TY - JOUR
T1 - Detection and significance of fluconazole resistance in oropharyngeal candidiasis in human immunodeficiency virus-infected patients
AU - Revankar, Sanjay G.
AU - Kirkpatrick, William R.
AU - McAtee, Robert K.
AU - Dib, Olga P.
AU - Fothergill, Annette W.
AU - Redding, Spencer W.
AU - Rinaldi, Michael G.
AU - Patterson, Thomas F.
N1 - Funding Information:
Received 7 February 1996; revised 30 May 1996. Human experimentation guidelines of the US Department of Health and Human Services and the University of Texas Health Science Center at San Antonio Institutional Review Board were followed. Grant support: NIH (DE-II381; RR-O1346 for the Frederic C. Bartter General Clinical Research Center), Pfizer Inc., and the Medical Research Service of the Department of Veterans Affairs. Chromogenic media were kindly provided by CHROMagar (Paris). Reprints or correspondence: Dr. Sanjay G. Revankar, University of Texas Health Science Center at San Antonio, Dept. of Medicine/Infectious Diseases, 7703 Floyd Curl Dr., San Antonio, TX 78284-7881.
PY - 1996
Y1 - 1996
N2 - 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.
AB - 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.
UR - https://www.scopus.com/pages/publications/0029792490
UR - https://www.scopus.com/pages/publications/0029792490#tab=citedBy
U2 - 10.1093/infdis/174.4.821
DO - 10.1093/infdis/174.4.821
M3 - Article
C2 - 8843222
AN - SCOPUS:0029792490
SN - 0022-1899
VL - 174
SP - 821
EP - 827
JO - Journal of Infectious Diseases
JF - Journal of Infectious Diseases
IS - 4
ER -