Change in fluconazole susceptibility patterns and genetic relationship among oral Candida albicans isolates. NLM AIDSLINE Important note: Information in this article was accurate in 1999. The state of the art may have changed since the publication date.

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Change in fluconazole susceptibility patterns and genetic relationship among oral Candida albicans isolates.

AIDS. 1998 Sep 10;12(13):1601-10. Unique Identifier : AIDSLINE MED/98435807
Diaz-Guerra TM; Martinez-Suarez JV; Laguna F; Valencia E; Rodriguez-Tudela JL; Unidad de Micologia, Centro Nacional de Microbiologia,; Majadahonda, Instituto de Salud Carlos III, Madrid, Spain.

Abstract: OBJECTIVE: To assess the genetic homogeneity or heterogeneity within each set of Candida albicans isolates colonizing/infecting the oral cavities of HIV-infected patients undergoing azole therapy when changes in susceptibility to fluconazole were detected. DESIGN: Fourteen HIV-positive patients suffering recurrent episodes of oral candidosis were prospectively followed from the first episode to the isolation of strains with decreased susceptibility to fluconazole. The strains of C. albicans isolated either from episodes or controls throughout the prospective study were analysed. METHODS: Electrophoretic karyotyping and hybridization with the repeated sequence probe 27A were used to delineate sequential isolates. In vitro susceptibility tests to fluconazole and ketoconazole were also performed. The results obtained by DNA fingerprinting with the probe combined with computer-assisted analysis were used to assess the genetic relationships amongst the strains. In addition, comparison with the genetic relatedness of a group of geographically unrelated strains was made. RESULTS: Isogenic populations of sequential isolates were observed only in two patients; 12 patients harboured heterogenic populations over time, although in 11 patients there was a predominant strain that was isolated more than once, and only one of these patients carried strains with a similarity index less than 80%. With the exception of two patients, each patient carried a major strain that became less susceptible to fluconazole. The similarity index for the unrelated strains was 59%. CONCLUSIONS: HIV-infected patients may carry a mixed population of strains, but the strains tend to be related to each other. The strains were maintained throughout the course of infection and at least one developed secondary resistance to fluconazole.
Keywords: CLINICAL TRIAL JOURNAL ARTICLE Antifungal Agents/*THERAPEUTIC USE AIDS-Related Opportunistic Infections/*DRUG THERAPY/*MICROBIOLOGY Candida albicans/*GENETICS/ISOLATION & PURIF Candidiasis, Oral/*DRUG THERAPY/*MICROBIOLOGY DNA, Fungal/CHEMISTRY Fluconazole/*THERAPEUTIC USE Human Karyotyping Microbial Sensitivity Tests Nucleic Acid Hybridization Prospective Studies Recurrence Restriction Mapping Support, Non-U.S. Gov't Variation (Genetics)KWDclinicaltrialjournalarticleantifungalagents/KWDtherapeuticuseaids-relatedopportunisticinfections/KWDdrugtherapy/KWDmicrobiologycandidaalbicans/KWDgenetics/isolation&purifcandidiasis,oral/KWDdrugtherapy/KWDmicrobiologydna,fungal/chemistryfluconazole/KWDtherapeuticusehumankaryotypingmicrobialsensitivitytestsnucleicacidhybridizationprospectivestudiesrecurrencerestrictionmappingsupport,non-uKWDsKWDgov'tvariation(genetics)
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Copyright © 1999 - National Library of Medicine. Reproduced under license with the National Library of Medicine, Bethesda, MD.

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