Oral Candida albicans isolates with reduced susceptibility to fluconazole in Swedish HIV-infected patients.
A total of 62 patients with HIV-related conditions were examined for clinical and mycological oral findings. Cultures from 51 patients were positive for yeasts and included 49 Candida albicans and 8 non-albicans isolates. Of patients with positive culture, 35% had pseudomembranous thrush. In vitro susceptibility testing of 49 C. albicans isolates revealed that the minimal inhibitory concentration for 50% of the strains (MIC50) was 2.0 mg/l for fluconazole, and the MIC50 was < or = 0.125 mg/l for both ketoconazole and itraconazole. Fluconazole resistance (MIC > or = 32.0 mg/l) was found for 14% of the C. albicans isolates tested. Two C. albicans isolates showed cross-resistance to ketoconazole and itraconazole. Associations between reduced susceptibility to fluconazole and low CD4+ cell counts, the length of time since the first AIDS-defining illness and the interval from the first fluconazole treatment, indirectly reflecting the total fluconazole exposure, were observed.
Chryssanthou
E
E
Department of Clinical Microbiology, Karolinska Hospital, Stockholm, Sweden.
Torssander
J
J
Petrini
B
B
D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy*; D000328:Adult; D000368:Aged; D000935:Antifungal Agents / Q000494:pharmacology* / Q000627:therapeutic use; D002176:Candida albicans / Q000187:drug effects* / Q000302:isolation & purification; D002180:Candidiasis, Oral / Q000188:drug therapy*; D004352:Drug Resistance, Microbial; D015725:Fluconazole / Q000494:pharmacology* / Q000627:therapeutic use; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D013548:Sweden
D000935:Antifungal Agents; D015725:Fluconazole