IN-VITRO SUSCEPTIBILITY OF CRYPTOCOCCUS-NEOFORMANS ISOLATES TO FLUCONAZOLE AND ITRACONAZOLE

The in-vitro susceptibilities of 149 isolates of Cryptococcus neoforma ns, collected from British patients between 1994 and 1996, to fluconaz ole and itraconazole were compared with those of 36 isolates collected between 1971 and 1985, 41 isolates collected between 1986 and 1989, a nd 43 Ugandan isolates collected in 1996. Testing was done with a brot h microdilution method in YNB medium supplemented with glucose, incuba tion at 30 degrees C for 72 h, and an endpoint of 50% inhibition. The results showed that the MIC ranges, MIC(50)s and MIC(90)s of fluconazo le and itraconazole for C. neoformans isolates from the UK have remain ed unchanged despite the recent widespread use of triazoles for long-t erm maintenance of patients with AIDS-associated cryptococcal meningit is. The MIC ranges, MIC(50)s and MIC(90)s of the 43 isolates from untr eated Ugandan patients with AIDS were similar to those of the British isolates. Examination of our records for 1994-96 revealed six cases in which a four-fold or greater rise in the MIC of fluconazole was assoc iated with relapsed cryptococcal meningitis.