Isolation and characterization of a polyene-resistant variant of Candida tropicalis

An atypical variant of Candida tropicalis was recovered from multiple specimens from a patient who had been a recipient of a bone marrow transplant. This yeast variant showed atypical morphology on corn meal agar distinguishable from typical isolates of C. tropicalis by the production of clusters of blastospores. Isolates of the variant produced acid, but no gas, from maltose and sucrose in fermentation tests. Isolates from blood, pleural fluid, respiratory secretions, and stool specimens were susceptible to amphotericin B and nystatin in an agar dilution system. However, eight isolates of the variant C. tropicalis recovered over a period of 4 weeks from the patient's urine after amphotericin B therapy were found to be resistant to amphotericin B and nystatin. The isolate recovered after 7 days of therapy had minimal inhibitory concentrations of 100 micrograms of amphotericin B and 20 micrograms of nystatin per ml, whereas the seven isolates recovered subsequently had minimal inhibitory concentrations of greater than 500 micrograms of amphotericin B and 50 micrograms of nystatin per ml. The resistant isolates concomitantly lost the capacity to utilize amino acids that susceptible isolates could utilize. Ultraviolet absorption spectra of nonsaponifiable fractions of whole cells showed that resistant isolates lacked ergosterol, which susceptible isolates contained.