Susceptibilidad antifúngica de Candida albicans recuperadas de pacientes con SIDA y candidiasis orofaríngea y esofágica: Experiencia con Etest®

Background: Oropharyngeal candidiasis (OPC) and esophageal candidiasis (EPC) are frequent complications in AIDS patients. The use of Fluconazole, an effective and a low toxicity drug, has been associated to the emergency of secondary resistant strains. For this reason, in vitro antifungal susceptibility tests are necessary to predict a therapeutic failure. Etest® is an easy to perform alternative test, that has showed a good agreement with the broth microdilution reference method (NCCLS, document M27-A). Aim: To measure the susceptibility of C. albicans isolates from AIDS patients complicated with OPC and EPC to Amphotericin B (AmB) and Fluconazole (Flu) using Etest®. Material and methods: Twenty strains from 20 AIDS patients were studied. AmB was tested in RPMI 1640 agar and Flu in Casitone agar. Results: All studied strains showed minimal inhibitory concentrations (MICs) <1 mg/mL for AmB. A highly resistant strain to Flu (>256 mg/mL) was isolated from a patient previously treated with Flu. Conclusions: In AIDS patients with OPC and EPC, the susceptibility to Flu of the isolates should be screened, to detect resistant strains. Etest®; is a reliable alternative in these cases, for laboratories that cannot use the reference method (Rev Méd Chile 2003; 131: 515-19).