Selection ofCandida glabrata strains with reduced susceptibility to azoles in four liver transplant patients with invasive candidiasis

• Published in: European journal of clinical microbiology & infectious diseases 1997-04, Vol.16 (4), p.314-318
• Main Authors: Fortún, J., Román, A. López -San, Velasco, J. J., Sánchez-Sousa, A., Vicente, E., Nuño, J., Quereda, C., Bárcena, R., Monge, G., Candela, A., Honrubia, A., Guerrero, A.
• Format: Article
• Language: English
• Subjects: Decontamination; Transplants & implants
• ISSN: 0934-9723; 1435-4373
• DOI: 10.1007/BF01695638

The cases of four liver transplant recipients who developed invasive candidiasis (2 cholangitis, 1 perihepatic abscess, 1 candidemia) due to azole-resistantCandida glabrata are reported. Three patients were receiving azolic compounds (2 itraconazole, 1 fluconazole) when the infection was diagnosed. All four patients received fluconazole as intestinal decontamination during the first three weeks post transplantation. The infections occurred two months after transplantation in all patients, and in one patientCandida infection was the direct cause of death. Infection of the biliary tree was the origin of candidiasis in three patients; the fourth patient developed neutropenic-related candidemia. Fluconazole MICs exceeded 16 μg/ml in all cases; itraconazole MICs were 16, 2, 1, and 2 μg/ml, respectively. The potential role ofCandida species other thanalbicans in these patients after administration of azole agents is discussed.[PUBLICATION ABSTRACT]