14th ICID - Poster Abstracts - International Society for Infectious ...

When citing these abstracts please use the following reference:
Author(s) of abstract. Title of abstract [abstract]. Int J Infect Dis 2010;14S1: Abstract number.
Please note that the official publication of the International Journal of Infectious Diseases 2010, Volume 14, Supplement 1
is available electronically on http://www.sciencedirect.com
Final Abstract Number: 30.023
Session: Mycology, Fungal Infections and Antifungal Drugs
Date: Wednesday, March 10, 2010
Time: 12:30-13:30
Room: Poster & Exhibition Area/Ground Level
Type: Poster Presentation
Cryptococcus: species distribution and susceptibility profile of isolates in a teaching hospital from
São Paulo-Brazil
A. Motta 1 , G. D. Almeida 2 , J. Almeida 3 , M. I. Pinto 4 , S. Onorio 5 , F. ROSSI 6
1 Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo,
Brazil, 2 Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São
Paulo, Brazil, 3 Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo,
São Paulo, São Paulo, Brazil, 4 Hospital das Clinicas da Faculdade de Medicina da Universidade
de São Paulo, Sao Paulo, Brazil, 5 Hospital das Clinicas da Faculdade de Medicina da
Universidade de Sao Paulo, SP, Brazil, 6 Hospital das Clínicas da Faculdade de Medicina da
Universidade de São Paulo, São Paulo, NA, Brazil
Background: To describe the percentage of Cryptococcus neoformans and Cryptococcus gattii
encountered in our hospital, a 2500-bed teaching hospital of São Paulo, and to compare minimal
inhibitory concentrations to different antifungal drugs.
Methods: Consecutive and no duplicate clinical isolates recovered from patients with infections
(meningitis, cryptococcaemia, pneumonia and peritonitis) between 2006 and 2008 were included
for analysis. Identification to the species level was performed by conventional methods based on
growth appearance on Sabouraud dextrose agar at 37ºC, production of urease and the presence
of a capsule. Results were confirmed using the API 20C (bioMerieux, St Louis, USA). L-
canavanine-glycine-bromothymol blue agar (CGB) was used to distinguish C. gattii from C.
neoformans. Minimal inhibitory concentrations (MIC) to amphotericin B, caspofungin, 5-
fluorocytosine, posaconazole, fluconazole, itraconazole and voriconazole were determined using
Sensititre Yeast-One Y8 (TREK Diagnostic Systems, Cleveland, USA).
Results: In the study period 43 isolates were included. Thirty three (77%) were C. neoformans
and 10 (23%) were C. gatti. C. neoformans MIC 50/90 for antifungal drugs were as follow:
amphotericin B.(0.5mg/L -1 mg/L,) caspofungin ( 16 mg/L-16 mg/L), posaconazol ( 0.064 mg/L-
0.25 mg/L), fluconazole, (4 mg/L-16 mg/L); itraconazol (0.125 mg/L-0.5 mg/L) and voriconazol
(0.032 mg/L-0.125 mg/L)
C. gatti MIC 50/90 mg/L for antifungal drugs were as follow: amphotericin: (0.5 -1mg/L ) ;
caspofungin (16 mg/L-32 mg/L); posaconazole ( 0.125 mg/L-0.25 mg/l ); fluconazole: (8mg/L-
16mg/L); itraconazole (0.25 mg/L-0.5 mg/L ) and for voriconazole (0.125 mg/L-0.25 mg/L).
Fluconazole MICs equal or higher than 16 mg/L was observed among 40%
of C. gattii and only 18% among C. neoformans isolates.
Conclusion: Species identification among Cryptococcus spp isolates is an important
epidemiological tool and should be done in a routine basis. C gattii showed higher fluconazole
MICs and it should be closed monitored.