The epidemiology of non-albicans Candida in oropharyngeal candidiasis in HIV patients.
Oropharyngeal candidiasis (OPC) is the most common fungal infection in patients with HIV infection. Fluconazole has been proven to be very effective in treating this infection, but decreased susceptibility of Candida to this drug has emerged. Certain non-albicans species such as C. glabrata and C. krusei are commonly less susceptible to fluconazole than C. albicans and are being isolated with increased frequency in HIV patients. The purpose of this study was to determine if the presence of non-albicans Candida with OPC in HIV patients had an impact on clinical presentation. This study shows that late-stage HIV patients have a high prevalence of Candida with decreased susceptibility to fluconazole, especially non-albicans species. OPC episodes with non-albicans isolates were more likely to require higher doses of fluconazole to achieve clinical cure. Also, the presence of non-albicans Candida was more frequently associated with severe symptoms.
Redding
S W
SW
Department of General Dentistry, University of Texas Health Center at San Antonio (UTHSCSA), 7703 Floyd Curl Drive, San Antonio, TX 78284, USA.
Kirkpatrick
W R
WR
Dib
O
O
Fothergill
A W
AW
Rinaldi
M G
MG
Patterson
T F
TF
D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy / Q000382:microbiology* / Q000503:physiopathology; D000935:Antifungal Agents / Q000008:administration & dosage / Q000627:therapeutic use; D002175:Candida / Q000145:classification* / Q000187:drug effects; D002176:Candida albicans / Q000187:drug effects; D002177:Candidiasis / Q000188:drug therapy / Q000382:microbiology* / Q000503:physiopathology; D016009:Chi-Square Distribution; D002863:Chromogenic Compounds; D004352:Drug Resistance, Microbial; D005260:Female; D015725:Fluconazole / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009960:Oropharynx / Q000382:microbiology*; D010608:Pharyngeal Diseases / Q000188:drug therapy / Q000382:microbiology* / Q000503:physiopathology; D015995:Prevalence; D012008:Recurrence; D013997:Time Factors
D000935:Antifungal Agents; D002863:Chromogenic Compounds; D015725:Fluconazole