Non-albicans oral candidosis in HIV-positive patients.
Specimens from HIV-positive patients with oral candidosis were taken for culture, species identification and azole susceptibility testing, which was correlated with treatment outcome. Of 921 specimens, 95 yielded non-albicans species, mainly from patients with low CD4 lymphocyte counts and extensive previous azole exposure. Most non-albicans isolates were from specimens co-infected with Candida albicans, complicating the interpretation of in-vitro susceptibility results, which accurately predicted antifungal failure when the non-albicans species was isolated alone. Eighty-five non-albicans isolates were resistant to fluconazole in vitro. Of 149 courses of azole therapy prescribed, 115 failed to clear non-albicans candidosis clinically. Culture media that discoloured in the presence of non-albicans colonies might, therefore, guide therapy.
Cartledge
J D
JD
Department of HIV and Genitourinary Medicine, St Stephen's Centre, Chelsea and Westminster Hospital, London, UK.
Midgley
J
J
Gazzard
B G
BG
D002175:Candida / Q000187:drug effects*; D002180:Candidiasis, Oral / Q000188:drug therapy*; D004352:Drug Resistance, Microbial; D006679:HIV Seropositivity / Q000382:microbiology*; D006801:Humans; D008826:Microbial Sensitivity Tests