Development of Fluconazole Resistance in Candida albicans Causing Disseminated Infection in a Patient Undergoing Marrow Transplantation

Oral candidiasis due to azole-resistant Candida albicans is an increasing problem in patients with AIDS who received prolonged periods of fluconazole prophylaxis. Infection with C. albicans is also frequent in patients undergoing transplantation. However, azole resistance has not been appreciated as...

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Bibliographic Details
Published in:Clinical infectious diseases 1997-10, Vol.25 (4), p.908-910
Main Authors: Marr, Kieren A., White, Theodore C., van Burik, Jo-Anne H., Bowden, Raleigh A.
Format: Article
Language:English
Subjects:
Adult
AIDS/HIV
Antibiotic Prophylaxis
Antifungal Agents - pharmacology
Antifungal Agents - therapeutic use
Antifungals
Azoles
Biological and medical sciences
Blood
Bone marrow
Bone Marrow Transplantation
Candida albicans
Candida albicans - drug effects
Candida albicans - genetics
Candidiasis
Candidiasis, Oral - drug therapy
DNA
Drug Resistance, Microbial
Fluconazole - pharmacology
Fluconazole - therapeutic use
Human mycoses
Humans
Immunocompromised Host
Infections
Infectious diseases
Lungs
Lymphoma, Non-Hodgkin - complications
Lymphoma, Non-Hodgkin - therapy
Male
Medical sciences
Mycoses
Mycotic sepsis
Transplantation
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Summary:Oral candidiasis due to azole-resistant Candida albicans is an increasing problem in patients with AIDS who received prolonged periods of fluconazole prophylaxis. Infection with C. albicans is also frequent in patients undergoing transplantation. However, azole resistance has not been appreciated as a major problem for these patients, presumably because they receive a relatively short duration of fluconazole prophylaxis. We describe a case of disseminated candidiasis due to fluconazoleresistant C. albicans in a patient following marrow transplantation. Restriction fragment length polymorphism analysis with use of the C. albicans strain-specific Ca3 probe was performed on sequential isolates. Identical banding patterns were obtained, thereby confirming that a fluconazolesusceptible endogenous C. albicans acquired azole resistance during a brief exposure to the drug and subsequently caused disseminated infection. This observation raises questions regarding the incidence, significance, and mechanism of azole resistance in fungi causing infection in this population.
ISSN:1058-4838
1537-6591
DOI:10.1086/515553