@article{mbs:/content/journal/jmm/10.1099/jmm.0.036152-0, author = "Vitale, Roxana G. and Pascuccelli, Veronica and Afeltra, Javier", title = "Influence of capsule size on the in vitro activity of antifungal agents against clinical Cryptococcus neoformans var. grubii strains", journal= "Journal of Medical Microbiology", year = "2012", volume = "61", number = "3", pages = "384-388", doi = "https://doi.org/10.1099/jmm.0.036152-0", url = "https://www.microbiologyresearch.org/content/journal/jmm/10.1099/jmm.0.036152-0", publisher = "Microbiology Society", issn = "1473-5644", type = "Journal Article", abstract = "Cryptococcosis causes disseminated disease in AIDS patients. In contrast to what occurs in laboratory conditions, a large capsule is produced by Cryptococcus neoformans in vivo during infection. The aim of this study was to compare the in vitro activity of different antifungal agents against 34 clinical isolates of C. neoformans var. grubii without or with capsule induction (CLSI, CLSI-C, respectively), following the CLSI M27A3 document. Capsule induction was obtained by addition of NaHCO3 and incubation with CO2. The geometric means of the MICs, in µg ml−1, for CLSI and CLSI-C cultures, respectively, were 1.9 and 9.8 for fluconazole; 0.04 and 0.08 for itraconazole; 0.04 and 0.05 for voriconazole; 0.16 and 0.38 for amphotericin B; and 1.6 and 5.6 for 5-flucytosine. Thus fluconazole showed the highest MICs after capsule induction. Determination of antifungal activity after capsule induction may be clinically relevant and could be used to evaluate the correlation between in vitro results and clinical outcome.", }