Antimicrobial agents and chemotherapy, Jan 31, 2015
Cryptococcal antigen screening is recommended among people living with AIDS when entering HIV car... more Cryptococcal antigen screening is recommended among people living with AIDS when entering HIV care with CD4 count <100 cells/μL, and preemptive fluconazole monotherapy treatment is recommended for those with subclinical cryptococcal antigenemia. Yet, knowledge is limited of current antimicrobial resistance in Africa. We examined antifungal drug susceptibility in 198 clinical isolates collected from Kampala, Uganda, between 2010-2014 using the CLSI broth microdilution assay. In comparison with two previous studies from 1998/99 reporting an MIC50 of 4 μg/mL and an MIC90 of 8 μg/mL prior to wide-spread human fluconazole and agricultural azole fungicide usage, we report an upward shift in fluconazole MIC50 to 8 μg/mL, and a MIC90 value of 32 μg/mL. We observed an amphotericin B MIC50 of 0.5 μg/mL and an MIC90 of 1 μg/mL, of which 99.5% (197/198) of isolates were still susceptible. No correlation between MIC and clinical outcome was observed in the context of amphotericin B and flucon...
Antimicrobial agents and chemotherapy, Jan 31, 2015
Cryptococcal antigen screening is recommended among people living with AIDS when entering HIV car... more Cryptococcal antigen screening is recommended among people living with AIDS when entering HIV care with CD4 count <100 cells/μL, and preemptive fluconazole monotherapy treatment is recommended for those with subclinical cryptococcal antigenemia. Yet, knowledge is limited of current antimicrobial resistance in Africa. We examined antifungal drug susceptibility in 198 clinical isolates collected from Kampala, Uganda, between 2010-2014 using the CLSI broth microdilution assay. In comparison with two previous studies from 1998/99 reporting an MIC50 of 4 μg/mL and an MIC90 of 8 μg/mL prior to wide-spread human fluconazole and agricultural azole fungicide usage, we report an upward shift in fluconazole MIC50 to 8 μg/mL, and a MIC90 value of 32 μg/mL. We observed an amphotericin B MIC50 of 0.5 μg/mL and an MIC90 of 1 μg/mL, of which 99.5% (197/198) of isolates were still susceptible. No correlation between MIC and clinical outcome was observed in the context of amphotericin B and flucon...
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Papers by Laura Okagaki