Previous Article | Next Article 
Journal of Clinical Microbiology, March 1999, p. 870-872, Vol. 37, No. 3
Departments of
Pathology1 and
Biology,3 University of Iowa, Iowa City,
Iowa, and
Departments of Oral Medicine and Pathology,
School of Dental Science, and Dublin Dental Hospital, Trinity
College, University of Dublin, Dublin 2, Republic of
Ireland2
Received 15 October 1998/Returned for modification 24 November
1998/Accepted 12 December 1998
Candida dubliniensis is a newly recognized fungal
pathogen causing mucosal disease in AIDS patients. Although
preliminary studies indicate that most strains of C. dubliniensis are susceptible to established antifungal
agents, fluconazole-resistant strains have been detected. Furthermore,
fluconazole-resistant strains are easily derived in vitro, and these
strains exhibit increased expression of multidrug resistance
transporters, especially MDR1. Because of the potential for
the development of resistant strains of C. dubliniensis, it
is prudent to explore the in vitro activities of several of the newer
triazole and echinocandin antifungals against isolates of C. dubliniensis. In this study we tested 71 isolates of C. dubliniensis against the triazoles BMS-207147, Sch 56592, and
voriconazole and a representative of the echinocandin class of
antifungal agents, MK-0991. We compared the activities of
these agents with those of the established antifungal agents fluconazole, itraconazole, amphotericin B, and 5-fluorocytosine (5FC)
by using National Committee for Clinical Laboratory Standards microdilution reference methods. Our findings indicate that the vast
majority of clinical isolates of C. dubliniensis are
highly susceptible to both new and established antifungal agents.
Strains with decreased susceptibilities to fluconazole remained
susceptible to the investigational agents as well as to amphotericin B
and 5FC. The increased potencies of the new triazole and
echinocandin antifungal agents may provide effective therapeutic
options for the treatment of infections due to C. dubliniensis.
Candida dubliniensis is a
recently identified opportunistic yeast pathogen that is now recognized
to be a minor constituent of normal human oral microbial flora. In
previous studies C. dubliniensis was recovered from the
oral cavities of 27% of human immunodeficiency virus (HIV)-infected
individuals and 32% of AIDS patients with clinical symptoms of oral
candidiasis (2, 6, 14-16). The role and incidence of
C. dubliniensis in other infections has yet to be
established. Despite this fact, there have been very few studies
evaluating the in vitro susceptibilities of C. dubliniensis isolates to existing antifungal agents
(15). Moran et al. (6) reported on the in vitro
susceptibilities of 20 isolates of C. dubliniensis to
fluconazole, itraconazole, ketoconazole, and amphotericin B. They found
that the majority (80%) of C. dubliniensis isolates were susceptible to commonly used antifungal agents, including fluconazole. However, they did recover C. dubliniensis
isolates with reduced susceptibilities to fluconazole (MIC range, 8.0 to 32 µg/ml) from AIDS patients with prior exposure to fluconazole. They also demonstrated that C. dubliniensis, unlike
Candida albicans, was able to rapidly develop stable
resistance to fluconazole following direct exposure to the drug in
vitro (6). In these derivatives, fluconazole resistance was
associated with increased expression of multidrug transporter genes,
particularly C. dubliniensis MDR1 (7). These
findings may have implications for antifungal drug treatment regimens
and suggest that antifungal resistance may be a factor in the emergence
of C. dubliniensis infection (15).
In the present study, we investigated the in vitro susceptibilities of
71 isolates of C. dubliniensis from 68 patients to several antifungal agents, including the triazoles BMS-207147, Sch
56592, and voriconazole and a representative of the echinocandin class
of antifungal agents, MK-0991. We compared the in vitro activities of
these new antifungal agents to those of established agents, including
fluconazole, itraconazole, amphotericin B, and 5-fluorocytosine (5FC),
by using National Committee for Clinical Laboratory Standards
(NCCLS) reference broth microdilution methods (8). Our
findings indicate that the vast majority of clinical isolates of
C. dubliniensis are highly susceptible to both new and
established antifungal agents. Isolates with decreased susceptibilities to fluconazole (MICs, 32 to 64 µg/ml) remained susceptible to the
investigational agents as well as to amphotericin B and 5FC. The
increased potencies of the new triazole and echinocandin antifungal agents may provide effective therapeutic options for the treatment of
infections due to C. dubliniensis.
A total of 71 isolates (68 patients) of C. dubliniensis
from the culture collection of the University of Dublin, Dublin,
Ireland, were selected for testing. The isolates included the
C. dubliniensis type strain, CD36 (CBS strain 7987);
five previously described derivatives with decreased susceptibilities
to fluconazole (MICs, The isolates were identified as C. dubliniensis by
their ability to produce abundant chlamydospores on rice agar-Tween
medium (RAT medium; bioMérieux), by their inability to grow at
45°C (1), by indirect immunofluorescence with
C. dubliniensis blastospore-specific polyvalent
antiserum (12), by their characteristic DNA fingerprints following hybridization with the C. albicans
mid-repeat sequence probes 27A and Ca3 (16), and
by hybridization with the C. dubliniensis-specific complex probe Cd25-1 (3).
Fluconazole (Pfizer Pharmaceuticals Group, New York, N.Y.),
voriconazole (Pfizer), itraconazole (Janssen, Beerse, Belgium), BMS-207147 (Bristol-Myers Squibb, Wallingford, Conn.), Sch 56592 (Schering-Plough Research Institute, Kenilworth, N.J.), MK-0991 (Merck
Research Laboratories, Rahway, N.J.), amphotericin B (Sigma Chemical
Co., St. Louis, Mo.), and 5FC (Sigma) were all obtained as reagent
grade powders from their respective manufacturers. Reference
microdilution trays containing serial dilutions of the antifungal
agents in RPMI 1640 medium (Sigma) were prepared in a single lot and
were stored frozen at Broth microdilution testing was performed according to NCCLS
guidelines by the spectrophotometric method of inoculum preparation with an inoculum concentration of 0.5 × 103 to
2.5 × 103 cells per ml and RPMI 1640 medium buffered
to pH 7.0 with 0.165 M morpholinepropanesulfonic acid (MOPS) buffer
(Sigma) (8). Yeast inocula (100 µl) were added to each
well of microdilution trays containing 100 µl of antifungal drug
solution (2× final concentration). Final concentrations of the
antifungal agents were 0.008 to 8.0 µg/ml for voriconazole,
BMS-207147, Sch 56592, itraconazole, and MK-0991 and 0.125 to 128 µg/ml for fluconazole and 5FC. Amphotericin B MICs were
determined by using the Etest performed according to the instructions
of the manufacturer (AB BIODISK, Solna, Sweden) (18). The
microdilution trays and plates containing Etest strips were incubated
in air at 35°C and were observed for the presence or absence of
growth at 48 h. The MICs of 5FC, fluconazole, voriconazole,
itraconazole, Sch 56592, and BMS-207147 were read as the lowest
concentration at which a prominent decrease in turbidity (approximately
80% inhibition) relative to that of the growth control well was
observed (8). The MICs of amphotericin B and MK-0991 were
read as the lowest concentration at which complete growth inhibition
was observed.
The interpretive criteria used for fluconazole (susceptible
[S], <64 µg/ml), itraconazole (S, <1.0 µg/ml), and 5FC
(S, <8.0 µg/ml) were those published by Rex et al.
(13) and by the NCCLS (8). Interpretive
criteria have not been defined for BMS-207147, voriconazole, Sch 56592, MK-0991, or amphotericin B. For purposes of comparison, the threshold
concentration used for itraconazole (S, <1.0 µg/ml) was applied to
these agents (Table 1).
0095-1137/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.
In Vitro Susceptibilities of Candida dubliniensis
Isolates Tested against the New Triazole and Echinocandin
Antifungal Agents
ABSTRACT
Top
Abstract
Text
References
TEXT
Top
Abstract
Text
References
32 µg/ml) (6, 7), CD36-70,
CD51-IIA, CD51-IIB, CD51-IIC, and CD57-B; and clinical isolates from a
wide variety of geographic locations. The majority of the clinical
isolates were oral isolates obtained from HIV-infected individuals or
AIDS patients.
70°C until used in the study.
TABLE 1.
In vitro susceptibilities of 71 Candida
dubliniensis isolates tested against eight antifungal agents
Quality control (QC) was ensured by testing the NCCLS recommended QC strains (8) C. krusei ATCC 6258 and C. parapsilosis ATCC 22019.
In vitro susceptibility testing of the 71 isolates of C. dubliniensis revealed that 97% were susceptible to fluconazole,
100% were susceptible to itraconazole, and 100% were susceptible to 5FC at the recently published NCCLS MIC interpretive
breakpoint concentrations (Table 1) (8, 13). The
investigational agents were also highly active with 99% of
isolates susceptible to BMS-207147, Sch 56592, voriconazole, and
MK-0991 at a threshold concentration of <1.0 µg/ml. The MICs
at which 90% of these isolates were inhibited (MIC90)
ranged from 0.03 µg/ml (BMS-207147 and voriconazole) to 0.5 µg/ml (MK-0991). Amphotericin B was also quite active, with 100%
of the isolates being inhibited by a concentration of <1.0 µg/ml.
Five C. dubliniensis strains were noted to have
decreased susceptibilities to fluconazole (MIC, 32 µg/ml) (Table
2). All five strains had previously been
selected for resistance by subculturing on fluconazole-containing
medium and had been shown to exhibit increased expression of
multidrug resistance transporter proteins, especially MDR1, which
mediate fluconazole resistance (6, 7). In Table 2, we
compare the in vitro susceptibilities of these derivatives, plus the
fluconazole-susceptible C. dubliniensis type strain,
CD36, to itraconazole and the investigational triazole (BMS-207147, Sch
56592, and voriconazole) and echinocandin (MK-0991) antifungal agents.
|
As noted previously (6, 7), the MICs of itraconazole, as
well as the newer triazole agents, remained quite low (
1.0 µg/ml)
for all of the five strains (Table 2). Compared to that for the
C. dubliniensis type strain, the MICs for these strains were elevated 2- to 32-fold for all of the triazoles tested, although in no instance was the increase in MIC considered sufficient to represent cross-resistance (7). Susceptibility to the
MK-0991 echinocandin agent remained stable (MICs ranging from 0.03 to 0.25 µg/ml) regardless of the change in triazole susceptibility. Likewise, no cross-resistance to amphotericin B or 5FC was observed with these strains (data not shown).
In summary, we have confirmed and extended the observations of Moran et al. (6, 7) regarding the in vitro susceptibilities of C. dubliniensis isolates to the presently available antifungal agents. We have shown that C. dubliniensis isolates are generally quite susceptible to both established and investigational antifungal agents. The pattern of susceptibility to the newer triazole and echinocandin antifungal agents is similar to that observed for C. albicans (4, 5, 9-11). Importantly, all of the investigational triazoles and the echinocandin agent remained active against strains of C. dubliniensis with decreased susceptibilities to fluconazole. Given the demonstrated capacity of C. dubliniensis to become resistant to fluconazole by expression of multidrug resistance transporters (7), further clinical and in vitro studies of the antifungal susceptibility and resistance of this organism are warranted.
| |
ACKNOWLEDGMENTS |
|---|
The excellent secretarial support of Kay Meyer is greatly appreciated.
This study was supported in part by Irish Health Research Board grant no. 41/96 and 05/97 (to D.C.C.), by Public Health Service grant DE10758 from the National Institutes of Health (to D.R.S.), and by grants from the Pfizer Pharmaceuticals Group and Bristol-Myers Squibb (to M.A.P.).
| |
FOOTNOTES |
|---|
* Corresponding author. Mailing address: Medical Microbiology Division, C606 GH, Department of Pathology, University of Iowa College of Medicine, Iowa City, IA 52242. Phone: (319) 394-9566. Fax: (319) 356-4916. E-mail: michael-pfaller{at}uiowa.edu.
| |
REFERENCES |
|---|
|
Top
Abstract
Text
References
|
|---|
| 1. |
Birkandi, J.,
R. San Millan,
M. D. Moragnes,
G. Cebas,
M. Clarke,
D. C. Coleman,
D. J. Sullivan,
G. Quindos, and J. Ponton.
1998.
Rapid identification of Candida dubliniensis by indirect immunofluorescence based on differential localization of antigens on C. dubliniensis blastospores and Candida albicans germ tubes.
J. Clin. Microbiol.
36:2428-2433 |
| 2. | Coleman, D. C., D. J. Sullivan, D. E. Bennett, G. P. Moran, H. J. Barry, and D. B. Shanley. 1997. Candidiasis: the emergence of a novel species, Candida dubliniensis. AIDS 11:557-567[Medline]. |
| 3. | Joly, S., et al. 1998. Unpublished observations. |
| 4. |
Marco, F.,
M. A. Pfaller,
S. Messer, and R. N. Jones.
1998.
In vitro activities of voriconazole (UK-109,496) and four other antifungal agents against 394 clinical isolates of Candida spp.
Antimicrob. Agents Chemother.
42:161-163 |
| 5. | Marco, F., M. A. Pfaller, S. A. Messer, and R. N. Jones. Activity of MK-0991 (L-743,872), a new echinocandin, compared with those of LY303366 and four other antifungal agents tested against bloodstream isolates of Candida spp. Diagn. Microbiol. Infect. Dis., in press. |
| 6. | Moran, G. P., D. J. Sullivan, M. C. Herman, C. E. McCreary, B. J. Harrington, D. B. Shanley, and D. C. Coleman. 1997. Antifungal drug susceptibilities of oral Candida dubliniensis isolates from human immunodeficiency virus (HIV)-infected and non-HIV-infected subjects and generation of stable fluconazole-resistant derivatives in vitro. Antimicrob. Agents Chemother. 41:617-623[Abstract]. |
| 7. |
Moran, G. P.,
D. Sanglard,
S. M. Donnelly,
D. B. Shanley,
D. J. Sullivan, and D. C. Coleman.
1998.
Identification and expression of multidrug transporters responsible for fluconazole resistance in Candida dubliniensis.
Antimicrob. Agents Chemother.
42:1819-1830 |
| 8. | National Committee for Clinical Laboratory Standards. 1997. Reference method for broth dilution antifungal susceptibility testing of yeast. Approved standard M27-A. National Committee for Clinical Laboratory Standards, Wayne, Pa. |
| 9. | Pfaller, M. A., S. Messer, and R. N. Jones. 1997. Activity of a new triazole, SCH56592, compared with those of four other antifungal agents tested against clinical isolates of Candida spp. and Saccharomyces cerevisiae. Antimicrob. Agents Chemother. 41:233-235[Abstract]. |
| 10. |
Pfaller, M. A.,
R. N. Jones,
G. V. Doern,
H. S. Sader,
R. J. Hollis, and S. A. Messer for the SENTRY Participant Group.
1998.
International surveillance of bloodstream infections due to Candida species: frequency of occurrence and antifungal susceptibilities of isolates collected in 1997 in the United States, Canada, and South America for the SENTRY program.
J. Clin. Microbiol.
36:1886-1889 |
| 11. |
Pfaller, M. A.,
S. A. Messer,
R. J. Hollis,
R. N. Jones,
G. V. Doern,
M. E. Brandt, and R. A. Hajjeh.
1998.
In vitro susceptibilities of Candida bloodstream isolates to the new triazole antifungal agents BMS-207147, Sch 56592, and voriconazole.
Antimicrob. Agents Chemother.
42:3242-3244 |
| 12. |
Pinjon, E.,
D. Sullivan,
I. Salkin,
D. Shantey, and D. Coleman.
1998.
Simple, inexpensive, reliable method for differentiation of Candida dubliniensis from Candida albicans.
J. Clin. Microbiol.
36:2093-2095 |
| 13. |
Rex, J. H.,
M. A. Pfaller,
J. N. Galgiani,
M. S. Bartlett,
A. Espinel-Ingroff,
M. A. Ghannoum,
M. Lancaster,
F. C. Odds,
M. G. Rinaldi,
T. J. Walsh, and A. L. Barry for the Subcommittee on Antifungal Susceptibility Testing of the National Committee for Clinical Laboratory Standards.
1997.
Development of interpretive breakpoints for antifungal susceptibility testing: conceptual framework and analysis of in vitro in vivo correlation data for fluconazole, itraconazole, and Candida infections.
Clin. Infect. Dis.
24:235-247[Medline].
|
| 14. | Schoofs, A., F. C. Odds, R. Colebunders, M. Leven, and H. Goosens. 1997. Use of specialized isolation media for recognition and identification of Candida dubliniensis isolates from HIV-infected patients. Eur. J. Clin. Infect. Dis. 16:296-300. |
| 15. |
Sullivan, D., and D. Coleman.
1998.
Candida dubliniensis: characteristics and identification.
J. Clin. Microbiol.
36:329-334 |
| 16. |
Sullivan, D. J.,
T. J. Westerneng,
K. A. Haynes,
D. E. Bennett, and D. C. Coleman.
1995.
Candida dubliniensis sp. nov.: phenotypic and molecular characterization of a novel species associated with oral candidiasis in HIV-infected individuals.
Microbiology
141:1507-1521 |
| 17. | Sullivan, D. J., K. Haynes, J. Bille, P. Boerlin, L. Rodero, S. Lloyd, M. Henman, and D. Coleman. 1997. Widespread geographic distribution of oral Candida dubliniensis strains in human immunodeficiency virus-infected individuals. J. Clin. Microbiol. 35:960-964[Abstract]. |
| 18. | Wanger, A., K. Mills, P. W. Nelson, and J. H. Rex. 1995. Comparison of Etest and National Committee for Clinical Laboratory Standards broth macrodilution method for antifungal susceptibility testing: enhanced ability to detect amphotericin B-resistant Candida isolates. Antimicrob. Agents Chemother. 39:2520-2522[Abstract]. |
| 19. |
White, T. C.,
K. A. Marr, and R. A. Bowden.
1998.
Clinical, cellular, and molecular factors that contribute to antifungal drug resistance.
Clin. Microbiol. Rev.
11:382-402 |
Journal of Clinical Microbiology, March 1999, p. 870-872, Vol. 37, No. 3
0095-1137/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.
This article has been cited by other articles:
-
McManus, B. A., Moran, G. P., Higgins, J. A., Sullivan, D. J., Coleman, D. C.
(2009). A Ser29Leu Substitution in the Cytosine Deaminase Fca1p Is Responsible for Clade-Specific Flucytosine Resistance in Candida dubliniensis. Antimicrob. Agents Chemother.
53: 4678-4685
[Abstract] [Full Text] -
Diekema, D. J., Messer, S. A., Boyken, L. B., Hollis, R. J., Kroeger, J., Tendolkar, S., Pfaller, M. A.
(2009). In Vitro Activity of Seven Systemically Active Antifungal Agents against a Large Global Collection of Rare Candida Species as Determined by CLSI Broth Microdilution Methods. J. Clin. Microbiol.
47: 3170-3177
[Abstract] [Full Text] -
Sabatelli, F., Patel, R., Mann, P. A., Mendrick, C. A., Norris, C. C., Hare, R., Loebenberg, D., Black, T. A., McNicholas, P. M.
(2006). In Vitro Activities of Posaconazole, Fluconazole, Itraconazole, Voriconazole, and Amphotericin B against a Large Collection of Clinically Important Molds and Yeasts.. Antimicrob. Agents Chemother.
50: 2009-2015
[Abstract] [Full Text] -
Al Mosaid, A., Sullivan, D. J., Polacheck, I., Shaheen, F. A., Soliman, O., Al Hedaithy, S., Al Thawad, S., Kabadaya, M., Coleman, D. C.
(2005). Novel 5-Flucytosine-Resistant Clade of Candida dubliniensis from Saudi Arabia and Egypt Identified by Cd25 Fingerprinting. J. Clin. Microbiol.
43: 4026-4036
[Abstract] [Full Text] -
Carr, M. J., Clarke, S., O'Connell, F., Sullivan, D. J., Coleman, D. C., O'Connell, B.
(2005). First Reported Case of Endocarditis Caused by Candida dubliniensis. J. Clin. Microbiol.
43: 3023-3026
[Abstract] [Full Text] -
Petraitiene, R., Petraitis, V., Lyman, C. A., Groll, A. H., Mickiene, D., Peter, J., Bacher, J., Roussillon, K., Hemmings, M., Armstrong, D., Avila, N. A., Walsh, T. J.
(2004). Efficacy, Safety, and Plasma Pharmacokinetics of Escalating Dosages of Intravenously Administered Ravuconazole Lysine Phosphoester for Treatment of Experimental Pulmonary Aspergillosis in Persistently Neutropenic Rabbits. Antimicrob. Agents Chemother.
48: 1188-1196
[Abstract] [Full Text] -
Pinjon, E., Moran, G. P., Jackson, C. J., Kelly, S. L., Sanglard, D., Coleman, D. C., Sullivan, D. J.
(2003). Molecular Mechanisms of Itraconazole Resistance in Candida dubliniensis. Antimicrob. Agents Chemother.
47: 2424-2437
[Abstract] [Full Text] -
Fotedar, R., Al Hedaithy, S. S. A.
(2003). Candida dubliniensis at a University Hospital in Saudi Arabia. J. Clin. Microbiol.
41: 1907-1911
[Abstract] [Full Text] -
Pfaller, M. A., Diekema, D. J., Messer, S. A., Hollis, R. J., Jones, R. N.
(2003). In Vitro Activities of Caspofungin Compared with Those of Fluconazole and Itraconazole against 3,959 Clinical Isolates of Candida spp., Including 157 Fluconazole-Resistant Isolates. Antimicrob. Agents Chemother.
47: 1068-1071
[Abstract] [Full Text] -
Letscher-Bru, V., Herbrecht, R.
(2003). Caspofungin: the first representative of a new antifungal class. J Antimicrob Chemother
51: 513-521
[Abstract] [Full Text] -
Fitzgerald, D. H., Coleman, D. C., O'Connell, B. C.
(2003). Susceptibility of Candida dubliniensis to Salivary Histatin 3. Antimicrob. Agents Chemother.
47: 70-76
[Abstract] [Full Text] -
Martinez, M., Lopez-Ribot, J. L., Kirkpatrick, W. R., Coco, B. J., Bachmann, S. P., Patterson, T. F.
(2002). Replacement of Candida albicans with C. dubliniensis in Human Immunodeficiency Virus-Infected Patients with Oropharyngeal Candidiasis Treated with Fluconazole. J. Clin. Microbiol.
40: 3135-3139
[Abstract] [Full Text] -
Perea, S., Lopez-Ribot, J. L., Wickes, B. L., Kirkpatrick, W. R., Dib, O. P., Bachmann, S. P., Keller, S. M., Martinez, M., Patterson, T. F.
(2002). Molecular Mechanisms of Fluconazole Resistance in Candida dubliniensis Isolates from Human Immunodeficiency Virus-Infected Patients with Oropharyngeal Candidiasis. Antimicrob. Agents Chemother.
46: 1695-1703
[Abstract] [Full Text] -
Clemons, K. V., Martinez, M., Calderon, L., Stevens, D. A.
(2002). Efficacy of Ravuconazole in Treatment of Systemic Murine Histoplasmosis. Antimicrob. Agents Chemother.
46: 922-924
[Abstract] [Full Text] -
Arathoon, E. G., Gotuzzo, E., Noriega, L. M., Berman, R. S., DiNubile, M. J., Sable, C. A.
(2002). Randomized, Double-Blind, Multicenter Study of Caspofungin versus Amphotericin B for Treatment of Oropharyngeal and Esophageal Candidiases. Antimicrob. Agents Chemother.
46: 451-457
[Abstract] [Full Text] -
Clemons, K. V., Stevens, D. A.
(2001). Efficacy of Ravuconazole in Treatment of Mucosal Candidosis in SCID Mice. Antimicrob. Agents Chemother.
45: 3433-3436
[Abstract] [Full Text] -
Muller, F.-M. C., Kurzai, O., Hacker, J., Frosch, M., Muhlschlegel, F.
(2001). Effect of the growth medium on the in vitro antifungal activity of micafungin (FK-463) against clinical isolates of Candida dubliniensis. J Antimicrob Chemother
48: 713-715
[Abstract] [Full Text] -
Ramage, G., Vande Walle, K., Wickes, B. L., Lopez-Ribot, J. L.
(2001). Biofilm Formation by Candida dubliniensis. J. Clin. Microbiol.
39: 3234-3240
[Abstract] [Full Text] -
Arikan, S., Lozano-Chiu, M., Paetznick, V., Rex, J. H.
(2001). In Vitro Susceptibility Testing Methods for Caspofungin against Aspergillus and Fusarium Isolates. Antimicrob. Agents Chemother.
45: 327-330
[Abstract] [Full Text] -
Abruzzo, G. K., Gill, C. J., Flattery, A. M., Kong, L., Leighton, C., Smith, J. G., Pikounis, V. B., Bartizal, K., Rosen, H.
(2000). Efficacy of the Echinocandin Caspofungin against Disseminated Aspergillosis and Candidiasis in Cyclophosphamide-Induced Immunosuppressed Mice. Antimicrob. Agents Chemother.
44: 2310-2318
[Abstract] [Full Text] -
Park, S., Wong, M., Marras, S. A. E., Cross, E. W., Kiehn, T. E., Chaturvedi, V., Tyagi, S., Perlin, D. S.
(2000). Rapid Identification of Candida dubliniensis Using a Species-Specific Molecular Beacon. J. Clin. Microbiol.
38: 2829-2836
[Abstract] [Full Text] -
Polacheck, I., Strahilevitz, J., Sullivan, D., Donnelly, S., Salkin, I. F., Coleman, D. C.
(2000). Recovery of Candida dubliniensis from Non-Human Immunodeficiency Virus-Infected Patients in Israel. J. Clin. Microbiol.
38: 170-174
[Abstract] [Full Text] -
Gales, A. C., Pfaller, M. A., Houston, A. K., Joly, S., Sullivan, D. J., Coleman, D. C., Soll, D. R.
(1999). Identification of Candida dubliniensis Based on Temperature and Utilization of Xylose and alpha -Methyl-D-Glucoside as Determined with the API 20C AUX and Vitek YBC Systems. J. Clin. Microbiol.
37: 3804-3808
[Abstract] [Full Text] -
Pincus, D. H., Coleman, D. C., Pruitt, W. R., Padhye, A. A., Salkin, I. F., Geimer, M., Bassel, A., Sullivan, D. J., Clarke, M., Hearn, V.
(1999). Rapid Identification of Candida dubliniensis with Commercial Yeast Identification Systems. J. Clin. Microbiol.
37: 3533-3539
[Abstract] [Full Text] -
Diekema, D. J., Pfaller, M. A., Messer, S. A., Houston, A., Hollis, R. J., Doern, G. V., Jones, R. N., The SENTRY PARTICIPANTS GROUP,
(1999). In Vitro Activities of BMS-207147 against Over 600 Contemporary Clinical Bloodstream Isolates of Candida Species from the SENTRY Antimicrobial Surveillance Program in North America and Latin America. Antimicrob. Agents Chemother.
43: 2236-2239
[Abstract] [Full Text]
| |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Copyright © 2009 by the American Society for Microbiology. For an alternate route to Journals.ASM.org, visit: http://intl-journals.asm.org | More Info»