Voriconazole, amphotericin and fluconasole susceptibility for keratitis and endophthalmitis fungal pathogens

Abstract number: 1134_02_349

Fedotova I.

Objectives:

Investigate in vitro efficacy of voriconazole and other antifungals.

Methods:

Microbiology database was scanned and fungal isolates associated with keratitis (186) and endophthalmitis (97) were analysed for classification and isolate frequency. The Sensititre YeastOne microdilution antifungal susceptibility test was used to evaluate susceptibility (MICs) of 34 common fungal pathogens against viriconazole, amphotericin , fluconazole.

Results:

Fusarium species remains the most frequent corneal fungal pathogen (57.2%). Colletotrichum species (5.4%) has emerged as the fifth most common mold in keratitis. Top yeast isolates from cornea included Candida albicans (58.6%) and Candida parapsilosis (36.8%). Half of the intraocular pathogens were Candida species. Paecilomyces (3.1%) and Philophora (2.8%) were unusual pathogens. In vitro susceptibility profiles were voriconazole (100%), amphotericin (71.4%), fluconazole (57,8%). Voriconazole MIC(90) were lowest for Candida species (0.014 microg/ml) and highest for Fusarium species (1.5 µg/ml). Reference laboratory MICs correlated 100% for yeast isolates (0.016 µg/ml) but were fourfold higher for Fusarium species (7 µg/ml). MIC(90) for Aspergillus species was 0.4 µg/ml.

Conclusions:

Candida, Fusarium, and Aspergillus species remain frequent fungal pathogens. Voriconazole may have a role in the therapeutic management of Candida and Aspergillus ocular infections. Human use and animal models will determine its use in the clinical setting.