Abstract
Purpose: :
To evaluate the efficacy of different antifungal supplementation to Optisol-GS in presence of inoculated ocular fungal isolates. To additionally study the efficacy of these antifungals after subsequent warming to room temperature.
Methods: :
3 sets of Optisol-GS solution were inoculated with different ocular fungal isolates, C. albicans, C. glabrata, C. parapsilosis, and A. fumigatus in separate vials. Viable colony counts were performed after 24 hours (Hr) of refrigeration (R) and then at 2Hr room temperature (RT), 6 Hr RT, 12 Hr RT, 24 Hr RT, 48 Hr RT. In a separate experiment, each of the following antifungals, amphotericin B (AMB) (5 mcg), caspofungin (Caspo) (50 mcg), voriconazole (Vor-50) (50 mcg), and voriconazole (Vor-100) (100 mcg) were supplemented into separate vials of Optisol GS at time of inoculation with one of the above fungi. Viable colony counts were then performed after 24 Hr R and then 2 Hr RT, 6 Hr RT, 12 Hr RT, 24 Hr RT, and 48 Hr RT. Fungicidal activity was defined as 99.9% killing or > 3 log10 drop in CFU/ml from the starting inoculum
Results: :
A. fumigatus counts were static during R and at all following time points at RT. All Candida species tested also demonstrated static counts during R and thereafter up to 12 Hr RT. The addition of AMB demonstrated fungicidal activity after 24 Hr R against C. albicans and C. glabrata. For C. parapsilosis an additional 6 Hr RT was needed for fungicidal activity. Caspo demonstrated fungicidal activity against C. albicans at 6 Hr RT, against C. glabrata at 24 Hr RT, and against C. parapsilosis at 48 Hr RT after initial R. Vor-50 and Vor-100 did not demonstrate fungicidal activity against any of the Candida species at any time point/temperature. None of the antifungals were fungicidal for A. fumigatus at any time point/temperature.
Conclusions: :
AMB in Optisol-GS was rapidly fungicidal against each of the Candida species. Caspo in Optisol-GS was rapidly fungicidal against C. albicans and slowly fungicidal for the other Candida species. RT storage of Optisol-GS does not increase fungal load within first 12 hours and augments fungicidal activity of supplemented AMB and Caspo.
Keywords: cornea: storage