[Drug sensitivity of Candida in patients with kidney diseases receiving immunosuppressive therapy].
It was shown that prednisolone and its combination with azathioprine++ increased contamination of the patients with yeast-like fungi and promoted development of candidiasis in them to a greater extent than cyclophosphamide. In the patients treated with the immunodepressants there was observed a carrier state in regard to various yeast-like fungi: 12 species belonging to 6 genera were isolated from the pathological materials. Determination of sensitivity to antifungal drugs in 200 Candida strains revealed that amphotericin B was the most active agent. Then followed mycoheptin, nystatin and nitroxolin. Levorin was the least active drug. The MICs of the drugs for the majority of the cultures were 0.5, 4-8, 8-16 and 32-64 micrograms/ml respectively. Candida resistant strains (mainly to levorin and mycoheptin) were isolated only from recipients of kidney transplants during the early postoperative period when the patients were subjected to intensive immunodepressive and prophylactic antifungal therapy. Among the fungi of the Candida genus C. guillermondii and C. parapsilosis proved to be the most resistant. Under the hospital conditions and in vitro studies it was found that cyclophosphamide and combinations of prednisolone with cytostatics increased resistance of Candida to the antifungal drugs. Rapid increasing of the fungi resistance to levorin and mycoheptin was observed. The increase in the resistance to amphotericin B was somewhat lower and that to nitroxolin and nystatin was extremely low. The study of the combined effect of the immunodepressants and antifungal drugs demonstrated that the immunodepressants increased the antifungal activity of amphotericin B, levorin and nitroxolin.(ABSTRACT TRUNCATED AT 250 WORDS)
Kudriavskaia
V M
VM
Rudenko
A V
AV
Pyrig
L A
LA
D000935:Antifungal Agents / Q000494:pharmacology* / Q000627:therapeutic use; D002175:Candida / Q000187:drug effects*; D002177:Candidiasis / Q000188:drug therapy / Q000209:etiology / Q000382:microbiology*; D004347:Drug Interactions; D004352:Drug Resistance, Microbial; D005921:Glomerulonephritis / Q000276:immunology / Q000601:surgery*; D006801:Humans; D007166:Immunosuppressive Agents / Q000494:pharmacology* / Q000627:therapeutic use; D066298:In Vitro Techniques; D016030:Kidney Transplantation; D009894:Opportunistic Infections / Q000188:drug therapy / Q000209:etiology / Q000382:microbiology*; D011182:Postoperative Care
D000935:Antifungal Agents; D007166:Immunosuppressive Agents
Lekarstvennaia chuvstvite'lnos't gribov roda Candida u bo'lnykh s zabolevaniiami pochek, poluchaiushchikh immunodepressivnuiu terapiiu.