Detection and significance of fluconazole resistance in oropharyngeal candidiasis in human immunodeficiency virus-infected patients

Sanjay G. Revankar, William R. Kirkpatrick, Robert K. McAtee, Olga P. Dib, Annette W. Fothergill, Spencer W. Redding, Michael G. Rinaldi, Thomas F. Patterson

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95 Scopus citations

Abstract

The epidemiology and clinical significance of fluconazole resistance were assessed in a cohort of advanced human immunodeficiency virus (HIV)- infected patients with recurrent oropharyngeal candidiasis. Fifty patients were prospectively evaluated using a novel method of detecting fluconazole resistance with chromogenic media containing fluconazole; results were confirmed with macrobroth testing. Resistant yeasts, defined as MICs ≤8 μg/mL, were detected in 16 (32%) of 50 patients: 7 (14%) had resistant Candida albicans, 7 (14%) had resistant non-C. albicans yeast, and 2 (4%) had mixed resistant yeasts. MICs were ≤32 in 11 of 16 isolates. Previous fluconazole use and severe immunosuppression were risk factors for resistance. However, 5 of 26 patients had resistant isolates with no prior fluconazole use, and all were severely immunosuppressed. Despite the high prevalence of resistance, 48 patients clinically responded to fluconazole. Fluconazole-resistant C. albicans and non-C. albicans yeast infections are common in patients with advanced immunodeficiency, but clinical efficacy of fluconazole remains high.

Original languageEnglish (US)
Pages (from-to)821-827
Number of pages7
JournalJournal of Infectious Diseases
Volume174
Issue number4
DOIs
StatePublished - Jan 1 1996

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ASJC Scopus subject areas

  • Immunology and Allergy
  • Infectious Diseases

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