Relationship between fluconazole sensitivity ofCandida albicans isolates from HIV positive patients and serotype, adherence and CD4+ lymphocyte count

The sensitivity to fluconazole, serotype and adherence to buccal epithelial cells of 46Candida albicans isolates was studied in vitro. Strains were isolated from 18 HIV-positive patients with variable CD4+ lymphocyte counts who were receiving long-term fluconazole therapy. Results showed that sensitivity to fluconazole correlated with serotype. Of the sensitive isolates 81.5 % were serotype A and 18.5 % serotype B, whereas of the resistant isolates 37.5 % were serotype A and 62.5 % serotype B. Sensitivity to fluconazole also correlated with adherence capacity, resistant isolates showing slightly less adherence to buccal epithelial cells than sensitive isolates. Weakly adherent isolates represented 87 % of resistant isolates and only 63 % of sensitive isolates. Resistant strains were isolated in highly immunocompromised patients. All strains isolated in patients with CD4+ lymphocyte counts above 200 lymphocytes/µl were sensitive, whereas intermediate and resistant strains were isolated in patients with counts below 200 lymphocytes/µl. Statistical analyses showed no correlation between adherence of isolates to buccal epithelial cells and CD4+ lymphocyte counts.