The evolution of Candida species and fluconazole susceptibility among oral and vaginal isolates recovered from human immunodeficiency virus (HIV)-seropositive and at-risk HIV-seronegative women

Jack D. Sobel, Suzanne E. Ohmit, Paula Schuman, Robert S. Klein, Kenneth Mayer, Ann Duerr, Jose A. Vazquez, Anne Rompalo, Robert S. Klein, Ellie Schoenbaum, Robert Burk, Julia Arnsten, Chee Jen Chang, Penelope Demas, Andrea Howard, Paula Schuman, Jack D. Sobel, Suzanne E. Ohmit, William Brown, Wayne LancasterAnne Rompalo, Keerti Shaw, David Vlahov, David Celantano, Kenneth Mayer, Susan Cu-Uvin, Timothy Flanigan, Joseph Hogan, Valerie Stone, Karen Tashima, Josiah Rich, Ann Duerr, Lytt Gardner, Dora Warren, Denise Jamieson, Jan Moore, Dawn Smith, Scott Holmberg, Ruby Phelps, Chad Heilig, Katherine Davenny

Research output: Contribution to journalArticle

74 Scopus citations

Abstract

Antifungal agents can effectively treat mucosal candidiasis; however, their use can lead to colonization with less susceptible species and to resistance among normally susceptible strains. Oral and vaginal Candida isolates obtained at 3 points over 2 years from human immunodeficiency virus (HIV)-seropositive and at-risk HIV-seronegative women were identified by species and were evaluated for in vitro fluconazole susceptibility. Prevalence of non-C. albicans strains increased over time, and these strains were more likely among women reporting current antifungal use. Among C. albicans isolates, resistance was rare, with no evidence for progressive reduction in susceptibility over time. Among non-C. albicans isolates, reduced susceptibility occurred frequently and increased with time. HIV-seropositive women were more likely to have non-C. albicans isolates with reduced susceptibility as were women reporting current antifungal use. This evolution and selection of mucosa-colonizing Candida species with reduced susceptibility could play a critical early role in the development of antifungal resistance among C. albicans isolates responsible for refractory candidiasis.

Original languageEnglish (US)
Pages (from-to)286-293
Number of pages8
JournalJournal of Infectious Diseases
Volume183
Issue number2
DOIs
StatePublished - Jan 15 2001

    Fingerprint

ASJC Scopus subject areas

  • Immunology and Allergy
  • Infectious Diseases

Cite this

Sobel, J. D., Ohmit, S. E., Schuman, P., Klein, R. S., Mayer, K., Duerr, A., Vazquez, J. A., Rompalo, A., Klein, R. S., Schoenbaum, E., Burk, R., Arnsten, J., Chang, C. J., Demas, P., Howard, A., Schuman, P., Sobel, J. D., Ohmit, S. E., Brown, W., ... Davenny, K. (2001). The evolution of Candida species and fluconazole susceptibility among oral and vaginal isolates recovered from human immunodeficiency virus (HIV)-seropositive and at-risk HIV-seronegative women. Journal of Infectious Diseases, 183(2), 286-293. https://doi.org/10.1086/317936