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Updated: Aug 13, 2026
Automated Measurement of Cryptococcal Species Polysaccharide Capsule and Cell Body
Published on: January 11, 2018
Timed-kill curves for Cryptococcus neoformans isolated from patients with AIDS
1Mycology Department, Instituto Nacional de Enfermedades Infecciosas, ANLIS: Dr. Carlos G. Malbrán, Buenos Aires, Argentina. lrodero@mail.retina.ar
Abstract:
Infection with Cryptococcus neoformans is an increasing problem in immunocompromised patients, particularly those with acquired immune deficiency syndrome (AIDS). Amphotericin B and fluconazole are currently acceptable therapies for cryptococcal meningitis; however, their effects remain suboptimal and recurrence or treatment failure is still a problem. Antifungal susceptibility testing may be an important tool for guiding therapy, but for C. neoformans, a reliable method is still not available. This retrospective study evaluated minimal inhibitory concentration (MIC) for amphotericin B and fluconazole, and minimal fungicidal concentration (MFC) and timed-kill curves for amphotericin B against 16 clinical isolates of C. neoformans obtained from AIDS patients with cryptococcal meningitis. No correlation between clinical outcome and MIC was observed for amphotericin B. In selected cases, the MFC seemed to be a better predictor of outcome than MIC. In this study, amphotericin B timed-kill curves appeared to show a correlation with clinical outcome of the 16 patients with AIDS-associated cryptococcal meningitis. These in vitro tests must be further evaluated in prospective studies to confirm their potential usefulness for guiding cryptococcal meningitis therapy.
Insights
Antifungal susceptibility testing for Cryptococcus neoformans is crucial for treating cryptococcal meningitis in AIDS patients. Timed-kill curves for amphotericin B showed promise in predicting treatment outcomes.
Area of Science:
- Mycology
- Infectious Diseases
- Clinical Microbiology
Background:
- Cryptococcus neoformans infections, particularly cryptococcal meningitis, pose a significant challenge in immunocompromised individuals, especially those with acquired immune deficiency syndrome (AIDS).
- Current therapies like amphotericin B and fluconazole have limitations, leading to suboptimal outcomes, recurrence, and treatment failures.
- Reliable antifungal susceptibility testing methods for C. neoformans are lacking, hindering personalized treatment strategies.
Purpose of the Study:
- To evaluate the utility of in vitro antifungal susceptibility testing methods, including minimal inhibitory concentration (MIC), minimal fungicidal concentration (MFC), and timed-kill curves, for predicting clinical outcomes in AIDS patients with cryptococcal meningitis.
- To assess the correlation between MIC and MFC of amphotericin B and fluconazole with clinical outcomes.
Main Methods:
- A retrospective study was conducted on 16 clinical isolates of C. neoformans from AIDS patients diagnosed with cryptococcal meningitis.
- Minimal inhibitory concentrations (MICs) for amphotericin B and fluconazole were determined.
- Minimal fungicidal concentrations (MFCs) and timed-kill curves for amphotericin B were evaluated against the isolates.
Main Results:
- No significant correlation was observed between the minimal inhibitory concentration (MIC) of amphotericin B and clinical outcomes.
- In certain cases, the minimal fungicidal concentration (MFC) appeared to be a better predictor of patient outcome than MIC.
- Amphotericin B timed-kill curves demonstrated a potential correlation with the clinical outcomes of patients with AIDS-associated cryptococcal meningitis.
Conclusions:
- In vitro antifungal susceptibility testing, particularly amphotericin B timed-kill curves, may offer valuable insights into predicting treatment success for cryptococcal meningitis in AIDS patients.
- Further prospective studies are essential to validate these findings and establish the clinical utility of these in vitro methods for guiding antifungal therapy.
