Document 0165
 DOCN  M9580165
 TI    Isolation of fluconazole-resistant Candida albicans from human
       immunodeficiency virus-negative patients never treated with azoles.
 DT    9506
 AU    Goff DA; Koletar SL; Buesching WJ; Barnishan J; Fass RJ; Department of
       Pharmacy, Ohio State University Medical Center,; Columbus.
 SO    Clin Infect Dis. 1995 Jan;20(1):77-83. Unique Identifier : AIDSLINE
       MED/95244757
 AB    Isolation of fluconazole-resistant strains of Candida species from human
       immunodeficiency virus (HIV)-infected patients after repeated or
       continuous courses of treatment has been reported with increasing
       frequency. During 1991-1992, MICs of fluconazole for 139 Candida
       albicans isolates from our institution were bimodally distributed: 102
       strains were susceptible (MICs, < or = 4 micrograms/mL) and 37 were
       resistant (MICs, > or = 8 micrograms/mL). There was incomplete
       cross-resistance between fluconazole and ketoconazole or miconazole, and
       there was no cross-resistance between azoles and amphotericin B or
       flucytosine. Twenty of the 37 fluconazole-resistant strains were
       isolated from 17 HIV-negative patients, some with systemic infections,
       who had never been treated with azoles. There were no differences in
       characteristics or risk factors for those patients as compared with
       those for an equal number of HIV-negative patients from whom
       fluconazole-susceptible strains were isolated. Among patients with
       systemic infection, 6 (50%) of 12 with infection caused by
       fluconazole-resistant strains survived and 11 (69%) of 16 with infection
       caused by fluconazole-susceptible strains survived (P = .54). Survival
       was not found to be related to treatment regimen, but the number of
       patients was small. The emergence of fluconazole-resistant C. albicans
       among HIV-negative patients never exposed to azoles is of concern.
 DE    Adolescence  Adult  Aged  Aged, 80 and over  Antifungal
       Agents/PHARMACOLOGY  Azoles/PHARMACOLOGY  Candida albicans/*DRUG
       EFFECTS/*ISOLATION & PURIF  Candidiasis/DRUG THERAPY/*MICROBIOLOGY  Drug
       Resistance, Microbial  Female  Fluconazole/*PHARMACOLOGY  Human  HIV
       Seronegativity  Infant, Newborn  Male  Microbial Sensitivity Tests
       Middle Age  JOURNAL ARTICLE

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