Evolution of Antifungal Susceptibility among Candida Species Isolates Recovered from Human Immunodeficiency Virus–Infected Women Receiving Fluconazole Prophylaxis
Abstract
The effect of fluconazole on the susceptibility of Candida isolates recovered from women infected with human immunodeficiency virus (HIV) was evaluated in a randomized, double-blind, placebo-controlled trial. Women with CD4(+) cell counts of < or =300 cells/mm(3) received either fluconazole (200 mg/week) or placebo as prophylaxis. The antifungal susceptibility of specimens was evaluated. One patient who received fluconazole and 2 patients assigned to placebo had Candida albicans isolates recovered that were resistant to fluconazole (MIC, > or =64 microg/mL). Eleven patients assigned fluconazole and 4 patients assigned placebo had non-albicans Candida strains (all Candida glabrata) recovered that were resistant to fluconazole. There was significant azole cross-resistance among the non-albicans Candida species isolates. Although the rate of azole resistance did not significantly increase after fluconazole prophylaxis, there was a trend toward more in vitro azole resistance in C. glabrata isolates from patients assigned fluconazole. Moreover, the majority of resistant vaginal isolates of Candida species were recovered after initiation of open-label fluconazole use.
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Intrinsically reduced susceptibility to fluconazole has been reported for non-albicans species of Candida like C. glabrata, C. krusei, and C. lusitaniae.
“An intrinsically reduced susceptibility to fluconazole has been also reported for non-albicans species of Candida like C. glabrata, C. krusei, and C. lusitaniae [90, 91].”
From <i>Candida</i>Infections, Causes, Targets, and Resistance Mechanisms: Traditional and Alternative Antifungal Agents (2013) · cites this paper as [90]
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- Authors
- Vazquez, J. A., Peng, G., Sobel, J. D., Steele‐Moore, L., Schuman, P., Holloway, W., Neaton, J. D., & (CPCRA), T. T. B. C. P. F. C. R. O. A.
- Affiliations
- University of Minnesota (US)
- Wayne State University (US)
- Christiana Care Health System (US)
- Venue
- Clinical Infectious Diseases
- Publisher
- Oxford University Press (OUP)
- Published
- 2001-10
- Volume
- 33
- Issue
- 7
- Pages
- 1069-1075
- ISSN
- 1058-4838 (ISSN-L)
- 1537-6591
- OpenAlex
- W2091529600
- Cited by
- 57
- References
- 29
- Citations by year
- 2022: 1 · 2021: 2 · 2020: 1 · 2018: 3 · 2017: 1 · 2016: 3 · 2015: 3 · 2014: 4 · 2013: 2 · 2012: 2
- FWCI
- 3.09
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Infectious Diseases (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
- Life Sciences › Agricultural and Biological Sciences › Ecology, Evolution, Behavior and Systematics › Fungal Plant Pathogen Control
- Health Sciences › Medicine › Ophthalmology › Ocular Infections and Treatments
- Keywords
- antifungal susceptibility, fluconazole prophylaxis, Candida, HIV infection, Candida albicans, Candida glabrata, non-albicans Candida, azole resistance, cross-resistance, vaginal candidiasis, women, CD4 count
- MeSH terms
- Adult, Antifungal Agents, Candida, Candidiasis, Double-Blind Method, Female, Humans, Microbial Sensitivity Tests, HIV Infections, Fluconazole, AIDS-Related Opportunistic Infections, Drug Resistance, Fungal
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