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Journal of Clinical Microbiology, October 2000, p. 3595-3607, Vol. 38, No. 10
0095-1137/00/$04.00+0
Copyright © 2000, American Society for Microbiology. All rights reserved.

Elevated Phenotypic Switching and Drug Resistance of Candida albicans from Human Immunodeficiency Virus-Positive Individuals prior to First Thrush Episode

Kaaren Vargas,1 Shawn A. Messer,2 Michael Pfaller,2 Shawn R. Lockhart,3 Jack T. Stapleton,4 John Hellstein,5 and David R. Soll1,3,*

College of Dentistry,1 Department of Pathology,2 Department of Internal Medicine,4 and Department of Biological Sciences,3 University of Iowa, Iowa City, Iowa 52242, and Department of Pathology, William Beaumont Army Medical Center, El Paso, Texas 799205

Received 30 May 2000/Returned for modification 1 July 2000/Accepted 25 July 2000

Strains of Candida albicans obtained from human immunodeficiency virus (HIV)-positive individuals prior to their first episode of oral thrush were already in a high-frequency mode of switching and were far more resistant to a number of antifungal drugs than commensal isolates from healthy individuals. Switching in these isolates also had profound effects both on susceptibility to antifungal drugs and on the levels of secreted proteinase activity. These results suggest that commensal strains colonizing HIV-positive individuals either undergo phenotypic alterations or are replaced prior to the first episode of oral thrush. They also support the suggestion that high-frequency phenotypic switching functions as a higher-order virulence trait, spontaneously generating in colonizing populations variants with alterations in a variety of specific virulence traits.

* Corresponding author. Mailing address: Department of Biological Sciences, University of Iowa, 138 Biology Bldg., Iowa City, IA 52242. Phone: (319) 335-1117. Fax: (319) 335-2772. E-mail: david-soll{at}uiowa.edu.

Journal of Clinical Microbiology, October 2000, p. 3595-3607, Vol. 38, No. 10
0095-1137/00/$04.00+0
Copyright © 2000, American Society for Microbiology. All rights reserved.


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Antimicrob. Agents Chemother. Clin. Microbiol. Rev.
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Copyright © 2000 by the American Society for Microbiology. All rights reserved.