Infection due to fluconazole-resistant Candida in patients with AIDS: Prevalence and microbiology

被引:113
作者
Maenza, JR [1 ]
Merz, WG [1 ]
Romagnoli, MJ [1 ]
Keruly, JC [1 ]
Moore, RD [1 ]
Gallant, JE [1 ]
机构
[1] JOHNS HOPKINS UNIV, SCH MED, DEPT MED, BALTIMORE, MD 21205 USA
关键词
D O I
10.1093/clinids/24.1.28
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
A cross-sectional study was conducted to assess the prevalence and microbiology of oral infection due to fluconazole-resistant Candida in patients with AIDS, Oral swab specimens for fungal cultures were obtained from 100 consecutive outpatients with CD4 lymphocyte counts of <200/mm(3). At least one fungal organism demonstrating in vitro resistance to fluconazole (minimum inhibitory concentration, greater than or equal to 8 mu g/mL) was isolated from 26 (41%) of 64 patients for whom cultures were positive. When fluconazole-resistant C. albicans was isolated, in vitro resistance correlated with clinical thrush. None of 10 patients from whom only non-albicans species of Candida were isolated had active thrush. The patients from whom fluconazole-resistant Candida albicans was isolated had lower CD4 cell counts (median, 9/mm(3)), a greater number of treated episodes of thrush (median, 4.5), and a greater median duration of prior fluconazole treatment (231 days) than did patients from whom fluconazole-susceptible C. albicans was isolated (median CD4 cell count, 58/mm(3) [P = .004]; median number of treated episodes of thrush, 2.0 [P = .001]; and median duration of prior fluconazole treatment, 10 days [P = .01]; respectively). In a multivariate analysis, the number of episodes and duration of fluconazole therapy were independent predictors of resistance.
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页码:28 / 34
页数:7
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