Molecular epidemiology of Candida albicans strains isolated from the oropharynx of HIV-positive patients at successive clinic visits

Citation
Ba. Lasker et al., Molecular epidemiology of Candida albicans strains isolated from the oropharynx of HIV-positive patients at successive clinic visits, MED MYCOL, 39(4), 2001, pp. 341-352
Citations number
26
Categorie Soggetti
Microbiology
Journal title
MEDICAL MYCOLOGY
ISSN journal
13693786 → ACNP
Volume
39
Issue
4
Year of publication
2001
Pages
341 - 352
Database
ISI
SICI code
1369-3786(200108)39:4<341:MEOCAS>2.0.ZU;2-O
Abstract
Candida albicans strain diversity and fluconazole resistance were prospecti vely analyzed in oral strains from 29 adult human immunodeficiency virus (H IV)-positive patients followed for >1 year who had five or more culture-pos itive clinic visits. Molecular typing consisted of genomic blots probed wit h the Ca3 repetitive element. Sixteen patients had one or more episodes of oropharyngeal candidiasis (OPC), 12 (75%) maintained the original genotype, whereas the remaining four patients had a succession of 2-3 genotypes. The original genotype, either alone or mixed with another strain or with non-C . albicans Candida spp., was recovered from oral lesions in 13 of 15 evalua ble (86.7%) patients. C dubliniensis was the infecting yeast in the remaini ng two patients. Different patterns of fluconazole resistance occurred in t hree OPC patients. One patient's infecting strain became less susceptible. A second patient was infected with a resistant genotype and a progressively more susceptible minor genotype variant. C dubliniensis isolates from the third patient varied in susceptibility. Thirteen colonized patients who nev er developed OPC harbored a greater variety of C. albicans genotypes (2-6) than their infected counterparts (P=0.35). OPC patients maintained their or iginal endogenous C albicans strains for prolonged periods, whether or not they demonstrated decreased in vitro susceptibility to fluconazole. The ada ptation and maintenance of an endogenous C albicans strain within its host may be linked to as yet uncharacterized factors.