Prevalence of fluconazole-resistant strains of Candida albicans in otherwise healthy outpatients.
BACKGROUND
In contrast to the immunosuppressed patient population, the prevalence of fluconazole-resistant strains of Candida albicans among healthy individuals has not been extensively studied.


METHODS
Candida species were cultured form 50 healthy outpatients with clinical signs of oral candidiasis. Following one week of the recommended fluconazole regimen, post-treatment cultures were obtained. Both pre- and post-treatment yeasts were identified and in vitro susceptibility testing was performed using the NCCLS M-27A method. Strains were further differentiated using established cDNA probes.


RESULTS
Forty-four patients (88%) had positive C.albicans cultures prior to treatment. Antifungal susceptibility testing of these strains demonstrated no in vitro resistance to fluconazole. At post-treatment evaluation, eight patients (18%) had persistent signs of infection and 10 patients (23%) had positive Candida sp. cultures despite no clinical signs of infection. DNA analysis confirmed that the same C. albicans strain was present both in the pre-treatment and the post-treatment cultures.


CONCLUSIONS
Our results showed that the presence of fluconazole-resistant strains of C.albicans does not appear to be prevalent among healthy outpatients furthermore, in vitro antifungal susceptibility testing does not always predict successful therapy in these patients.
Haberland-Carrodeguas
Christel
C
Section of Oral Maxillofacial and Pathology, Temple University School of Dentistry, Philadelphia, Pennsylvania 19140, USA. chaberland@dental.temple.edu
Allen
Carl M
CM
Beck
F Michael
FM
Buesching
William J
WJ
Koletar
Susan L
SL
Sundstrom
Paula
P
D000328:Adult; D000935:Antifungal Agents / Q000494:pharmacology / Q000627:therapeutic use*; D015139:Blotting, Southern; D002176:Candida albicans / Q000187:drug effects* / Q000302:isolation & purification; D002180:Candidiasis, Oral / Q000188:drug therapy*; D002353:Carrier State; D016009:Chi-Square Distribution; D004271:DNA, Fungal / Q000032:analysis; D025141:Drug Resistance, Fungal; D005260:Female; D015725:Fluconazole / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D016533:Mycological Typing Techniques; D016896:Treatment Outcome
D000935:Antifungal Agents; D004271:DNA, Fungal; D015725:Fluconazole