title: Increased adherence of fluconazole-resistant isolates of Candida species to explanted esophageal mucosa.
abstract: The adherence of fluconazole-resistant and fluconazole-susceptible isolates of Candida albicans to explanted rabbit esophageal mucosa was examined in vivo. Among six Candida albicans isolates collected from HIV-infected patients, three fluconazole-resistant (MIC > 64 microg/ml) isolates attached more avidly than three fluconazole-susceptible strains (MIC < or = 0.5 microg/ml) to esophageal mucosa (P < or = 0.05). When three strains each of six different Candida spp. were compared, the more inherently fluconazole-resistant isolates adhered more avidly in the following order: Candida glabrata>Candida krusei>Candida albicans fluconazole-sensitive>Candida tropicalis>Candida parapsilosis. Nonetheless, fluconazole-resistant Candida albicans demonstrated the greatest degree of adherence in comparison to all fluconazole-susceptible Candida albicans (P<0.001) and to all Candida spp. tested (P<0.001). Thus, the refractoriness of esophageal candidiasis in patients infected with fluconazole-resistant isolates may be related to both in vitro drug resistance and increased mucosal adherence.
authors.affiliation: Immunocompromised Host Section, Pediatric Oncology Branch, National Cancer Institute, Bethesda, Maryland 20892, USA. lymanc@mail.nih.gov
authors.forename: C A
authors.initials: CA
authors.lastname: Lyman
authors.forename: K F
authors.initials: KF
authors.lastname: Garrett
authors.forename: J
authors.initials: J
authors.lastname: Peter
authors.forename: C
authors.initials: C
authors.lastname: Gonzalez
authors.forename: T J
authors.initials: TJ
authors.lastname: Walsh
mesh_terms: D000818:Animals; D000935:Antifungal Agents / Q000494:pharmacology*; D002175:Candida / Q000187:drug effects* / Q000254:growth & development* / Q000472:pathogenicity; D004352:Drug Resistance, Microbial; D004947:Esophagus / Q000382:microbiology*; D005260:Female; D015725:Fluconazole / Q000494:pharmacology*; D008826:Microbial Sensitivity Tests; D009092:Mucous Membrane / Q000382:microbiology; D011817:Rabbits
chemical_list: D000935:Antifungal Agents; D015725:Fluconazole