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dc.contributor.authorMCMANUS, BRENDAen
dc.contributor.authorMORAN, GARYen
dc.contributor.authorFLEMING, PADRAIGen
dc.contributor.authorCOLEMAN, DAVIDen
dc.contributor.authorHEALY, CLAIREen
dc.contributor.authorNUNN, JUNEen
dc.contributor.authorSULLIVAN, DEREKen
dc.date.accessioned2011-05-20T11:00:31Z
dc.date.available2011-05-20T11:00:31Z
dc.date.issued2011en
dc.date.submitted2011en
dc.identifier.citationMcMANUS, B.A., McGOVERN, E., MORAN, G.P., HEALY, C.M., NUNN, J., FLEMING, P., COSTIGAN, C., SULLIVAN, D.J., COLEMAN, D.C., MICROBIOLOGICAL SCREENING OF IRISH AUTOIMMUNE POLYENDOCRINOPATHY-CANDIDIASIS-ECTODERMAL DYSTROPHY (APECED) PATIENTS REVEALS PERSISTENCE OF CANDIDA ALBICANS STRAINS, GRADUAL REDUCTION IN SUSCEPTIBILITY TO AZOLES AND INCIDENCES OF CLINICAL SIGNS OF ORAL CANDIDIASIS WITHOUT CULTURE EVIDENCE, JOURNAL OF CLINICAL MICROBIOLOGY, 49, 5, 2011, 1879 - 1889en
dc.identifier.otherYen
dc.identifier.urihttp://hdl.handle.net/2262/55876
dc.descriptionPUBLISHEDen
dc.description.abstractPatients with Autoimmune Polyendocrinopathy Candidiasis Ectodermal Dystrophy (APECED) are prone to chronic mucocutaneous candidiasis, which is often treated with azoles. The purpose of this study was to characterize the oral Candida populations from 16 Irish APECED patients, approximately half the total number identified in Ireland, and to examine the effect of intermittent antifungal therapy on the azole susceptibility patterns of Candida isolates. Patients attended between one and four clinical evaluations over a five-year period, providing oral rinses and/or oral swab samples each time. Candida was recovered from 14/16 patients and Candida albicans was the only Candida species identified. Interestingly, clinical diagnosis of candidiasis did not correlate with microbiological evidence of Candida infection at 7/22 (32%) clinical assessments. Multilocus sequence typing (MLST) analysis of C. albicans isolates recovered from the same patients on separate occasions identified the same sequence type each time. Fluconazole resistance was detected in isolates from one patient, and isolates exhibiting a progressive reduction in itraconazole and/or fluconazole susceptibility were identified in a further 3/16 patients, in each case correlating with upregulation of CDR- and MDR-encoded efflux pumps. Mutations were also identified in the ERG11 and the TAC1 genes of isolates from these four patients, some of which have previously been associated with azole resistance. The study suggests that alternative Candida treatment options, other than azoles such as chlorhexidine, should be considered in APECED patients and that clinical diagnosis of oral candidiasis should be confirmed by culture prior to the commencement of anti-Candida therapy.en
dc.description.sponsorshipMicrobiology Research Unit, Dublin Dental University Hospitalen
dc.format.extent1879en
dc.format.extent1889en
dc.language.isoenen
dc.relation.ispartofseriesJOURNAL OF CLINICAL MICROBIOLOGYen
dc.relation.ispartofseries49en
dc.relation.ispartofseries5en
dc.rightsYen
dc.subjectC. albicansen
dc.subjectOral candidiasisen
dc.subjectAPECEDen
dc.subjectMLSTen
dc.subjectReduced azole susceptibilityen
dc.subjectCDR1/CDR2/MDR1 gene expressionen
dc.subjectDentistryen
dc.titleMICROBIOLOGICAL SCREENING OF IRISH AUTOIMMUNE POLYENDOCRINOPATHY-CANDIDIASIS-ECTODERMAL DYSTROPHY (APECED) PATIENTS REVEALS PERSISTENCE OF CANDIDA ALBICANS STRAINS, GRADUAL REDUCTION IN SUSCEPTIBILITY TO AZOLES AND INCIDENCES OF CLINICAL SIGNS OF ORAL CANDIDIASIS WITHOUT CULTURE EVIDENCEen
dc.typeJournal Articleen
dc.type.supercollectionscholarly_publicationsen
dc.type.supercollectionrefereed_publicationsen
dc.identifier.peoplefinderurlhttp://people.tcd.ie/dcolemanen
dc.identifier.peoplefinderurlhttp://people.tcd.ie/gmoranen
dc.identifier.peoplefinderurlhttp://people.tcd.ie/pflemingen
dc.identifier.peoplefinderurlhttp://people.tcd.ie/djsullvnen
dc.identifier.peoplefinderurlhttp://people.tcd.ie/bmcmanuen
dc.identifier.peoplefinderurlhttp://people.tcd.ie/nunnjen
dc.identifier.peoplefinderurlhttp://people.tcd.ie/clhealyen
dc.identifier.rssinternalid71125en
dc.subject.TCDThemeGenes & Societyen
dc.subject.TCDThemeImmunology, Inflammation & Infectionen
dc.identifier.rssurihttp://dx.doi.org/10.1128/JCM.00026-11en
dc.identifier.rssurihttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=21367996&dopt=Abstracten
dc.identifier.orcid_id0000-0003-1797-2888en


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