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Cited by 46Antifungal resistance and susceptibilityHIV/AIDS oral health manifestationsFungal Infections and Studies

Determinants for the development of oropharyngeal colonization or infection by fluconazole-resistant Candida strains in HIV-infected patients

Masiá Canuto, M., Gutiérrez Rodero, F., Ortiz de la Tabla Ducasse, V., Hernández Aguado, I., Martín González, C., Sánchez Sevillano, A., Martín Hidalgo, A.·2000·European Journal of Clinical Microbiology & Infectious Diseases
DOI 10.1007/s100960000323
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Abstract

A point prevalence study to document oral yeast carriage was undertaken. Risk factors for the development of oropharyngeal colonization or infection by fluconazole-resistant Candida strains in HIV-infected patients were investigated with a case-control design. Cases included all patients with fluconazole-resistant strains (MIC> or =64 microg/ml), and controls were those with susceptible (MIC< or =8 microg/ml) or susceptible-dependent-upon-dose (MIC 16-32 microg/ml) strains. One hundred sixty-eight Candida strains were isolated from 153 (88%) patients, 28 (16%) of whom had oropharyngeal candidiasis. Overall, 19 (12%) of the patients harbored at least one resistant organism (MIC > or = 64 microg/ml). Among patients with resistant strains, tuberculosis (P<0.001), esophageal candidiasis (P = 0.001), clinical thrush (P<0.001), and a CD4 + cell count < 200/mm3 (P = 0.03) were more frequent. These patients had also been treated more commonly with antituberculous drugs (adjusted odds ratio [OR] 6.13; 95% confidence interval [CI] 2.11-17.80), ciprofloxacin (OR 6.0; 95% CI 1.23-29.26), fluconazole (OR 4.59; 95% CI 1.55-13.52), and steroids (OR 4.13; 95% CI 1.11-15.39). Multivariate analysis showed that the determinants for fluconazole resistance were therapy with antituberculous drugs (OR 3.61; 95% CI 1.08-12.07; P=0.03) and one of the following: previous tuberculosis (OR 3.53; 95% CI 1.08-14.57; P=0.03) or fluconazole exposure (OR 3.41; 95% CI 1.10-10.54). Findings from this study indicate that treatment with antituberculous drugs, previous tuberculosis, and fluconazole exposure are the strongest determinants for development of oropharyngeal colonization or infection by fluconazole-resistant Candida strains in HIV-infected patients.

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  • In North American oral candidiasis (HIV/AIDS-positive) patients, the prevalence of fluconazole-resistant C. albicans isolates was found to be between 12% and 22%.

    “This has occurred with greatest frequency in the setting of patients suffering from HIV/AIDS during treatment for oropharyngeal candidiasis, where the prevalence of fluconazole-resistant C. albicans isolates in North American oral candidiasis (HIV/AIDS-positive) patients was found to be between 12% and 22%.38–42”

    From Molecular and genetic basis of azole antifungal resistance in the opportunistic pathogenic fungus<i>Candida albicans</i> (2020) · cites this paper as [42]

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Authors
Masiá Canuto, M., Gutiérrez Rodero, F., Ortiz de la Tabla Ducasse, V., Hernández Aguado, I., Martín González, C., Sánchez Sevillano, A., & Martín Hidalgo, A.
Venue
European Journal of Clinical Microbiology & Infectious Diseases
Publisher
Springer Science and Business Media LLC
Published
2000-09-05
Volume
19
Issue
8
Pages
593-601
ISSN
  • 0934-9723 (ISSN-L)
  • 1435-4373
DOI
10.1007/s100960000323
OpenAlex
W2015859713
Cited by
46
References
36
Citations by year
2021: 2 · 2020: 1 · 2019: 1 · 2017: 1 · 2016: 1 · 2015: 2 · 2014: 4 · 2013: 1 · 2012: 2
FWCI
3.38
Type
journal article
Language
en
Open access
closed
Licence
www.springer.com/tdm (tdm)
Locations
  • European Journal of Clinical Microbiology & Infectious Diseases (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › HIV/AIDS oral health manifestations
  • Health Sciences › Medicine › Epidemiology › Fungal Infections and Studies
Keywords
Candida, oropharyngeal candidiasis, HIV infection, antitubercular agents, tuberculosis, risk factors, CD4 count, oral candidiasis, esophageal candidiasis, antifungal susceptibility, ciprofloxacin, corticosteroids
MeSH terms
Adult, Antifungal Agents, Candida, Candidiasis, Oral, Carrier State, Drug Resistance, Microbial, Female, Humans, Male, Microbial Sensitivity Tests, Oropharynx, Prospective Studies, Risk Factors, Fluconazole, Case-Control Studies, AIDS-Related Opportunistic Infections

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