DIVERSITY AMONG YEASTS ISOLATED FROM PATIENTS WITH AIDS AND ORAL CANDIDOSIS - FOCUS ON FLUCONAZOLE SUSCEPTIBILITY TESTING RESULTS

Objective: To study the fungal flora and the antifungal susceptibility of yeasts isolated from buccal lesions from AIDS patients with oral c andidiasis and to see if our antifungal susceptibility testing method could predict the emergence of resistant isolates. Patients and method s: The buccal lesions from ten AIDS patients with oral candidosis were sampled. Twenty colonies were identified to the species level and stu died for their susceptibility to three azole antifungal agents. The mi nimal inhibitory concentrations of fluconazole, itraconazole and ketoc onazole were determined at 24 hours and 48 hours using a microbroth di lution method. Four of the patients were also sampled during the follo wing episode and five colonies were then studied in the same condition s. Results: Patients with AIDS were found to be colonized/infected by various genus (Candida and Geotrichum) and species (C. albicans, C. gl abrata, C. krusei) during the same episode. The species changed overti me. Susceptibility to fluconazole could vary among colonies of C. albi cans isolated from the same patient and also, for some colonies accord ing to the duration of the in vitro incubation. This pattern defined a s unstable susceptibility might be predictive of resistance. Conclusio ns: The diversity among fungal buccal flora of AIDS patients and the e mergence of Candida isolates resistant to fluconazole suggest that cli nical practice as well as routine laboratory techniques may have to ch ange. Finally, preliminary results suggest that our antifungal suscept ibility testing method may offer a means to predict resistance to fluc onazole.