GENOTYPIC CHARACTERIZATION OF SEQUENTIAL CANDIDA-ALBICANS ISOLATES FROM FLUCONAZOLE-TREATED NEUTROPENIC PATIENTS

A polymerase chain reaction (PCR)-mediated genotyping assay for Candid a albicans has been developed. By amplification of genomic regions bor dered by eukaryotic or prokaryotic repeat-like motifs, differences bet ween C. albicans isolates can be determined. The resolution of this ty ping procedure is at least as good as that of other genotypic assays. To ascertain the epidemiologic and clinical usefulness of this PCR gen otyping, a retrospective analysis of serial C. albicans isolates from neutropenic adults treated with fluconazole was done. By PCR genotypin g, 40 strains were detected in 24 patients. Eighteen C. albicans strai ns were found on multiple samplings in individual patients. It appears that most patients remain colonized with a C. albicans strain of cons tant genotypic characteristics. However, exceptions were observed. In 7 (29%) of 24 patients, strains deviating from the most frequently enc ountered type could be identified. All but 1 strain remained susceptib le to fluconazole in vitro after treatment in vivo. It was not possibl e to demonstrate a relation of genotypic variation and antifungal susc eptibility changes.