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Cited by 54Antifungal resistance and susceptibilityHIV/AIDS oral health manifestationsFungal Infections and Studies

Point Prevalence of Oropharyngeal Carriage of Fluconazole‐Resistant Candida in Human Immunodeficiency Virus–Infected Patients

Martins, Marcelo D., Lozano‐Chiu, Mario, Rex, John H.·1997·Clinical Infectious Diseases
DOI 10.1086/515554
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Abstract

To estimate the prevalence of both clinically evident and asymptomatic carriage of fluconazole-resistant Candida, we prospectively surveyed 128 adults infected with human immunodeficiency virus (HIV). The patients had an average CD4 cell count of 206/mm3. Ninety-seven isolates of Candida were obtained from the oropharynx of 82 patients (64%). Of these 82 patients, 76% carried C. albicans alone; 18%, both albicans and non-albicans isolates; and 6%, non-albicans species alone. Oropharyngeal candidiasis was evident in only 38 (46%) of the 82 patients for whom a culture was positive and was never seen unless C. albicans was present. When MICs were measured by using the National Committee for Clinical Laboratory Standards M27-T methodology and grouped by using recently proposed breakpoints, we found that eight of the 38 patients with oropharyngeal candidiasis and six of the 44 patients who were asymptomatically colonized carried C. albicans isolates resistant to fluconazole (MIC, > or = 64 micrograms/mL); estimated rates of carriage were 21% (95% confidence interval, 10%-37%) and 14% (95% confidence interval, 5%-27%), respectively. Carriage of resistant isolates of C. albicans by HIV-infected adults is more common than previously suspected, and clinicians should be alert to the possible need for either higher doses of fluconazole or alternative treatment modalities.

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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 [39]

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Authors
Martins, M. D., Lozano‐Chiu, M., & Rex, J. H.
Corresponding author
Rex, John H.
ORCID
Rex, John H.
Venue
Clinical Infectious Diseases
Publisher
Oxford University Press (OUP)
Published
1997-10
Volume
25
Issue
4
Pages
843-846
ISSN
  • 1058-4838 (ISSN-L)
  • 1537-6591
DOI
10.1086/515554
OpenAlex
W2121373447
Cited by
54
References
21
Citations by year
2019: 2 · 2018: 2 · 2017: 1 · 2016: 1 · 2015: 1 · 2014: 1 · 2013: 2 · 2012: 5
FWCI
1.75
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
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › HIV/AIDS oral health manifestations
  • Health Sciences › Medicine › Epidemiology › Fungal Infections and Studies
Keywords
fluconazole resistance, Candida albicans, oropharyngeal candidiasis, HIV infection, non-albicans Candida, oropharyngeal colonization
MeSH terms
Adult, Antifungal Agents, Candida, Candidiasis, Oral, Carrier State, Drug Resistance, Microbial, Female, Humans, Male, Oropharynx, Prospective Studies, HIV Infections, Fluconazole, CD4 Lymphocyte Count

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