title: Azole resistance among oral Candida species isolates from AIDS patients under ketoconazole exposure.
abstract: This is a prospective study designed to investigate species distribution and azole susceptibility profile among Candida spp. isolated from the oral cavities of AIDS patients. One hundred thirty-two AIDS patients sequentially admitted at a teaching tertiary care hospital were enrolled in this study. Samples were obtained by swabbing the oral cavities of the patients. Yeast isolates were identified by classical methods and the antifungal susceptibility profile was further determined according to the NCCLS microbroth assay. Among all patients with prescriptions of systemic antifungal drugs, ketoconazole had been elected to treat 56% of patients. We found 82% of oral yeast carriage, 22% of them harboring non-albicans species. Overall rates of susceptibility dose dependent/resistance to azoles was 16% for itraconazole, 13% for ketoconazole, and 10% for fluconazole with a high agreement rate among the susceptibility profiles of all isolates tested against the triazoles.
authors.affiliation: Division of Infectious Diseases, Escola Paulista de Medicina, Universidade Federal de São Paulo, Brazil.
authors.forename: E P
authors.initials: EP
authors.lastname: Milan
authors.forename: M N
authors.initials: MN
authors.lastname: Burattini
authors.forename: E G
authors.initials: EG
authors.lastname: Kallás
authors.forename: O
authors.initials: O
authors.lastname: Fischmann
authors.forename: P R
authors.initials: PR
authors.lastname: Costa
authors.forename: A L
authors.initials: AL
authors.lastname: Colombo
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000150:complications*; D000328:Adult; D000368:Aged; D000935:Antifungal Agents / Q000494:pharmacology* / Q000627:therapeutic use; D001393:Azoles / Q000494:pharmacology* / Q000627:therapeutic use; D001938:Brazil / Q000453:epidemiology; D002176:Candida albicans / Q000187:drug effects*; D002180:Candidiasis, Oral / Q000188:drug therapy* / Q000382:microbiology; D004352:Drug Resistance, Microbial; D005260:Female; D015725:Fluconazole / Q000494:pharmacology / Q000627:therapeutic use; D006801:Humans; D017964:Itraconazole / Q000494:pharmacology / Q000627:therapeutic use; D007654:Ketoconazole / Q000494:pharmacology / Q000627:therapeutic use; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009061:Mouth Mucosa / Q000382:microbiology; D009172:Mycology / Q000379:methods; D015995:Prevalence; D011446:Prospective Studies; D018709:Statistics, Nonparametric
chemical_list: D000935:Antifungal Agents; D001393:Azoles; D017964:Itraconazole; D015725:Fluconazole; D007654:Ketoconazole