Transmission of fluconazole-resistant candida albicans betweenpatients with AIDS and oropharyngeal candidiasis documented by pulsed-field gel electrophoresis

Electrophoretic karyotype and restriction endonuclease analysis of genomic DNA were used forthe typing of nine isolates of Candida albicans from the oral cavities of two patients with AIDSa husband and wifewhose infections became resistant to treatment with fluconazole (400 mg/d). The in vitro susceptibilities of sequential isolates to fluconazole and two other triazoles, itraconazole and the investigational drug D0870, were also evaluated. DNA analysis showed that the isolates responsiblefor fluconazole-resistant episodes of oropharyngeal candidiasis in the two patients were genetically related. In vitro susceptibility to fluconazole correlated well with clinical outcome. Although the minimal inhibitory concentrations of itraconazole and D0870 for fluconazole-resistant isolates were higher than those for fluconazole-susceptible isolates, both of the former triazoles exhibited good in vitro activity against the isolates tested.