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Updated: Jul 23, 2026
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Whole Genome Sequencing of Candida glabrata for Detection of Markers of Antifungal Drug Resistance
Published on: December 28, 2017
Fluconazole-resistant candidosis in an HIV cohort
G G Baily1, F M Perry, D W Denning
1Department of Infectious Diseases and Tropical Medicine (Monsall Unit), North Manchester General Hospital, University of Manchester School of Medicine, UK.
AIDS (London, England)
|June 1, 1994
Summary
Fluconazole-resistant mucosal candidosis is a growing issue in HIV patients. Intravenous amphotericin B is effective for severe cases, highlighting potential azole cross-resistance in recurrent infections.
Area of Science:
- Mycology
- Infectious Diseases
- HIV Medicine
Background:
- Mucosal candidosis is a common opportunistic infection in individuals with advanced HIV.
- Fluconazole is a primary antifungal agent for treating candidosis.
- Emerging antifungal resistance poses a significant challenge in managing HIV-related infections.
Purpose of the Study:
- To document fluconazole-resistant HIV-related mucosal candidosis.
- To correlate in vitro antifungal susceptibility with clinical outcomes.
- To evaluate alternative treatment strategies for refractory cases.
Main Methods:
- Retrospective chart review of patients with fluconazole failure and those with low CD4 counts.
- Prospective in vitro susceptibility testing of Candida isolates.
- Analysis of clinical data including CD4 counts and antifungal dosing.
Main Results:
- Nine cases (5.8%) of fluconazole failure were identified, with reduced in vitro susceptibility in all isolates.
- Intravenous amphotericin B demonstrated efficacy in severe cases, suggesting azole cross-resistance.
- Higher cumulative fluconazole doses were associated with treatment failure.
Conclusions:
- Clinical fluconazole failure is a significant problem in HIV-positive individuals with recurrent mucosal candidosis.
- Antifungal resistance necessitates alternative treatment approaches.
- Monitoring antifungal susceptibility is crucial for effective management.
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