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Journal of Antimicrobial Chemotherapy (1999) 43, 419-422
© 1999 The British Society for Antimicrobial Chemotherapy

Brief reports

Non-albicansoralcandidosis in HIV-positive patients

J. D. Cartledge, J. Midgley and B. G. Gazzard*

Department of HIV and Genitourinary Medicine, St Stephen's Centre, Chelsea and Westminster Hospital, 369 Fulham Road, London SW10 9NH, UK

Specimens from HIV-positive patients with oral candidosis were taken for culture, species identification and azole susceptibility testing, which was correlated with treatment outcome. Of 921 specimens, 95 yielded non-albicans species, mainly from patients with low CD4 lymphocyte counts and extensive previous azole exposure. Most non-albicans isolates were from specimens co-infected with Candida albicans, complicating the interpretation of in-vitro susceptibility results, which accurately predicted antifungal failure when the non-albicans species was isolated alone. Eighty-five non-albicans isolates were resistant to fluconazole in vitro. Of 149 courses of azole therapy prescribed, 115 failed to clear non-albicans candidosis clinically. Culture media that discoloured in the presence of non-albicans colonies might, therefore, guide therapy.

* Corresponding author. Tel: +44-181-746-8239; Fax: +44-181-746-5611


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