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Persistence of Oropharyngeal Candida albicans Strains with Reduced Susceptibilities to Fluconazole among Human Immunodeficiency Virus-Seropositive Children and Adults in a Long-Term Care Facility

Natalya U. Makarova,¹ V. V. Pokrowsky,¹ A. V. Kravchenko,¹ L. V. Serebrovskaya,¹ Michael J. James,^2, Michael M. McNeil,^2, Brent A. Lasker,² David W. Warnock,² and Errol Reiss^2*

Laboratory of Bacteriology and Mycology, Department of Laboratory Medicine, Russia AIDS Centre, Central Institute of Epidemiology, Moscow, Russia,¹ Mycotic Diseases Branch, Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia²

Received 13 December 2002/ Returned for modification 23 January 2003/ Accepted 14 February 2003

Nineteen oropharyngeal Candida albicans isolates from six children and seven adults living with AIDS at the Russia AIDS Centre, Moscow, from 1990 to 1998 were selected for molecular typing. Two fluconazole-resistant C. albicans genotypes were identified from a child who contracted human immunodeficiency virus infection during the Elista Hospital outbreak in the Kalmyk Republic in 1989. Highly related strains were observed 4 years later in the oral lesions and colonization of two patients and a health care worker. There may be a tendency for persons who are living with AIDS in a long-term care facility and who receive fluconazole therapy for oropharyngeal candidiasis to harbor and spread fluconazole-resistant C. albicans strains.

Present address: Ohio College of Osteopathic Medicine, Athens, Ohio.

Present address: Division of Epidemiology and Surveillance, National Immunization Program, Centers for Disease Control and Prevention, Atlanta, Ga.

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