Fluconazole- and itraconazole-resistant Candida albicans strains from AIDS patients: multilocus enzyme electrophoresis analysis and antifungal susceptibilities
Fluconazole- and itraconazole-resistant Candida albicans strains from AIDS patients: multilocus enzyme electrophoresis analysis and antifungal susceptibilities
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艾滋病患者中耐氟康唑和伊曲康唑的白色念珠菌菌株：多位点酶电泳分析和抗真菌敏感性
DOI：
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发表时间：
1995
影响因子：
9.4
通讯作者：
J. Bastide
中科院分区：
文献类型：
--
作者：
Ronan LE Guennec;J. Reynes;M. Mallié;C. Pujol;F. Janbon;J. Bastide
采用多位点酶电泳和体外药敏试验，对4例先后对氟康唑（FCZ）和伊曲康唑（ITZ）出现临床耐药的艾滋病复发性口咽念珠菌进行菌株多样性分析。从初始FCZ治疗前和其他抗真菌治疗前收集的口腔洗液中随机抽取每个样本1至10个菌落；共分离98株。多位点酶电泳分析显示了14种不同的电泳类型（ETs）。遗传距离统计分析表明，白色念珠菌分离株可分为5个亚群（I ~ V）。在每个亚群中，分离物密切相关，亚群I和亚群IV之间的遗传距离很短。与此相反，包含ET8和ET14型分离株的V亚群与其他亚群有强烈的差异；这些分离株可能代表非典型白色念珠菌分离株。在唑治疗过程中，只有1例患者感染了单一菌株；对其余3例患者同时分离同一株和不同株的变异体。3例患者的临床FCZ耐药与体外数据有明显相关性。同时，在治疗过程中，ITZ的mic值升高，临床出现ITZ耐药时，ITZ的mic值为bb0或= 1.56微克/毫升；来自亚群V的分离株表现出最高的mic。由于临床FCZ耐药后又出现了临床ITZ耐药，长期用唑治疗艾滋病黏膜念珠菌病的可行性受到质疑。
Multilocus enzyme electrophoresis and in vitro susceptibility testing with a broth microdilution method were used to analyze Candida albicans strain diversity in four AIDS patients with recurrent oropharyngeal candidiasis who successively developed clinical resistance to fluconazole (FCZ) and itraconazole (ITZ). One to ten colonies per sample were randomly chosen from oral washings collected before the initial FCZ treatment and just before every other antifungal treatment; a total of 98 isolates were analyzed. Multilocus enzyme electrophoresis analysis revealed 14 different electrophoretic types (ETs). Statistical analysis of genetic distances showed that C. albicans isolates clustered into five subpopulations (I to V). In each subpopulation, isolates are closely related, and genetic distances between subpopulations I to IV are short. In contrast, subpopulation V, which contained isolates typed as ET8 and ET14, is strongly divergent from the others; these isolates may represent atypical C. albicans isolates. Only one patient was infected with a single strain during the course of azole therapy; for the three remaining patients, variants of the same strain and different strains were concurrently isolated. Clinical FCZ resistance was clearly correlated with in vitro data for three patients. Moreover, MICs of ITZ increased during FCZ therapy, and MICs of ITZ which were > or = 1.56 micrograms/ml were found when clinical ITZ resistance occurred; isolates from subpopulation V showed the highest MICs of ITZ. Because of the emergence of clinical ITZ resistance after clinical FCZ resistance, the feasibility of long-term azole therapy for mucosal candidiasis in AIDS patients is questioned.
从 HIV 血清阳性个体的口腔病变中分离出白色念珠菌的鉴定和追踪。
DOI：
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发表时间：
1992
期刊：
Journal of acquired immune deficiency syndromes
影响因子：
--
作者：
Miyasaki,SH;Hicks,JB;Greenspan,D;Polacheck,I;MacPhail,LA;White,TC;Agabian,N;Greenspan,JS
通讯作者：
Greenspan,JS
影响因子：
158.5
作者：
KLEIN, RS;HARRIS, CA;FRIEDLAND, GH
通讯作者：
FRIEDLAND, GH