In vitro invetigation of voriconazole uceptibility for keratiti and endophthalmiti fungal pathogen

Purpoe To update the pectrum of ocular fungal iolate and invetigate the in vitro efficacy of voriconazole and other antifungal. Deign Experimental tudy. Method Microbiology databae wa canned and fungal iolate aociated with keratiti (419) and endophthalmiti (122) were analyzed for claification and iolate frequency. The enititre YeatOne microdilution antifungal uceptibility tet wa ued to evaluate uceptibility (MIC) of 34 common fungal pathogen againt amphotericin B, fluconazole, ketoconazole, 5-flucytoine, itraconazole, and voriconazole. Ten of the tet iolate were ent to a reference laboratory to validate the enititre reult. Reult Fuarium pecie remain the mot frequent corneal fungal pathogen (60.1%). Colletotrichum pecie (4.1%) ha emerged a the fifth mot common mold in keratiti. Top yeat iolate from cornea included Candida albican (52.3%) and Candida parapiloi (37.3%). Half of the intraocular pathogen were Candida pecie. Paecilomyce (2.9%) and Philophora (1.9) were unuual pathogen. In vitro uceptibility profile were voriconazole (100%), ketoconazole (82.4%), amphotericin (76.5%), itraconazole (67%), fluconazole (60%), and 5-FC (60%). Voriconazole MIC90 were lowet for Candida pecie (0.016 μg/ml) and highet for Fuarium pecie (2 μg/ml). Reference laboratory MIC correlated 100% for yeat iolate (0.016 μg/ml) but were fourfold higher for Fuarium pecie (8 μg/ml). MIC90 for Apergillu pecie wa 0.5 μg/ml. Concluion Candida, Fuarium, and Apergillu pecie remain frequent fungal pathogen. Voriconazole may have a role in the therapeutic management of Candida and Apergillu ocular infection. Clinical efficacy mut determine the role for other fungal pathogen. Human ue and animal model will determine it ue in the clinical etting.