Fusarium Keratitis: Genotyping, in Vitro Susceptibility and Clinical Outcomes

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dc.contributor.author Oechsler, Rafael Allan [UNIFESP]
dc.contributor.author Feilmeier, Michael R.
dc.contributor.author Miller, Darlene
dc.contributor.author Shi, Wei
dc.contributor.author Hofling-Lima, Ana Luisa [UNIFESP]
dc.contributor.author Alfonso, Eduardo C.
dc.date.accessioned 2016-01-24T14:31:44Z
dc.date.available 2016-01-24T14:31:44Z
dc.date.issued 2013-05-01
dc.identifier http://dx.doi.org/10.1097/ICO.0b013e318277ac74
dc.identifier.citation Cornea. Philadelphia: Lippincott Williams & Wilkins, v. 32, n. 5, p. 667-673, 2013.
dc.identifier.issn 0277-3740
dc.identifier.uri http://repositorio.unifesp.br/handle/11600/36317
dc.description.abstract Purpose: To determine differences in the clinical characteristics and antifungal susceptibility patterns among molecularly characterized ocular Fusarium sp isolates.Methods: Fifty-eight isolates of Fusarium sp obtained from 52 eyes of 52 patients were retrieved from the Ocular Microbiology Laboratory of the Bascom Palmer Eye Institute and grown in pure culture. These isolates were characterized based on DNA sequence analysis of the ITS1/2 and ribosomal deoxyribonucleic acid regions. Antifungal susceptibilities were determined for each isolate using broth microdilution methods, and the corresponding medical records were reviewed to determine the clinical outcomes.Results: Fusarium solani isolates had significantly higher values of minimum inhibitory concentration for 90% isolates (MIC90) with voriconazole than F. non-solani organisms (16 and 4 mu g/mL, respectively). Isolates of F. solani also exhibited a significantly longer time to cure (65 vs. 40.5 days), a worse follow-up best-corrected visual acuity (20/118 vs. 20/36), and an increased need for urgent surgical management (7 vs. 0 penetrating keratoplasties) when compared with those of F. non-solani.Conclusions: This is the first report to examine the correlation between ocular genotyped Fusarium sp and clinical outcomes. It supports the overall worse prognosis of F. solani versus F. non-solani isolates, including higher voriconazole resistance by the former. the clinical implementation of molecular-based diagnostics and antifungal efficacy testing may yield important prognostic and therapeutic information that could improve the management of fungal ocular infections. en
dc.description.sponsorship Research to Prevent Blindness
dc.description.sponsorship National Eye Institute
dc.description.sponsorship University of Miami Wallace H. Coulter Center for Translational Research
dc.description.sponsorship Bausch Lomb Inc
dc.description.sponsorship Alcon Labs
dc.format.extent 667-673
dc.language.iso eng
dc.publisher Lippincott Williams & Wilkins
dc.relation.ispartof Cornea
dc.rights Acesso restrito
dc.subject keratitis en
dc.subject Fusarium sp en
dc.subject genotyping en
dc.subject antifungal en
dc.subject clinical outcomes en
dc.title Fusarium Keratitis: Genotyping, in Vitro Susceptibility and Clinical Outcomes en
dc.type Artigo
dc.contributor.institution Univ Miami
dc.contributor.institution Universidade Federal de São Paulo (UNIFESP)
dc.description.affiliation Univ Miami, Miller Sch Med, Bascom Palmer Eye Inst, Miami, FL 33136 USA
dc.description.affiliation Universidade Federal de São Paulo, Dept Ophthalmol, São Paulo, Brazil
dc.description.affiliationUnifesp Universidade Federal de São Paulo, Dept Ophthalmol, São Paulo, Brazil
dc.identifier.doi 10.1097/ICO.0b013e318277ac74
dc.description.source Web of Science
dc.identifier.wos WOS:000317467300036



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