Fungi isolated from mouthrinse specimens during episodes of acute pseudomembranous fungal stomatitis and deep-seated mycoses in patients with haematological malignancies were tested for susceptibility to seven antifungal agents. Topical treatment of stomatitis with clotrimazole or chlorhexidine did not induce any change in the susceptibility of oral Candida albicans. Treatment of deeper mycoses with 5-fluorocytosine, however, resulted in a significant increase in oral strains resistant to this agent. Of C. albicans strains isolated, 7% were resistant to 5-fluorocytosine <32 μg/ml. One patient died of disseminated mycosis during treatment with this drug; the resistant C. albicans was isolated from the mouth, liver, spleen and kidneys. Strains of Torulopsis glabrata and C. krusei resistant to 5-fluorocytosine were also found in some patients. Organisms resistant to 5-fluorocytosine were generally sensitive to polyenes and imidazoles.
AugerP.,
DumasC.,
JolyJ.1979; A study of 666 strains of Candida albicans: Correlation between serotype and susceptibility to 5-fluorocytosine. Journal of Infectious Diseases 139:590–594
DefeverK. S.,
WhelanW. L.,
RogersA. L.,
BenekeE. S.,
VeselenakJ. M.,
SoliD. R.1982; Candida albicans resistance to 5-fluorocytosine: frequency of partially resistant strains among clinical isolates. Antimicrobial Agents and Chemotherapy 22:810–815
Hamilton-MillerJ. M. T.1972; A comparative in vitro study of amphotericin B. clotrimazole and 5-fluorocytosine against clinically isolated yeasts. Sabouraudia 10:276–283
HoeprichP. D.,
IngrahamJ. L.,
KlekerE.,
WinshipM. J.1974; Development of resistance to 5-fluorocytosine in Candida parapsilosis during therapy. Journal of Infectious Diseases 130:112–118
HotchiM.,
OkadaM.,
NasuT.1980; Present state of fungal infections in autopsy cases in Japan. A statistical survey of all autopsy cases during the ten-year period from 1966 to 1975. American Journal of Clinical Pathology 74:410–416
KahanpääA.1972; Bronchopulmonary occurrence of fungi in adults especially according to cultivation material. Acta Pathologica Microbiologica Scandinavica (B) Suppl 227:1–147
KostialaI.,
KostialaA. A. I.,
ElonenE.,
ValtonenV. V.,
VuopioP.1982a; Comparison of clotrimazole and chlorhexidine in the topical treatment of acute fungal stomatitis in patients with hematological malignancies. Current Therapeutic Research 31:752–762
KostialaI.,
KostialaA. A. I.,
KahanpaaA.,
ElonenE.1982b; Acute fungal stomatitis in patients with hematologic malignancies: quantity and species of fungi. Journal of Infectious Diseases 146:101
MilneL. J. R.1974; Mycological studies in the use of clotrimazole in bronchopulmonary aspergillosis and neonatal and vaginal candidiasis. Postgraduate Medical Journal 50: Suppl 1 20–23
StahelR. A.,
VogtP.,
SchulerG.,
RuttnerJ. R.,
FrickP.,
OelzO.1982; Systemic fungal infections in haematological malignancies: a growing problem. Journal of Infection 5:269–275
StillerR. L.,
BennettJ. E.,
ScholerH. J.,
WallM.,
PolakA.,
StevensD. A.1982; Susceptibility to 5-fluorocytosine and prevalence of serotype in 402 Candida albicans isolates from the United States. Antimicrobial Agents and Chemotherapy 22:482–487
StillerR. L.,
BennettJ. E.,
ScholerH. J.,
WallM.,
PolakA.,
StevensD. A.1983; Correlation of in vitro susceptibility test results with in vivo response: flucytosine therapy in a systemic candidiasis model. Journal of Infectious Diseases 147:1070–1077