DNA fingerprinting of serial Candida albicans isolates obtained during itraconazole prophylaxis in patients with AIDS.
DNA fingerprinting of serial Candida albicans isolates obtained during itraconazole prophylaxis in patients with AIDS.
复制标题
艾滋病患者伊曲康唑预防期间获得的系列白色念珠菌分离株的 DNA 指纹图谱。
DOI：
10.1080/mmy.39.2.207.213
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发表时间：
2001
期刊：
影响因子：
2.9
通讯作者：
NationalInstituteofAllergyandInfectiousDiseaseMycosesStudyGroup
中科院分区：
文献类型：
--
作者：
LeMonte,AM;Goldman,M;Smedema,ML;Connolly,PA;McKinsey,DS;Cloud,GA;Kauffman,CA;Wheat,LJ;NationalInstituteofAllergyandInfectiousDiseaseMycosesStudyGroup
在一项随机双盲安慰剂对照研究中，伊曲康唑预防获得性免疫缺陷综合征患者全身和粘膜真菌感染的有效性，298例患者入组，其中295例可评价。其中，46名患者被认为是预防失败，因为复发性口腔或食管念珠菌病。在疑似鹅口疮或食管炎时进行口咽真菌培养，但在基线时不进行。所有的人。分离株在CHROMagar念珠菌培养基上培养，然后用API 20 AUX条鉴定。抗真菌药敏试验按照国家临床实验室标准委员会M-27 A指南进行。使用随机扩增多态性DNA对连续分离株进行基因分型。用两个重复序列引物（GGA）7和（GACA）4产生聚合酶链反应指纹图谱。研究组由23名患者组成，9名来自伊曲康唑组，14名来自安慰剂组，他们是预防失败的，并且有超过2C。白色念珠菌23例患者中有5例分离株的敏感性降低了±4倍;其中4例患者在伊曲康唑预防组，1例患者在安慰剂组。这种变化可能表明同一菌株中的遗传变化可能与获得性伊曲康唑耐药性有关，或与新菌株的获得有关，或与原始种群中以前较少的组分的出现有关。
During a randomized double-blind placebo-controlled study testing the efficacy of itraconazole for prophylaxis of systemic and mucosal fungal infections in patients with acquired immune deficiency syndrome, 298 patients were enrolled with 295 evaluable. Of those, 46 patients were considered prophylaxis failures because of recurrent oral or esophageal candidiasis. Oropharyngeal fungal cultures were taken at the time of suspected thrush orCandidaesophagitis, but not at baseline. All of theCandidaspp. isolates were cultured on CHROMagar Candida medium then identified using API 20 AUX strips. Antifungal susceptibility testing was performed following the National Committee for Clinical Laboratory Standards M-27A guidelines. Sequential isolates were genotyped using randomly amplified polymorphic DNA. Polymerase chain reaction fingerprints were generated using two repetitive sequence primers, (GGA)7and (GACA)4. The study group consisted of 23 patients, nine from the itraconazole arm and 14 from the placebo arm, who were prophylaxis failures and had more than twoC. albicansisolates. Five of 23 had isolates showing a ±4-fold reduction in susceptibility; four of these patients were in the itraconazole prophylaxis arm and one was in the placebo arm. Three of the five had yeast isolations showing changes in banding patterns over time. Such changes may indicate genetic changes in the same strain that could be linked to acquired resistance to itraconazole, or acquisition of a new strain, or emergence of a previously minor component of the original population.