Development of simultaneous resistance to fluconazole in Candida albicans and Candida dubliniensis in a patient with AIDS

In this report, we describe a patient with recurrent episodes of oral candidosis who finally suffered from fluconazole-refractory oral and oesophageal candidosis. The patient was monitored for 4 years until his death from AIDS. During the observation period, persistent colonization with both Candida...

Full description

Saved in:
Bibliographic Details
Published in:Journal of antimicrobial chemotherapy 2000-08, Vol.46 (2), p.291-295
Main Authors: Ruhnke, Markus, Schmidt-Westhausen, Andrea, Morschhäuser, Joachim
Format: Article
Language:English
Subjects:
Acquired Immunodeficiency Syndrome - complications
AIDS/HIV
Antibiotics. Antiinfectious agents. Antiparasitic agents
Antifungal agents
Antifungal Agents - pharmacology
Biological and medical sciences
Candida - drug effects
Candida albicans
Candida albicans - drug effects
Candida albicans - genetics
Candida dubliniensis
Candidiasis, Oral - microbiology
Drug Resistance, Microbial
Fatal Outcome
fluconazole
Fluconazole - pharmacology
Human immunodeficiency virus
Human immunodeficiency virus 1
Humans
Male
Medical sciences
Microbial Sensitivity Tests
Middle Aged
Pharmacology. Drug treatments
Reverse Transcriptase Polymerase Chain Reaction
Citations: Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:In this report, we describe a patient with recurrent episodes of oral candidosis who finally suffered from fluconazole-refractory oral and oesophageal candidosis. The patient was monitored for 4 years until his death from AIDS. During the observation period, persistent colonization with both Candida albicans and Candida dubliniensis was observed. From the appearance of the first episode of oral candidosis, the patient was treated with fluconazole for 18 months. The infection became unresponsive to fluconazole 400 mg/day. In vitro susceptibility testing revealed the development of resistance to fluconazole in C. albicans and C. dubliniensis. Molecular typing confirmed the persistence of the same C. albicans and C. dubliniensis strains which developed resistance after up to 3 years of asymptomatic colonization. This observation demonstrates that Candida spp. other than C. albicans may develop resistance to fluconazole in a patient who is repeatedly exposed to the drug.
ISSN:0305-7453
1460-2091
1460-2091
DOI:10.1093/jac/46.2.291