       Document 0457
 DOCN  M9460457
 TI    Variations in fluconazole susceptibility and electrophoretic karyotype
       among oral isolates of Candida albicans from patients with AIDS and oral
       candidiasis.
 DT    9404
 AU    Pfaller MA; Rhine-Chalberg J; Redding SW; Smith J; Farinacci G;
       Fothergill AW; Rinaldi MG; Department of Pathology, Oregon Health
       Sciences University,; Portland 97201.
 SO    J Clin Microbiol. 1994 Jan;32(1):59-64. Unique Identifier : AIDSLINE
       MED/94172054
 AB    DNA subtyping by pulsed-field gel electrophoresis and in vitro
       susceptibility testing were used to study strain variation and
       fluconazole resistance in Candida albicans isolates from patients with
       AIDS undergoing azole (fluconazole and clotrimazole) therapy for
       oropharyngeal candidiasis. A total of 29 patients suffered 71 episodes
       of oropharyngeal candidiasis. Overall, 121 isolates of C. albicans
       recovered throughout the course of treatment of each infection were
       available for further characterization. DNA subtyping revealed a total
       of 61 different DNA subtypes. In vitro susceptibility testing of the 121
       isolates by using proposed standard methods of the National Committee
       for Clinical Laboratory Standards revealed MICs of fluconazole ranging
       from < or = 0.125 to > 64 micrograms/ml. The MIC for 50% of isolates
       tested was 0.25 microgram/ml, and the MIC for 90% of isolates tested was
       8.0 micrograms/ml. MICs were > or = 64 micrograms/ml for only 7.4% of
       the isolates tested. The majority (62%) of the patients with
       oropharyngeal candidiasis and undergoing azole therapy were infected or
       colonized with more than one DNA subtype, and the introduction or
       selection of strains with a more resistant DNA subtype during the course
       of fluconazole therapy was not uncommon. With one exception, this did
       not appear to have an adverse effect on clinical outcome. In contrast,
       for patients with AIDS and oropharyngeal candidiasis infected with a
       single DNA subtype of C. albicans, an increase in fluconazole MICs for
       the infecting strain was rarely demonstrated over the course of therapy.
 DE    Acquired Immunodeficiency Syndrome/COMPLICATIONS/*MICROBIOLOGY  Candida
       albicans/*GENETICS  Candidiasis, Oral/DRUG THERAPY/GENETICS  Drug
       Resistance, Microbial/*GENETICS  DNA, Fungal/*CLASSIFICATION
       Electrophoresis, Gel, Pulsed-Field  Female
       Fluconazole/*PHARMACOLOGY/THERAPEUTIC USE  Human  Karyotyping  Male
       Restriction Fragment Length Polymorphisms  Support, Non-U.S. Gov't
       Treatment Outcome  Variation (Genetics)  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

