MOLECULAR EPIDEMIOLOGY OF CANDIDA ISOLATES FROM AIDS PATIENTS SHOWINGDIFFERENT FLUCONAZOLE RESISTANCE PROFILES

Thirty Candida isolates obtained from the oropharynxes of three AIDS p atients were genotypically characterized. In vitro fluconazole MIC det ermination revealed increasing fluconazole resistances during treatmen t, thereby confirming the in vivo situation. Pulsed-field gel electrop horesis 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 var iants. One patient experienced a strain snitch to Candida krusei. Hori zontal spread of identical strains between the patients could be exclu ded. However, the molecular methods used might not be sufficient to de tect the underlying genetic basis of resistance to fluconazole.