[Antifungal susceptibility for Candida albicans isolated from AIDS patients with oropharyngeal and esophageal candidiasis: experience with Etest].
BACKGROUND
Oropharyngeal candidiasis (OPC) and esophageal candidiasis (EPC) are frequent complications in AIDS patients. The use of Fluconazole, an effective and a low toxicity drug, has been associated to the emergency of secondary resistant strains. For this reason, in vitro antifungal susceptibility tests are necessary to predict a therapeutic failure. Etest is an easy to perform alternative test, that has showed a good agreement with the broth microdilution reference method (NCCLS, document M27-A).


OBJECTIVE
To measure the susceptibility of C. albicans isolates from AIDS patients complicated with OPC and EPC to Amphotericin B (AmB) and Fluconazole (Flu) using Etest.


METHODS
Twenty strains from 20 AIDS patients were studied. AmB was tested in RPMI 1640 agar and Flu in Casitone agar.


RESULTS
All studied strains showed minimal inhibitory concentrations (MICs) < 1 mg/mL for AmB. A highly resistant strain to Flu (> 256 mg/mL) was isolated from a patient previously treated with Flu.


CONCLUSIONS
In AIDS patients with OPC and EPC, the susceptibility to Flu of the isolates should be screened, to detect resistant strains. Etest is a reliable alternative in these cases, for laboratories that cannot use the reference method.
Tapia
Cecilia
C
Laboratorio de Microbiología, Servicio de Medicina, Hospital Dr. Sótero del Río, Laboratorio de Microbiología, Pontificia Universidad Católica de Chile. cvtapia@entelchile.net
González
Patricia
P
Pereira
Angélica
A
Pérez
Jorge
J
Noriega
Luis M
LM
Palavecino
Elizabeth
E
D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy* / Q000382:microbiology; D000666:Amphotericin B / Q000494:pharmacology / Q000627:therapeutic use; D000935:Antifungal Agents / Q000494:pharmacology* / Q000627:therapeutic use; D018791:CD4 Lymphocyte Count; D002176:Candida albicans / Q000187:drug effects* / Q000302:isolation & purification; D002177:Candidiasis / Q000188:drug therapy*; D002180:Candidiasis, Oral / Q000188:drug therapy; D025141:Drug Resistance, Fungal; D004935:Esophageal Diseases / Q000150:complications / Q000188:drug therapy / Q000401:mortality*; D005260:Female; D015725:Fluconazole / Q000494:pharmacology / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests / Q000379:methods; D010608:Pharyngeal Diseases / Q000188:drug therapy
D000935:Antifungal Agents; D000666:Amphotericin B; D015725:Fluconazole