Relationship between fluconazole sensitivity of Candida albicans isolates from HIV positive patients and serotype, adherence and CD4+ lymphocyte count.
The sensitivity of fluconazole, serotype and adherence to buccal epithelial cells of 46 Candida albicans isolates was studied in vitro. Strains were isolated from 18 HIV-positive patients with variable CD4+ lymphocyte counts who were receiving long-term fluconazole therapy. Results showed that sensitivity to fluconazole correlated with serotype. Of the sensitive isolates 81.5% were serotype A and 18.5% serotype B, whereas of the resistant isolates 37.5% were serotype A and 62.5% serotype B. Sensitivity to fluconazole also correlated with adherence capacity, resistant isolates showing slightly less adherence to buccal epithelial cells than sensitive isolates. Weakly adherent isolates represented 87% of resistant isolates and only 63% of sensitive isolates. Resistant strains were isolated in highly immunocompromised patients. All strains isolated in patients with CD4+ lymphocyte counts above 200 lymphocytes/microliters were sensitive, whereas intermediate and resistant strains were isolated in patients with counts below 200 lymphocytes/microliters. Statistical analyses showed no correlation between adherence of isolates to buccal epithelial cells and CD4+ lymphocyte counts.
Laboratoire de Parasitologie-Immunologie, Faculté de Pharmacie, Montpellier, France.
C
C
Imbert-Bernard
A
A
Valentin
J
J
Reynes
M
M
Mallié
J M
JM
Bastide
D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy* / Q000276:immunology; D018791:CD4 Lymphocyte Count; D002176:Candida albicans / Q000145:classification / Q000187:drug effects* / Q000502:physiology; D002180:Candidiasis, Oral / Q000188:drug therapy* / Q000276:immunology; D016001:Confidence Intervals; D015725:Fluconazole / Q000494:pharmacology* / Q000627:therapeutic use; D006679:HIV Seropositivity / Q000276:immunology / Q000382:microbiology; D015497:HIV-1; D006801:Humans; D008826:Microbial Sensitivity Tests; D009061:Mouth Mucosa / Q000382:microbiology*; D012703:Serotyping
D015725:Fluconazole