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  • 1
    ISSN: 1437-7780
    Keywords: Key words Aspergillus ; Alamar blue ; Voriconazole ; MIC ; Antifungal agents
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Voriconazole is a new triazole antifungal agent with potent activity against yeast and molds. We investigated the in-vitro activity of voriconazole compared with that of other antifungal agents against 50 clinical isolates of Aspergillus spp., measured by the National Committee for Clinical Laboratory Standards (NCCLS) reference method described in the M27-A document, and by an alamar blue colorimetric method. Voriconazole was the most potent agent against Aspergillus fumigatus (minimum inhibitory concentration [MIC]90, 0.5 mg/l) and Aspergillus niger (MIC90, 1.0 mg/l). Voriconazole was less active (MIC90, 1.0 mg/l) against Aspergillus flavus than itraconazole (MIC90, 0.5 mg/l). Voriconazole was more active than itraconazole against Aspergillus fumigatus and Aspergillus flavus by the alamar blue indicator method for the measurement of MIC. Based on these results, voriconazole has promising activity against commonly encountered isolates of Aspergillus spp., and its clinical usefulness should be established by further studies.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1437-7780
    Keywords: Key words Amphotericin B ; Aspergillus fumigatus ; Combination effects ; Azole antifungal agents
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Patients with aspergillosis have a poor prognosis because there are no effective antifungal agents except for amphotericin B. However, administration of amphotericin B is limited in immunocompromised patients due to its toxicity, which includes impairment of renal function. We attempted to evaluate the efficacy of a sequential combination of antifungal agents against Aspergillus fumigatus strain. The in vitro effects of sequential combinations of antifungal agents against five strains of Aspergillus fumigatus were determined by assessing changes in the wet weight of mycelial cells. The effect of a sequential combination was examined by pretreating mycelial cells with an antifungal agent, followed by the addition of a second antifungal agent. Pretreatment with amphotericin B (AMPH) followed by miconazole (MCZ) or fluconazole (FLCZ) resulted in better in vitro effects compared with the effect of simultaneous use of the agents. In contrast, pretreatment of mycelial cells with azole antifungal agents, other than MCZ, followed by AMPH, resulted in an increase in the wet weight compared with that recorded after simultaneous incubation with AMPH and azole antifungal agents. Our results showed that combined treatment, of AMPH followed by MCZ or FLCZ, inhibited the growth of A. fumigatus, suggesting that such a regimen may be effective against aspergillosis.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1437-7780
    Keywords: Key words Ofloxacin ; Fluconazole ; CDR1 ; Candida albicans ; Rhodamine 6G
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We investigated the combination effects of ofloxacin and fluconazole against azole-resistant Candida albicans strains in vitro and in vivo. Ofloxacin alone showed no efficacy against the azole-resistant C. albicans strain, C26. The in-vitro combination effects were evaluated by the checkerboard method, calculated as the fractional inhibitory concentration (FIC) index, but there was no synergistic effect of the combination. The activity of the drug efflux pump in the azole-resistant C. albicans strains was measured by intracellular rhodamine 6G concentration. When the cells were incubated with ofloxacin or grepafloxacin, the intracellular rhodamine 6G concentration was significantly increased in the azole-resistant C. albicans strain. In-vivo combination effects were evaluated in murine disseminated candidiasis. The survival of the mice was not prolonged, but counts of the yeast cells in the kidney and spleen were reduced following treatment with the combination of ofloxacin (20 mg/kg) and fluconazole (20 mg/kg). The combination of ofloxacin and fluconazole may represent an effective strategy to treat infections caused by azole-resistant C. albicans.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1573-0832
    Keywords: Antigen detection ; Capsular polysaccharide ; Cryptococcus neoformans ; Latex agglutination assay ; Pulmonary cryptococcosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Medicine
    Notes: Abstract Two different kits for the detection of serum cryptococcal antigen in patients with pulmonary cryptococcosis were evaluated. The Eiken test (the Eiken Co., Tokyo), which uses pronase for pretreatment of serum, was compared with the Crypto-LA test (International Biological Laboratories, Cranbury, NJ), which did not use pronase prior to testing. Cryptococcal antigen was detected in 21 of 23 patients (91%) with the Eiken test and in only 10 of 23 patients (43%) with the Crypto-LA test (p〈0.01 by Mcnemar test). However, the sensitivity of two tests was identical without use of pronase, as both tests could detect as little as 104 cells/ml ofCryptococcus neoformans and 10 ng/ml of capsular polysaccharide ofC. neoformans. In those serum specimens for which both tests were positive, titers were much higher for the Eiken test, but there was a statistically significant correlation between the two tests (coefficient correlation 0.79,p〈0.01). Cryptococcal antigen titer levels measured by the Eiken test correlated well with clinical courses. There was one false-positive reaction among 82 sera of non-cryptococcal patients. Pronase enhanced the sensitivity of the Eiken test, which appeared to be useful in patients with pulmonary cryptococcal disease, and its use may prevent unneeded lung biopsies.
    Type of Medium: Electronic Resource
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