Antifungal Drug Resistance in Mycosis: The Problem of Azole Resistance.:The Problem of Azole Resistance
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The emergence of Candida albicans resistant to fluconazole (FLCZ) because of long-term treatment in AIDS patients and the increase of infections with C. krusei and C. glabrata poorly sensitive to FLCZ have attracted attention in other countries. This study examined the possibility of a tendency toward azole-resistance among fungal isolates in Japan and the effect of antifungal agent treatment of infections by resistant fungi. The following results were obtained:1. The sensitivity to FLCZ and ketoconazole was determined on eight species of yeast-like fungi, including 122 strains isolated before marketing of FLCZ (up to December 1987) and 138 strains isolated afterward (July 1991 to October 1992). No significant differences in sensitivity were detected, which suggests the absence of a tendency toward azole resistance among the fungal strains.2. Among the clinical isolates tested, C. albicans, C. parapsilosis and C. tropicalis were highly sensitive to FLCZ (IC99≤0.78μg/ml), C. guilliermondii, Cr. neoformans and T. cutaneum were moderately sensitive (1.56 to 6.25μg/ml) and C. krusei and C. glabrata were poorly sensitive (up to 25μg/ml).3. An experimental model of lethal C. glabrata infection in mice was established. Using this model and comparing it with C. albicans infection, the relationship between the effectiveness of FLCZ treatment and the drug sensitivity of the challenged fungi to FLCZ were examined. A good correlation was obtained depending on the serum drug level.
- 日本医真菌学会の論文
日本医真菌学会 | 論文
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