May 2005
Volume 46, Issue 13
Free
ARVO Annual Meeting Abstract  |   May 2005
Sensitivity of Filamentous Fungi Isolated From Fungal Keratitis to Amphotericin B, Natamycin, Caspofungin, Itraconazole, Voriconazole, and Posaconazole
Author Affiliations & Notes
  • B.L. Shapiro
    Proctor Foundation, UCSF, San Francisco, CA
  • P. Lalitha
    Aravind Eye Care System, Madurai, India
  • A.W. Fothergill
    Department of Pathology, University of Texas Health Sciences Center at San Antonio, San Antonio, TX
  • J. Ruiz
    Department of Pathology, University of Texas Health Sciences Center at San Antonio, San Antonio, TX
  • M. Srinivasan
    Aravind Eye Care System, Madurai, India
  • N.V. Prajna
    Aravind Eye Care System, Madurai, India
  • J. Chidambaram
    Proctor Foundation, UCSF, San Francisco, CA
  • Y. Pan
    Proctor Foundation, UCSF, San Francisco, CA
  • S. McLeod
    Proctor Foundation, UCSF, San Francisco, CA
  • T.M. Lietman
    Proctor Foundation, UCSF, San Francisco, CA
  • Footnotes
    Commercial Relationships  B.L. Shapiro, None; P. Lalitha, None; A.W. Fothergill, None; J. Ruiz, None; M. Srinivasan, None; N.V. Prajna, None; J. Chidambaram, None; Y. Pan, None; S. McLeod, None; T.M. Lietman, None.
  • Footnotes
    Support  That Man May See (TMMS), Alta California Foundation
Investigative Ophthalmology & Visual Science May 2005, Vol.46, 2622. doi:
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      B.L. Shapiro, P. Lalitha, A.W. Fothergill, J. Ruiz, M. Srinivasan, N.V. Prajna, J. Chidambaram, Y. Pan, S. McLeod, T.M. Lietman; Sensitivity of Filamentous Fungi Isolated From Fungal Keratitis to Amphotericin B, Natamycin, Caspofungin, Itraconazole, Voriconazole, and Posaconazole . Invest. Ophthalmol. Vis. Sci. 2005;46(13):2622.

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

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Abstract
 
Abstract:
 

 

Fungal corneal ulcers are notoriously difficult to manage, and physicians currently choose antifungal agents empirically. A range of new antifungal agents has become available that has not been widely applied in ocular disease. The non–ocular infectious disease literature has suggested that susceptibility testing of fungal isolates can provide clinically relevant information. This study aims to characterize the susceptibility of six antifungal agents against filamentous fungi cultured from scrapings of fungal keratitis.

 

 

Corneal isolates from 98 consecutive cases of culture–proven fungal keratitis presenting to the Aravind Eye Hospital were collected. Fungi were identified and tested for susceptibility to the following antifungal agents: Amphotericin B, Natamycin, Caspofungin, Itraconazole, Voriconazole, and Posaconazole. The fungal isolates were analyzed for susceptibility to antifungal agents by conducting Minimal Inhibitory Concentration (MIC) testing performed using the macrobroth dilution technique according to NCCLS guidelines set forth in NCCLS M38–A. MIC50 and MIC90 values for Fusarium spp., Aspergillus spp., and all species together were estimated.

 

 

We identified the fungal genus in 95 of the 98 specimens; the other 3 were unidentifiable or contaminated. Thirty–nine isolates were identified as Fusarium spp. and 43 as Aspergillus spp.

 

Table 1: Minimal inhibitory concentration of antifungal agents to filamentous fungi

 

 

Results are broken down by species.

 

 

No single agent was uniformly most effective for all filamentous species tested. In vitro, Posaconazole had the lowest MICs against Aspergillus spp., while Voriconazole gave the lowest MICs against Fusarium spp.. Future studies may determine how in vitro susceptibilities correlate with in vivo clinical results.

 

 
Keywords: keratitis • fungal disease • antibiotics/antifungals/antiparasitics 
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