Skip to main content
PMC home page
Journal of Clinical Microbiology logoLink to Journal of Clinical Microbiology
. 1995 Mar;33(3):769–771. doi: 10.1128/jcm.33.3.769-771.1995

Molecular epidemiology of Candida isolates from AIDS patients showing different fluconazole resistance profiles.

A Lischewski 1, M Ruhnke 1, I Tennagen 1, G Schönian 1, J Morschhäuser 1, J Hacker 1
PMCID: PMC228034  PMID: 7751395

Abstract

Thirty Candida isolates obtained from the oropharynxes of three AIDS patients were genotypically characterized. In vitro fluconazole MIC determination revealed increasing fluconazole resistances during treatment, thereby confirming the in vivo situation. Pulsed-field gel electrophoresis karyotyping, randomly amplified polymorphic DNA analysis, and hybridizations with Candida albicans repetitive element 2 were used to determine possible genotypic changes. The isolates from two patients showed genetic homogeneity, suggesting the selection for resistant variants. One patient experienced a strain switch to Candida krusei. Horizontal spread of identical strains between the patients could be excluded. However, the molecular methods used might not be sufficient to detect the underlying genetic basis of resistance to fluconazole.

Full Text

The Full Text of this article is available as a PDF (290.1 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Asakura K., Iwaguchi S., Homma M., Sukai T., Higashide K., Tanaka K. Electrophoretic karyotypes of clinically isolated yeasts of Candida albicans and C. glabrata. J Gen Microbiol. 1991 Nov;137(11):2531–2538. doi: 10.1099/00221287-137-11-2531. [DOI] [PubMed] [Google Scholar]
  2. Como J. A., Dismukes W. E. Oral azole drugs as systemic antifungal therapy. N Engl J Med. 1994 Jan 27;330(4):263–272. doi: 10.1056/NEJM199401273300407. [DOI] [PubMed] [Google Scholar]
  3. Cutler J. E. Putative virulence factors of Candida albicans. Annu Rev Microbiol. 1991;45:187–218. doi: 10.1146/annurev.mi.45.100191.001155. [DOI] [PubMed] [Google Scholar]
  4. Gallagher P. J., Bennett D. E., Henman M. C., Russell R. J., Flint S. R., Shanley D. B., Coleman D. C. Reduced azole susceptibility of oral isolates of Candida albicans from HIV-positive patients and a derivative exhibiting colony morphology variation. J Gen Microbiol. 1992 Sep;138(9):1901–1911. doi: 10.1099/00221287-138-9-1901. [DOI] [PubMed] [Google Scholar]
  5. Hellstein J., Vawter-Hugart H., Fotos P., Schmid J., Soll D. R. Genetic similarity and phenotypic diversity of commensal and pathogenic strains of Candida albicans isolated from the oral cavity. J Clin Microbiol. 1993 Dec;31(12):3190–3199. doi: 10.1128/jcm.31.12.3190-3199.1993. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Iwaguchi S., Homma M., Tanaka K. Variation in the electrophoretic karyotype analysed by the assignment of DNA probes in Candida albicans. J Gen Microbiol. 1990 Dec;136(12):2433–2442. doi: 10.1099/00221287-136-12-2433. [DOI] [PubMed] [Google Scholar]
  7. Lasker B. A., Page L. S., Lott T. J., Kobayashi G. S. Isolation, characterization, and sequencing of Candida albicans repetitive element 2. Gene. 1992 Jul 1;116(1):51–57. doi: 10.1016/0378-1119(92)90628-3. [DOI] [PubMed] [Google Scholar]
  8. Magee P. T. Variations in chromosome size and organization in Candida albicans and Candida stellatoidea. Trends Microbiol. 1993 Dec;1(9):338–342. doi: 10.1016/0966-842x(93)90074-2. [DOI] [PubMed] [Google Scholar]
  9. McCullough M. J., Ross B. C., Dwyer B. D., Reade P. C. Genotype and phenotype of oral Candida albicans from patients infected with the human immunodeficiency virus. Microbiology. 1994 May;140(Pt 5):1195–1202. doi: 10.1099/13500872-140-5-1195. [DOI] [PubMed] [Google Scholar]
  10. Mercure S., Montplaisir S., Lemay G. Correlation between the presence of a self-splicing intron in the 25S rDNA of C.albicans and strains susceptibility to 5-fluorocytosine. Nucleic Acids Res. 1993 Dec 25;21(25):6020–6027. doi: 10.1093/nar/21.25.6020. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Millon L., Manteaux A., Reboux G., Drobacheff C., Monod M., Barale T., Michel-Briand Y. Fluconazole-resistant recurrent oral candidiasis in human immunodeficiency virus-positive patients: persistence of Candida albicans strains with the same genotype. J Clin Microbiol. 1994 Apr;32(4):1115–1118. doi: 10.1128/jcm.32.4.1115-1118.1994. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Newman S. L., Flanigan T. P., Fisher A., Rinaldi M. G., Stein M., Vigilante K. Clinically significant mucosal candidiasis resistant to fluconazole treatment in patients with AIDS. Clin Infect Dis. 1994 Oct;19(4):684–686. doi: 10.1093/clinids/19.4.684. [DOI] [PubMed] [Google Scholar]
  13. Ott M. Dynamics of the bacterial genome: deletions and integrations as mechanisms of bacterial virulence modulation. Zentralbl Bakteriol. 1993 Jun;278(4):457–468. doi: 10.1016/s0934-8840(11)80817-0. [DOI] [PubMed] [Google Scholar]
  14. Pahls S., Schaffner A. Aspergillus fumigatus pneumonia in neutropenic patients receiving fluconazole for infection due to Candida species: is amphotericin B combined with fluconazole the appropriate answer? Clin Infect Dis. 1994 Mar;18(3):484–486. doi: 10.1093/clinids/18.3.484. [DOI] [PubMed] [Google Scholar]
  15. Pfaller M. A., Rhine-Chalberg J., Redding S. W., Smith J., Farinacci G., Fothergill A. W., Rinaldi M. G. Variations in fluconazole susceptibility and electrophoretic karyotype among oral isolates of Candida albicans from patients with AIDS and oral candidiasis. J Clin Microbiol. 1994 Jan;32(1):59–64. doi: 10.1128/jcm.32.1.59-64.1994. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Redding S., Smith J., Farinacci G., Rinaldi M., Fothergill A., Rhine-Chalberg J., Pfaller M. Resistance of Candida albicans to fluconazole during treatment of oropharyngeal candidiasis in a patient with AIDS: documentation by in vitro susceptibility testing and DNA subtype analysis. Clin Infect Dis. 1994 Feb;18(2):240–242. doi: 10.1093/clinids/18.2.240. [DOI] [PubMed] [Google Scholar]
  17. Ruhnke M., Eigler A., Tennagen I., Geiseler B., Engelmann E., Trautmann M. Emergence of fluconazole-resistant strains of Candida albicans in patients with recurrent oropharyngeal candidosis and human immunodeficiency virus infection. J Clin Microbiol. 1994 Sep;32(9):2092–2098. doi: 10.1128/jcm.32.9.2092-2098.1994. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Rustchenko-Bulgac E. P., Sherman F., Hicks J. B. Chromosomal rearrangements associated with morphological mutants provide a means for genetic variation of Candida albicans. J Bacteriol. 1990 Mar;172(3):1276–1283. doi: 10.1128/jb.172.3.1276-1283.1990. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Rustchenko E. P., Curran T. M., Sherman F. Variations in the number of ribosomal DNA units in morphological mutants and normal strains of Candida albicans and in normal strains of Saccharomyces cerevisiae. J Bacteriol. 1993 Nov;175(22):7189–7199. doi: 10.1128/jb.175.22.7189-7199.1993. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Saiki R. K., Gelfand D. H., Stoffel S., Scharf S. J., Higuchi R., Horn G. T., Mullis K. B., Erlich H. A. Primer-directed enzymatic amplification of DNA with a thermostable DNA polymerase. Science. 1988 Jan 29;239(4839):487–491. doi: 10.1126/science.2448875. [DOI] [PubMed] [Google Scholar]
  21. Schönian G., Meusel O., Tietz H. J., Meyer W., Gräser Y., Tausch I., Presber W., Mitchell T. G. Identification of clinical strains of Candida albicans by DNA fingerprinting with the polymerase chain reaction. Mycoses. 1993 May-Jun;36(5-6):171–179. doi: 10.1111/j.1439-0507.1993.tb00746.x. [DOI] [PubMed] [Google Scholar]
  22. Soll D. R., Morrow B., Srikantha T. High-frequency phenotypic switching in Candida albicans. Trends Genet. 1993 Feb;9(2):61–65. doi: 10.1016/0168-9525(93)90189-O. [DOI] [PubMed] [Google Scholar]
  23. Southern E. M. Detection of specific sequences among DNA fragments separated by gel electrophoresis. J Mol Biol. 1975 Nov 5;98(3):503–517. doi: 10.1016/s0022-2836(75)80083-0. [DOI] [PubMed] [Google Scholar]
  24. Vanden Bossche H., Marichal P., Odds F. C. Molecular mechanisms of drug resistance in fungi. Trends Microbiol. 1994 Oct;2(10):393–400. doi: 10.1016/0966-842x(94)90618-1. [DOI] [PubMed] [Google Scholar]
  25. White A., Goetz M. B. Azole-resistant Candida albicans: report of two cases of resistance to fluconazole and review. Clin Infect Dis. 1994 Oct;19(4):687–692. doi: 10.1093/clinids/19.4.687. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Clinical Microbiology are provided here courtesy of American Society for Microbiology (ASM)

RESOURCES