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• W2056309904 abstract "Zusammenfassung. Bei 23 von 83 HIV‐Patienten, die wegen rezidivierender Candida ‐Stomatitiden mit Fluconazol behandelt wurden, wurde die Resistenzent‐wicklung von Candida ‐Isolaten gegenüber Fluconazol im Mikrodilutionstest mit High‐Resolution (HR) Medium und RPMI 1640‐Medium über einen Zeitraum bis zu zwei Jahren beobachtet. Die zu Begim und am Ende des Beobachtungszeitraumes gewonnenen Candida ‐Isolate wurden auf eine Kreuzresistenz zu Itraconazol und Ketoconazol untersucht. Bei Verwendung von RPMI 1640 war die Empfindlichkeit gegenüber Ketoconazol deutlich, die gegenüber Itraconazol geringfügig schlechter. Die Fluconazolempfindlichkeit war vom Testmedium unabhängig. Bei 21 Patienten traten unter Fluconazoltherapie in vitro Fluconazol resistente oder vermindert empfindliche C.‐albicans ‐Isolate auf. 9 von 21 Isolaten waren gleichzeitig gegenüber Itraconazol und Ketoconazol resistent. 10 Isolate zeigten nur eine Kreuzresistenz zu Itraconazol. Im Verlauf der Studie stieg unter der Fluconazoltherapie die Zahl der Patienten mit einer Mehrfachinfektion mit C. albicans und C. glabrata oder C. krusei von 20% auf 78% an. C. krusei war gegenüber alien drei Azolen resistent. C. glabrata war vermindert empfindlich (4–8 mg/l) oder resistent gegenüber Fluconazol (<8mg/l) bei gleichzeitiger Itraconazol‐ und Ketoconazolresistenz. Eine hochdosierte intravenöse Fluconazoltherapie mit 400 bis 600 mg Fluconazol pro Tag war bei 11 (11/11) Patienten mit resistenten C.‐albicans ‐Isolaten und bei 3 (3/10) Patienten mit vermindert empfindlichen C.‐albicans ‐Isolaten unwirksam. Abstract. In vitro susceptibility to fluconazole of Candida species isolated from 83 HIV‐infected patients treated with fluconazole because of recurrent Candida stomatitis was monitored over a period of two years. A microdilution assay with high‐resolution antifungal assay (HR) medium and RPMI 1640‐medium were compared. In vitro less susceptible and fluconazole resistant C. species were observed in 23 patient at the end of the study. The Candida isolates recovered from oral rinsing fluids at the beginning and the end of study were tested for crossresistance to itraconazole and ketoconazole. Susceptibility to ketoconazole and to itraconazole was reduced using RPMI 1640‐medium. Susceptibility of the isolates to fluconazole was not influenced by the assay medium. In 21 patients in vitro fluconazole resistant or less susceptible C. albicans were observed. 9 of 21 isolates showed crossresistance to itrcconazole and ketoconazole. in 10 isolates only crossresistance to itraconazole was observed. During fluconazole treatment double infections due to combination of C. albicans and C. glabrata or C. krusei increased from 20% to 78%. C. krusei was resistant to the three azoles. C. glabrata was less susceptible (4–8 mg/l) or resistant (>8 mg/l) to fluconazole and resistant to itraconazole and ketoconazole. High dosed intravenous fluconazole treatment with 400 to 600 mg daily failed in 11 patients with fluconazole resistant C. albicans and in 3 (3/10) patients with les susceptible C. albicanr isolates." @default.
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• W2056309904 title "Fluconazol‐resistente <i>Candida</i>‐Arten bei HIV‐Patienten mit rezidivierenden <i>Candida</i>‐Stomatitiden: Kreuzresistenz zu Itraconazol und Ketoconazol" @default.
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