caa a22 4500 475832507 CHVBK 20180406123844.0 cr unu---uuuuu 170329e20000901xx s 000 0 eng 10.1007/s100960000323 doi (NATIONALLICENCE)springer-10.1007/s100960000323 Determinants for the Development of Oropharyngeal Colonization or Infection by Fluconazole-Resistant Candida Strains in HIV-Infected Patients [Elektronische Daten] [M. Masiá Canuto, F. Gutiérrez Rodero, V. Ortiz de la Tabla Ducasse, I. Hernández Aguado, C. Martín González, A. Sánchez Sevillano, A. Martín Hidalgo]  A point prevalence study to document oral yeast carriage was undertaken. Risk factors for the development of oropharyngeal colonization or infection by fluconazole-resistant Candida strains in HIV-infected patients were investigated with a case-control design. Cases included all patients with fluconazole-resistant strains (MIC≥64 μg/ml), and controls were those with susceptible (MIC≤8 μg/ml) or susceptible-dependent-upon-dose (MIC 16-32 μg/ml) strains. One hundred sixty-eight Candida strains were isolated from 153 (88%) patients, 28 (16%) of whom had oropharyngeal candidiasis. Overall, 19 (12%) of the patients harbored at least one resistant organism (MIC≥64 μg/ml). Among patients with resistant strains, tuberculosis (P<0.001), esophageal candidiasis (P=0.001), clinical thrush (P<0.001), and a CD4+ cell count <200/mm3 (P=0.03) were more frequent. These patients had also been treated more commonly with antituberculous drugs (adjusted odds ratio [OR] 6.13; 95% confidence interval [CI] 2.11-17.80), ciprofloxacin (OR 6.0; 95% CI 1.23-29.26), fluconazole (OR 4.59; 95% CI 1.55-13.52), and steroids (OR 4.13; 95% CI 1.11-15.39). Multivariate analysis showed that the determinants for fluconazole resistance were therapy with antituberculous drugs (OR 3.61; 95% CI 1.08-12.07;P=0.03) and one of the following: previous tuberculosis (OR 3.53; 95% CI 1.08-14.57;P=0.03) or fluconazole exposure (OR 3.41; 95% CI 1.10-10.54). Findings from this study indicate that treatment with antituberculous drugs, previous tuberculosis, and fluconazole exposure are the strongest determinants for development of oropharyngeal colonization or infection by fluconazole-resistant Candida strains in HIV-infected patients. Springer-Verlag Berlin Heidelberg, 2000 Masiá Canuto M. Servicio de Medicina Interna, Unidad de Enfermedades Infecciosas, Hospital General Universitario de Elche, Partida de Huertos y Molinos s/n, 03202 Elche, Alicante, Spain e-mail: fgutierrezr@medynet.com, ES aut Gutiérrez Rodero F. Servicio de Medicina Interna, Unidad de Enfermedades Infecciosas, Hospital General Universitario de Elche, Partida de Huertos y Molinos s/n, 03202 Elche, Alicante, Spain e-mail: fgutierrezr@medynet.com, ES aut Ortiz de la Tabla Ducasse V. Sección de Microbiología, Hospital Universitario de San Juan, Alicante, Spain, ES aut Hernández Aguado I. Universidad Miguel Hernández, Elche, Alicante, Spain, ES aut Martín González C. Sección de Microbiología, Hospital Universitario de San Juan, Alicante, Spain, ES aut Sánchez Sevillano A. Servicio de Medicina Interna, Unidad de Enfermedades Infecciosas, Hospital General Universitario de Elche, Partida de Huertos y Molinos s/n, 03202 Elche, Alicante, Spain e-mail: fgutierrezr@medynet.com, ES aut Martín Hidalgo A. Servicio de Medicina Interna, Unidad de Enfermedades Infecciosas, Hospital General Universitario de Elche, Partida de Huertos y Molinos s/n, 03202 Elche, Alicante, Spain e-mail: fgutierrezr@medynet.com, ES aut https://doi.org/10.1007/s100960000323 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s100960000323 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Masiá Canuto M. Servicio de Medicina Interna, Unidad de Enfermedades Infecciosas, Hospital General Universitario de Elche, Partida de Huertos y Molinos s/n, 03202 Elche, Alicante, Spain e-mail: fgutierrezr@medynet.com, ES aut NATIONALLICENCE 700 1- Gutiérrez Rodero F. Servicio de Medicina Interna, Unidad de Enfermedades Infecciosas, Hospital General Universitario de Elche, Partida de Huertos y Molinos s/n, 03202 Elche, Alicante, Spain e-mail: fgutierrezr@medynet.com, ES aut NATIONALLICENCE 700 1- Ortiz de la Tabla Ducasse V. Sección de Microbiología, Hospital Universitario de San Juan, Alicante, Spain, ES aut NATIONALLICENCE 700 1- Hernández Aguado I. Universidad Miguel Hernández, Elche, Alicante, Spain, ES aut NATIONALLICENCE 700 1- Martín González C. Sección de Microbiología, Hospital Universitario de San Juan, Alicante, Spain, ES aut NATIONALLICENCE 700 1- Sánchez Sevillano A. Servicio de Medicina Interna, Unidad de Enfermedades Infecciosas, Hospital General Universitario de Elche, Partida de Huertos y Molinos s/n, 03202 Elche, Alicante, Spain e-mail: fgutierrezr@medynet.com, ES aut NATIONALLICENCE 700 1- Martín Hidalgo A. Servicio de Medicina Interna, Unidad de Enfermedades Infecciosas, Hospital General Universitario de Elche, Partida de Huertos y Molinos s/n, 03202 Elche, Alicante, Spain e-mail: fgutierrezr@medynet.com, ES aut Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer