April 2014
Volume 55, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2014
Comparative Anti-Fungal Susceptibility Analysis of Candida Albicans versus Non-Albicans Candida Corneal Isolates
Author Affiliations & Notes
  • Oriel Spierer
    Ophthalmology, Bascom Palmer Eye Institute, Palm Beach Gardens, FL
  • Jyoti R Dugar
    Ophthalmology, Bascom Palmer Eye Institute, Palm Beach Gardens, FL
  • Darlene Miller
    Ophthalmology, Bascom Palmer Eye Institute, Palm Beach Gardens, FL
  • Terrence P O’Brien
    Ophthalmology, Bascom Palmer Eye Institute, Palm Beach Gardens, FL
  • Footnotes
    Commercial Relationships Oriel Spierer, None; Jyoti Dugar, None; Darlene Miller, None; Terrence O’Brien, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science April 2014, Vol.55, 5792. doi:
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      Oriel Spierer, Jyoti R Dugar, Darlene Miller, Terrence P O’Brien; Comparative Anti-Fungal Susceptibility Analysis of Candida Albicans versus Non-Albicans Candida Corneal Isolates. Invest. Ophthalmol. Vis. Sci. 2014;55(13):5792.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: To compare in vitro topical amphotericin B (AMB), natamycin, voriconazole and fluconazole in the treatment of Candida keratitis.

Methods: Seventy two candida isolates (36 albicans and 36 non-albicans isolates) recovered from corneal scrapings submitted to rule out microbial keratitis, during the years 2005-2011, at the Bascom Palmer Eye Institute, were examined. Corneal isolates were cultured on fungal agars for 48 hours. Each yeast isolate was dispensed into 4 microtiter wells, each containing 100 microliter of commercial (natamycin 5%) or compounded (AMB 0.15%, voriconazole 1% and fluconazole 0.2%) antifungal medications. Microtiter plates were incubated at 30 °C and monitored for growth or inhibition at 48 hours. A comparison of growth patterns was done.

Results: One hundred percent of the samples showed growth inhibition after treatment with AMB or natamycin. The isolates treated with voriconazole presented 85% inhibition rate overall, with the Candida albicans samples showing 77% inhibition rate and the non-albicans 93% inhibition rate. In the fluconazole group only 19.6% inhibition rate was noted, with 7.7% inhibition rate in the Candida albicans group versus 30% inhibition rate in the non-albicans group.

Conclusions: AMB 0.15% and natamycin 5% have equal effectiveness and full inhibition against Candida keratitis isolates. Fluconazole 0.2% is not the drug of choice in both Candida albicans and non-albicans keratitis. Voriconazole 1% may need a stronger concentration for higher effectiveness, but may be helpful as a second agent in the treatment of Candida keratitis.

Keywords: 480 cornea: basic science • 530 fungal disease • 573 keratitis  
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