Candida albicans resistance in AIDS

Kitchen, V. S.; Savage, M; Harris, J. R. W.

doi:10.1016/0163-4453(91)91789-z

Cited by 70 publications

(34 citation statements)

References 3 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…A 25-±g fluconazole disc was used, and the plates were incubated at 28°C for 24 h. The intralaboratory reproducibility was reported to be good, with 91% of the results within 4 mm of others in the same set, whereas the interlaboratory agreement was poor, as only 59% of the disc test results agreed within 4 mm (13). In the present study, we have evaluated the ability of the agar diffusion test to separate strains into susceptibility (5,6,9,16,17). In previous studies, fluconazoleresistant strains of C. albicans were isolated from 13 AIDS patients not responding to fluconazole treatment.…”

Section: Resultsmentioning

confidence: 99%

Susceptibilities of Norwegian Candida albicans strains to fluconazole: emergence of resistance. The Norwegian Yeast Study Group

Sandven¹,

Bjørneklett²,

Mæland³

1993

Antimicrob Agents Chemother

View full text Add to dashboard Cite

All Candida albicans isolates in Norwegian microbiological laboratories in 1991 judged clinically important (except vaginal isolates) were collected. The isolates were tested for susceptibility to fluconazole with an agar dilution test and a commercially available agar diffusion test. A total of 212 strains (95%) were susceptible to fluconazole, and MICs for most of the strains (92%) were .1.56 pg/ml. The agar diffusion test using a 15-,Lg tablet and a 48-h incubation period separated resistant from susceptible strains with a wide margin. The only exception was a strain for which the MIC was 6.25 ILg/ml. The difference in zone size between the resistant and the susceptible populations of strains was 11 mm. Accordingly, it appears that the agar diffusion test is an appropriate method for detecting fluconazole resistance. The 12 fluconazole-resistant isolates originated from eight AIDS patients with oral or esophageal Candida infections. Seven of the patients had been given fluconazole for 1 month or more, often as self medication. Four had infections that were clinically resistant to fluconazole; one additional patient responded only when the dose was increased. All isolates recovered from these patients were analyzed by multilocus enzyme electrophoresis. The 12 C. albicans isolates belonged to five electrophoretic types, but three of four patients attending one hospital had isolates belonging to one electrophoretic type. One possible explanation for this finding could be that a nosocomial spread of resistant strains has occurred.

show abstract

Section: Resultsmentioning

confidence: 99%

Susceptibilities of Norwegian Candida albicans strains to fluconazole: emergence of resistance. The Norwegian Yeast Study Group

Sandven¹,

Bjørneklett²,

Mæland³

1993

Antimicrob Agents Chemother

View full text Add to dashboard Cite

show abstract

“…Although the triazole antifungal agents, especially FCZ, can attain low incidences of side effects coupled with good therapeutic responses particularly in nonimmunocompromised patients, the clinical efficacy of those drugs is not always sufficient in immunocompromised patients, especially in those with persistent neutropenia (18). Additionally, strains resistant to FCZ have also been isolated (5,11,20) in cases of disseminated C. albicans infection in AIDS patients. Furthermore, it has been reported that the infections caused by other Candida species such as C. glabrata and C. krusei, which are resistant to FCZ, are increasing in the patients treated with FCZ (1,3,15,21 Comparing MICs between D0870 and M16355, we found that D0870 was much more active than M16355 against various fungi, except for C. albicans.…”

Section: Discussionmentioning

confidence: 99%

In vitro and in vivo antifungal activities of D0870, a new triazole agent

Yamada

Tsuda

Watanabe

et al. 1993

Antimicrob Agents Chemother

View full text Add to dashboard Cite

In vitro and in vivo antifungal activities of D0870 were evaluated in comparison with those of fluconazole. D0870, which is the R-enantiomer of IC1195,739, was found to be the mycologically active enantiomer by comparing the activities of D0870 with those of M16355 (S-enantiomer of IC1195,739). D0870 showed a broad spectrum of antifungal activity and MICs and minimum antibiotic concentrations 4-to 2,000-fold lower in synthetic amino acid medium (fungal) agar than those of fluconazole for various fungi. Although MICs of D0870 were affected by variation of the test conditions, such as type of medium, inoculum size of fungi, supplementation with fetal bovine serum, and pH of medium, they were consistently much lower than those of fluconazole under any condition. In vivo activities of D0870 in the systemic infection models with Candida albicans, Cryptococcus neoformans, and Aspergillus fiumigatus in normal mice and in the mice immunosuppressed with cyclophosphamide or cortisone acetate were 2-to 7-fold and 3-to 89-fold greater than those of fluconazole, respectively. In these infection models in immunosuppressed mice, the therapeutic efficacy of D0870 was almost equivalent to that in normal mice, whereas the efficacy of fluconazole was 2-to 50-fold lower than that in normal mice.It has been reported that the recent rise in the number of patients with systemic fungal infections closely relates to therapy using immunosuppressive or anticancer agents (6, 7). These kinds of agents reportedly cause the destruction of the cellular or humoral host defense system, and that destruction inevitably raises the frequency of opportunistic infections caused by fungi such as Candida, Aspergillus, or Cryptococcus species. Under these circumstances, the need for potent systemic antifungal agents has been increasing recently. Six systemic antifungal agents, amphotericin B (AMPH), flucytosine, miconazole (MCZ), ketoconazole, fluconazole (FCZ), and itraconazole, have been developed so far for clinical use. However, the clinical values of these agents have been limited primarily by their relatively high risks of toxicity, emergence of drug resistance, pharmacokinetic deficiencies, and/or insufficiency of their antifungal activities (7,8,14). Thus, much effort still has been made to develop novel potent antifungal agents which are safe and systemically effective against various deep-seated mycoses. D0870 (Fig. 1) is the R-enantiomer of IC1195,739, which has excellent in vitro and in vivo antifungal activities (4,16 In vitro antifungal activity. MICs and minimum antibiotic concentrations (MACs) were determined by the twofold agar dilution method with synthetic amino acid medium (fungal)

show abstract

“…After antifungal treatments, relapses are common and are often due to Candida glabrata (also known as Torulopsis glabrata) (2,7,18). Furthermore, the use of antifungal azoles seems to enhance the development of such mycoses (8,15).C. glabrata is a commensal yeast commonly isolated from the human digestive tract.…”

mentioning

confidence: 99%

Genetic Structure ofCandida glabrataPopulations in AIDS and Non-AIDS Patients

Meeûs

Renaud

Mouveroux³

et al. 2002

J Clin Microbiol

View full text Add to dashboard Cite

Analysis of the population genetics structure of natural populations elucidates the functioning and evolutionary capabilities of natural populations. It is particularly appropriate for organisms that cannot be directly observed (37). Indeed, the genotypic structure can provide useful clues for estimating the reproductive mode, gene flow, geographical structure, and approximate sizes of reproductive units (10).Infectious diseases involve organisms whose population biology is difficult to assess. This is why molecular markers are useful tools in increasing our understanding of their epidemiology (40).Candidoses are cosmopolitan infections due to yeast-like fungi. These yeasts are responsible for severe mucocutaneous or systemic infections, particularly in premature infants, pregnant women (in that case the infection is mildly self-limiting), after invasive intervention, in AIDS and immunodeficient patients (e.g., cancer, graft, and transplantation patients), and during chemotherapy (corticoids or antimitotics) and radiotherapy (26). Oropharyngeal candidosis is the earliest and the most common fungal infection found in AIDS patients (5, 6, 16). Moreover, susceptibility to other mycoses increases with the development of AIDS (17). Primary infections are essentially due to Candida albicans. After antifungal treatments, relapses are common and are often due to Candida glabrata (also known as Torulopsis glabrata) (2,7,18). Furthermore, the use of antifungal azoles seems to enhance the development of such mycoses (8,15).C. glabrata is a commensal yeast commonly isolated from the human digestive tract. This yeast is considered to be haploid and without a sexual cycle (45). Until know, very little attention has been devoted to the genetics of this opportunistic pathogen compared to the related C. albicans (1,3,28,48). Thus, basic information on the biology and epidemiology of C. glabrata is needed.We report here the enzyme polymorphism observed for 33 putative gene loci in 63 C. glabrata strains in 11 reference strains and in 52 strains isolated from hospitalized patients (22 in Paris and 30 in Montpellier). Furthermore, the patterns of 24 RAPD [random(ly) amplified polymorphic DNA] primers from 20 of these strains are compared to the multilocus enzyme electrophoresis (MLEE) results. This allows inferences to be made regarding the genetic structure and reproductive modality displayed by C. glabrata populations with respect to geography, infected organs, and the human immunodeficiency virus (HIV) status of the patient. MATERIALS AND METHODSOrigin of the different strains. We used 11 reference strains. Strain 774 comes from the Centraalbureau voor Schimmelcultures (Delft, The Netherlands), along with the reference CBS 138 T ; strains 918, 949, 957, 960, 962, 965, 970, and 971 were provided by the Institut Pasteur (Paris, France) with reference numbers IP 3, 811,13,20,14,12,32, and 9, respectively, and strains 1109 and 1110 came from SANOFI (Montpellier, France) with reference numbers SANOFI 2223 and 2231.

show abstract

Candida albicans resistance in AIDS

Cited by 70 publications

References 3 publications

Susceptibilities of Norwegian Candida albicans strains to fluconazole: emergence of resistance. The Norwegian Yeast Study Group

Susceptibilities of Norwegian Candida albicans strains to fluconazole: emergence of resistance. The Norwegian Yeast Study Group

In vitro and in vivo antifungal activities of D0870, a new triazole agent

Genetic Structure ofCandida glabrataPopulations in AIDS and Non-AIDS Patients

Contact Info

Product

Resources

About