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Isolation and characterization of fluconazole- and amphotericin B-resistant Candida albicans from blood of two patients with leukemia.




 

Antimicrob Agents Chemother. 1997 Jan;41(1):196-9. Unique Identifier :

Infections with fluconazole-resistant Candida albicans isolate have rarely been described in clinical settings other than oropharyngeal candidiasis in patients with late-stage AIDS. We report on two patients with leukemia who developed fungemia caused by fluconazole-resistant C. albicans after receiving fluconazole prophylaxis (400 mg/day) and empiric amphotericin B therapy (0.5 mg/kg of body weight per day). The fluconazole MICs for the isolates were > or = 64 micrograms/ml, and the isolates were resistant to other azoles and had membrane sterol changes consistent with a mutation in the delta 5,6-sterol desaturase gene. The lack of ergosterol in the cytoplasmic membrane of the fluconazole-resistant strains also imparted resistance to amphotericin B. Both patients were successfully treated with high-dose amphotericin B (1 to 1.25 mg/kg/day) and flucytosine 150 mg/kg/day).

*Amphotericin B/THERAPEUTIC USE *Antifungal Agents/THERAPEUTIC USE *Candida albicans/DRUG EFFECTS *Candidiasis/DRUG THERAPY *Fluconazole/THERAPEUTIC USE *Leukemia, Lymphocytic, Acute/COMPLICATIONS *Leukemia, Myelocytic, Acute/COMPLICATIONS



 




Information in this article was accurate in June 30, 1997. The state of the art may have changed since the publication date. This material is designed to support, not replace, the relationship that exists between you and your doctor. Always discuss treatment options with a doctor who specializes in treating HIV.