| dc.description.abstract | Poor susceptibility of Cryptococcus neoformans to fluconazole (FLC) is a matter of
concern among clinicians in Africa. The emergence of resistance to FLC was recently
reported in Kenya, but it is not known whether it is widespread. Thus, there is need for
more antifungal drug susceptibility studies in Kenya. The aim of this study was to
measure the in vitro antifungal drug susceptibilities of incident C. neoformans isolates
from acquired immunodeficiency syndrome patients in Kenya. Antifungal susceptibility
testing was performed in 67 C. neoformans isolates by broth microdilution method as
outlined in the Clinical and Laboratory Standards Institute document M27-A3 using
FLC, amphotericin B (AMB), voriconazole (VOR), ravuconazole (RAV) and flucytosine
(5-FC). Isolates were grown on L-canavanine glycine bromothymol blue medium for
serotype identification. Six per cent of the isolates were identified as C. neoformans var.
gattii serotype B or C and 94% as C. neoformans var. neoformans. All isolates tested were
susceptible to AMB, VOR and RAV (100%), and high susceptibilities were seen to FLC
(97%), and 5-FC (90%). Only 3% and 10% of the isolates susceptibility to FLC and
5-FC, respectively, was dose-dependent or intermediate. These results demonstrate high
susceptibilities of incident C. neoformans isolates to FLC and AMB, antifungals used for
treatment of cryptococcal meningitis in Kenya. | en |
