Increased adherence of fluconazole-resistant isolates of Candida species to explanted esophageal mucosa

The adherence of fluconazole-resistant and fluconazole-susceptible isolates of Candida albicans to explanted rabbit esophageal mucosa was examined in vivo. Among six Candida albicans isolates collected from HIV-infected patie nts, three fluconazole-resistant (MIC>64 mu g/ml) isolates attached more av idly than three fluconazole-susceptible strains (MIC less than or equal to 0.5 mu g/ml) to esophageal mucosa (P less than or equal to 0.05). When thre e strains each of six different Candida spp. were compared, the more inhere ntly fluconazole-resistant isolates adhered more avidly in the following or der: Candida glabrata>Candida krusei>Candida albicans fluconazole-sensitive >Candida tropicalis>Candida parapsilosis, Nonetheless, fluconazole-resista nt Candida albicans demonstrated the greatest degree of adherence in compar ison to all fluconazole-susceptible Candida albicans (P<0.001) and to all C andida spp. tested (P<0.001), Thus, the refractoriness of esophageal candid iasis in patients infected with fluconazole-resistant isolates may be relat ed to both in vitro drug resistance and increased mucosal adherence.