Journal Article

Development of Fluconazole Resistance in <i>Candida albicans</i> Causing Disseminated Infection in a Patient Undergoing Marrow Transplantation

Kieren A. Marr, Theodore C. White, Jo-Anne H. van Burik and Raleigh A. Bowden

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 25, issue 4, pages 908-910
Published in print October 1997 | ISSN: 1058-4838
Published online October 1997 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/515553
Development of Fluconazole Resistance in Candida albicans Causing Disseminated Infection in a Patient Undergoing Marrow Transplantation

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Oral candidiasis due to azole-resistant Candida albicans is an increasing problem in patients with AIDS who received prolonged periods of fluconazole prophylaxis. Infection with C. albicans is also frequent in patients undergoing transplantation. However, azole resistance has not been appreciated as a major problem for these patients, presumably because they receive a relatively short duration of fluconazole prophylaxis. We describe a case of disseminated candidiasis due to fluconazoleresistant C. albicans in a patient following marrow transplantation. Restriction fragment length polymorphism analysis with use of the C. albicans strain-specific Ca3 probe was performed on sequential isolates. Identical banding patterns were obtained, thereby confirming that a fluconazolesusceptible endogenous C. albicans acquired azole resistance during a brief exposure to the drug and subsequently caused disseminated infection. This observation raises questions regarding the incidence, significance, and mechanism of azole resistance in fungi causing infection in this population.

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Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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