This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Reprints and Permissions Copyright Information Books from ASM Press MicrobeWorld Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Le Guennec, R. Articles by Bastide, J. M. Search for Related Content PubMed PubMed Citation Articles by Le Guennec, R. Articles by Bastide, J. M.

 Previous Article  |  Next Article 

Journal of Clinical Microbiology, Oct 1995, 2732-2737, Vol 33, No. 10
Copyright © 1995 by the American Society for Microbiology. All rights reserved.

Fluconazole- and itraconazole-resistant Candida albicans strains from AIDS patients: multilocus enzyme electrophoresis analysis and antifungal susceptibilities

R Le Guennec, J Reynes, M Mallie, C Pujol, F Janbon and JM Bastide
Laboratoire d'Immunologie et Parasitologie, Faculte de Pharmacie, Montpellier, France.

Multilocus enzyme electrophoresis and in vitro susceptibility testing with a broth microdilution method were used to analyze Candida albicans strain diversity in four AIDS patients with recurrent oropharyngeal candidiasis who successively developed clinical resistance to fluconazole (FCZ) and itraconazole (ITZ). One to ten colonies per sample were randomly chosen from oral washings collected before the initial FCZ treatment and just before every other antifungal treatment; a total of 98 isolates were analyzed. Multilocus enzyme electrophoresis analysis revealed 14 different electrophoretic types (ETs). Statistical analysis of genetic distances showed that C. albicans isolates clustered into five subpopulations (I to V). In each subpopulation, isolates are closely related, and genetic distances between subpopulations I to IV are short. In contrast, subpopulation V, which contained isolates typed as ET8 and ET14, is strongly divergent from the others; these isolates may represent atypical C. albicans isolates. Only one patient was infected with a single strain during the course of azole therapy; for the three remaining patients, variants of the same strain and different strains were concurrently isolated. Clinical FCZ resistance was clearly correlated with in vitro data for three patients. Moreover, MICs of ITZ increased during FCZ therapy, and MICs of ITZ which were > or = 1.56 micrograms/ml were found when clinical ITZ resistance occurred; isolates from subpopulation V showed the highest MICs of ITZ. Because of the emergence of clinical ITZ resistance after clinical FCZ resistance, the feasibility of long-term azole therapy for mucosal candidiasis in AIDS patients is questioned.

This article has been cited by other articles:

• Odds, F. C., Davidson, A. D., Jacobsen, M. D., Tavanti, A., Whyte, J. A., Kibbler, C. C., Ellis, D. H., Maiden, M. C. J., Shaw, D. J., Gow, N. A. R. (2006). Candida albicans Strain Maintenance, Replacement, and Microvariation Demonstrated by Multilocus Sequence Typing.. J. Clin. Microbiol. 44: 3647-3658 [Abstract] [Full Text]  
• Pujol, C., Daniels, K. J., Lockhart, S. R., Srikantha, T., Radke, J. B., Geiger, J., Soll, D. R. (2004). The Closely Related Species Candida albicans and Candida dubliniensis Can Mate. Eukaryot Cell 3: 1015-1027 [Abstract] [Full Text]  
• Bennett, J. E., Izumikawa, K., Marr, K. A. (2004). Mechanism of Increased Fluconazole Resistance in Candida glabrata during Prophylaxis. Antimicrob. Agents Chemother. 48: 1773-1777 [Abstract] [Full Text]  
• Boldo, X. M., Villa-Tanaca, L., Zuniga, G., Hernandez-Rodriguez, C. (2003). Genetic Diversity among Clinical Isolates of Candida glabrata Analyzed by Randomly Amplified Polymorphic DNA and Multilocus Enzyme Electrophoresis Analyses. J. Clin. Microbiol. 41: 4799-4804 [Abstract] [Full Text]  
• Samaranayake, Y.H., Samaranayake, L.P., Dassanayake, R.S., Yau, J.Y. Y., Tsang, W.K., Cheung, B.P. K., Yeung, K.W. S. (2003). `Genotypic shuffling' of sequential clones of Candida albicans in HIV-infected individuals with and without symptomatic oral candidiasis. J Med Microbiol 52: 349-359 [Abstract] [Full Text]  
• Bertout, S., Renaud, F., Barton, R., Symoens, F., Burnod, J., Piens, M.-A., Lebeau, B., Viviani, M.-A., Chapuis, F., Bastide, J.-M., Grillot, R., Mallié, M., THE EUROPEAN RESEARCH GROUP ON BIOTYPE AND GENOTYP, (2001). Genetic Polymorphism of Aspergillus fumigatus in Clinical Samples from Patients with Invasive Aspergillosis: Investigation Using Multiple Typing Methods. J. Clin. Microbiol. 39: 1731-1737 [Abstract] [Full Text]  
• Vargas, K., Messer, S. A., Pfaller, M., Lockhart, S. R., Stapleton, J. T., Hellstein, J., Soll, D. R. (2000). Elevated Phenotypic Switching and Drug Resistance of Candida albicans from Human Immunodeficiency Virus-Positive Individuals prior to First Thrush Episode. J. Clin. Microbiol. 38: 3595-3607 [Abstract] [Full Text]  
• Soll, D. R. (2000). The Ins and Outs of DNA Fingerprinting the Infectious Fungi. Clin. Microbiol. Rev. 13: 332-370 [Abstract] [Full Text]  
• Joly, S., Pujol, C., Rysz, M., Vargas, K., Soll, D. R. (1999). Development and Characterization of Complex DNA Fingerprinting Probes for the Infectious Yeast Candida dubliniensis. J. Clin. Microbiol. 37: 1035-1044 [Abstract] [Full Text]  
• Vazquez, J. A., Arganoza, M. T., Boikov, D., Yoon, S., Sobel, J. D., Akins, R. A. (1998). Stable Phenotypic Resistance of Candida Species to Amphotericin B Conferred by Preexposure to Subinhibitory Levels of Azoles. J. Clin. Microbiol. 36: 2690-2695 [Abstract] [Full Text]  
• Sullivan, D., Coleman, D. (1998). Candida dubliniensis: Characteristics and Identification. J. Clin. Microbiol. 36: 329-334 [Full Text]