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Please use this identifier to cite or link to this item: http://hdl.handle.net/2262/55876

Title: 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
Author: MORAN, GARY
MC MANUS, BRENDA
SULLIVAN, DEREK
HEALY, CLAIRE
NUNN, JUNE
COLEMAN, DAVID
FLEMING, PADRAIG
Author's Homepage: http://people.tcd.ie/dcoleman
http://people.tcd.ie/gmoran
http://people.tcd.ie/bmcmanu
http://people.tcd.ie/djsullvn
http://people.tcd.ie/clhealy
http://people.tcd.ie/nunnj
Keywords: C. albicans
Oral candidiasis
APECED
MLST
Reduced azole susceptibility
CDR1/CDR2/MDR1 gene expression
Dentistry
Issue Date: 2011
Citation: McMANUS, 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 - 1889
Series/Report no.: JOURNAL OF CLINICAL MICROBIOLOGY
49
5
Abstract: Patients 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.
Description: PUBLISHED
URI: http://hdl.handle.net/2262/55876
Related links: http://dx.doi.org/10.1128/JCM.00026-11
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=21367996&dopt=Abstract
Appears in Collections:Dental Science (Scholarly Publications)

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