relevance无效：真菌性溃疡通常凭经验治疗;通常选择药物而不考虑敏感性数据。非眼部感染性疾病的文献表明，现代真菌易感性方法是临床相关的，但眼部研究是有限的。我们的研究结果表明，抗真菌治疗可能是针对个别生物体。
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.