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Correlation of susceptibility of Cryptococcus neoformans to amphotericin B with clinical outcome

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dc.contributor.author Larsen, R.A.
dc.contributor.author Bauer, M.
dc.contributor.author Pitisuttithum, P.
dc.contributor.author Sanchez, A.
dc.contributor.author Tansuphaswadikul, S.
dc.contributor.author Wuthiekanun, V.
dc.contributor.author Peacock, S.J.
dc.contributor.author Simpson, A.J.H.
dc.contributor.author Fothergill, A.W.
dc.contributor.author Rinaldi, M.G.
dc.contributor.author Bustamante Rufino, Ana Beatriz
dc.contributor.author Thomas, A.M.
dc.contributor.author Altomstone, R.
dc.contributor.author Day, N.P.J.
dc.contributor.author White, N.J.
dc.date.accessioned 2022-01-18T19:26:53Z
dc.date.available 2022-01-18T19:26:53Z
dc.date.issued 2011
dc.identifier.uri https://hdl.handle.net/20.500.12866/10990
dc.description.abstract Testing of Cryptococcus neoformans for susceptibility to antifungal drugs by standard microtiter methods has not been shown to correlate with clinical outcomes. This report describes a modified quantitative broth macrodilution susceptibility method showing a correlation with both the patient's quantitative biological response in the cerebrospinal fluid (CSF) and the survival of 85 patients treated with amphotericin B (AMB). The Spearman rank correlation between the quantitative in vitro measure of susceptibility and the quantitative measure of the number of organisms in the patient's CSF was 0.37 (P < 0.01; 95% confidence interval [95% CI], 0.20, 0.60) for the first susceptibility test replicate and 0.46 (P < 0.001; 95% CI, 0.21, 0.62) for the second susceptibility test replicate. The median in vitro estimated response (defined as the fungal burden after AMB treatment) at 1.5 mg/liter AMB for patients alive at day 14 was 5 CFU (95% CI, 3, 8), compared to 57 CFU (95% CI, 4, 832) for those who died before day 14. These exploratory results suggest that patients whose isolates show a quantitative in vitro susceptibility response below 10 CFU/ml were more likely to survive beyond day 14. en_US
dc.language.iso eng
dc.publisher American Society for Microbiology
dc.relation.ispartofseries Antimicrobial Agents and Chemotherapy
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Humans en_US
dc.subject article en_US
dc.subject controlled study en_US
dc.subject major clinical study en_US
dc.subject in vitro study en_US
dc.subject priority journal en_US
dc.subject quantitative analysis en_US
dc.subject Treatment Outcome en_US
dc.subject Survival Rate en_US
dc.subject AIDS-Related Opportunistic Infections en_US
dc.subject Microbial Sensitivity Tests en_US
dc.subject cerebrospinal fluid en_US
dc.subject broth dilution en_US
dc.subject Antifungal Agents en_US
dc.subject antifungal susceptibility en_US
dc.subject Amphotericin B en_US
dc.subject Cerebrospinal Fluid en_US
dc.subject Colony Count, Microbial en_US
dc.subject colony forming unit en_US
dc.subject correlation coefficient en_US
dc.subject Cryptococcus neoformans en_US
dc.subject Meningitis, Cryptococcal en_US
dc.subject survival en_US
dc.title Correlation of susceptibility of Cryptococcus neoformans to amphotericin B with clinical outcome en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1128/AAC.00034-11
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.02.21
dc.relation.issn 1098-6596


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