CORRELATION OF IN-VITRO FLUCONAZOLE RESISTANCE OF CANDIDA ISOLATES INRELATION TO THERAPY AND SYMPTOMS OF INDIVIDUALS SEROPOSITIVE FOR HUMAN-IMMUNODEFICIENCY-VIRUS TYPE-1

Yeast strains isolated from the oropharynx of 87 consecutive patients infected with human immunodeficiency virus type 1 were examined for in vitro susceptibility to fluconazole. Candida albicans was isolated fr om 73 patients. Fifty-one patients had received antifungal therapy in the month preceding the yeast infection. Thirty-two patients had sympt omatic oropharyngeal candidiasis. The MICs were correlated with azole use and with clinical symptoms and signs. Although there is overlap be tween groups, in vitro testing identified a large group of patients fo r whose yeast isolates the fluconazole MICs were high and who remained symptomatic while receiving azole therapy. This study supports the ab ility of in vitro testing to predict the clinical outcome of mucosal f ungal infections. The study also demonstrates that azole resistance of oropharyngeal yeasts is a common problem in patients infected with hu man immunodeficiency virus type 1 and that this azole resistance has c linical relevance.