PATTERNS OF FLUCONAZOLE SUSCEPTIBILITY IN ISOLATES FROM HUMAN IMMUNODEFICIENCY VIRUS-INFECTED PATIENTS WITH OROPHARYNGEAL CANDIDIASIS DUE TO CANDIDA-ALBICANS

We evaluated 119 episodes of oropharyngeal candidiasis due to C. albic ans to study the patterns of fluconazole susceptibility of the isolate s and the characteristics of the patients and to confirm the correlati on between fluconazole susceptibility of isolates and therapeutic outc ome. Sixty-one isolates were considered susceptible to fluconazole (MI Cs, less than or equal to 0.5 mu g/mL), 33 were intermediate (MICs, 1. 0-8.0 mu g/mL), and 25 were resistant (MICs, greater than or equal to 16.0 mu g/mL). Patients infected with resistant strains had significan tly lower CD4(+) cell counts and a less recent AIDS diagnosis than pat ients infected with intermediate or susceptible strains. Previous fluc onazole therapy and prophylaxis were significantly more frequent for p atients infected with resistant and intermediate strains (P < .001). D ecreased susceptibility to ketoconazole and itraconazole was observed in resistant and intermediate strains. Fluconazole treatment was ineff ective for patients infected with resistant isolates; however, high do ses of ketoconazole or itraconazole were successful for nine (81%) of them. Different patterns of fluconazole susceptibility among C. albica ns strains are correlated with patients' characteristics and with ther apeutic outcomes.