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Cited by 269Antifungal resistance and susceptibilityYeasts and Rust Fungi StudiesFungal Infections and Studies

Resistance of Candida albicans to fluconazole during treatment of oropharyngeal candidiasis in a patient with AIDS: documentation by in vitro susceptibility testing and DNA subtype analysis

Redding, S., Smith, J., Farinacci, G., Rinaldi, M., Fothergill, A., Rhine-Chalberg, J., Pfaller, M.·1994·Clinical Infectious Diseases
DOI 10.1093/clinids/18.2.240
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Abstract

We describe a patient with recurrent episodes of oropharyngeal candidiasis who required progressively higher doses of fluconazole to control and infection. The patient was treated for 14 infections over a 2-year period with doses of fluconazole that ranged from 100 to 800 mg per day. Clinical response, two methods of in vitro susceptibility testing, and molecular epidemiologic techniques were evaluated for 12 of the 14 episodes. Ultimately, the patient became unresponsive clinically to a dose of 800 mg of fluconazole per day. In vitro susceptibility testing of isolates obtained during these successive episodes of infection revealed the development of resistance to fluconazole, and molecular epidemiologic techniques confirmed the persistence of the same Candida albicans strain throughout all 12 episodes.

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  • Over the past 20 years, these strains have been extensively investigated at the genomic and transcriptomic levels to elucidate the mechanisms of resistance, revealing a combination of various resistance mechanisms among the resistant strains.

    “Over the past 20 years, these strains have been extensively investigated at the genomic and transcriptomic levels to elucidate the mechanisms of resistance (25–35), revealing a combination of various resistance mechanisms among the resistant strains (Table 1).”

    From Potential role of lysine acetylation in the stepwise adaptation of <i>Candida albicans</i> to fluconazole (2025) · cites this paper as [28]

  • C. albicans isolate CaCi-2 evolved resistance to fluconazole during treatment of an HIV-infected patient.

    “We employed a previously reported isolate of C. albicans (referred to as CaCi-2) that had evolved resistance to fluconazole during the treatment of an HIV-infected patient (Redding et al., 1994) (White, 1997).”

    From A Fungal-Selective Cytochrome bc1 Inhibitor Impairs Virulence and Prevents the Evolution of Drug Resistance (2016) · cites this paper as Redding et al., 1994

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Authors
Redding, S., Smith, J., Farinacci, G., Rinaldi, M., Fothergill, A., Rhine-Chalberg, J., & Pfaller, M.
Affiliations
Oregon Health & Science University (US)
Corresponding author
Redding, S.
ORCID
Pfaller, M.
Venue
Clinical Infectious Diseases
Publisher
Oxford University Press (OUP)
Published
1994-02-01
Volume
18
Issue
2
Pages
240-242
ISSN
  • 1058-4838 (ISSN-L)
  • 1537-6591
DOI
10.1093/clinids/18.2.240
OpenAlex
W2001756812
Cited by
269
References
0
Citations by year
2025: 4 · 2024: 2 · 2023: 1 · 2022: 5 · 2020: 1 · 2019: 1 · 2018: 3 · 2017: 5 · 2016: 6 · 2015: 3 · 2014: 3 · 2013: 6 · 2012: 7
FWCI
27.80
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 › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Yeasts and Rust Fungi Studies
  • Health Sciences › Medicine › Epidemiology › Fungal Infections and Studies
Keywords
Candida albicans, fluconazole resistance, oropharyngeal candidiasis, AIDS, recurrent candidiasis, antifungal susceptibility testing, molecular epidemiology, antifungal treatment failure
MeSH terms
Adult, Candida albicans, Candidiasis, Oral, DNA, Fungal, Drug Resistance, Microbial, Humans, Male, Microbial Sensitivity Tests, Recurrence, Fluconazole, Electrophoresis, Gel, Pulsed-Field, AIDS-Related Opportunistic Infections

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