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Antimicrob Agents Chemother. Aug 1997; 41(8): 1625–1635.
PMCID: PMC163976

Isolation of Candida species on media with and without added fluconazole reveals high variability in relative growth susceptibility phenotypes.


Mouthwashes from human immunodeficiency virus-positive individuals were sampled for yeasts by direct plating on a differential agar medium with and without added fluconazole and via enrichment broths with and without added fluconazole. The colonies of the yeasts isolated were tested for relative growth in the presence of single concentrations of itraconazole and fluconazole. Among 258 culture plates containing yeasts obtained via different isolation routes from 86 yeast-positive samples, 33 (12.7%) of the plates showed unexpectedly high colony-to-colony variation in relative growth. Intercolony variation was seen in 41 (47.7%) of the 86 isolates when relative growth data were analyzed for all colonies of an isolate tested, regardless of the medium used for isolation. The prevalence of relative growth variability with the azoles was highest for Candida glabrata (100% of 13 isolates), followed by Candida krusei (60% of 5 isolates) and Candida albicans (40% of 53 isolates), and the visual patterns of variability seen in scatter plots of the data showed species specificity. Relative growth phenotypes generally tended to be stable for each yeast colony in subcultures, whether or not the medium used for subculture contained antifungal agents. DNA fingerprinting of stable and variable C. albicans isolates showed changes in band patterns detected with the probe Ca3, suggesting that the variability may have resulted from selection of different subtypes of the yeasts during the isolation procedure. These findings suggest that the yeasts isolated from single clinical samples were often not clonal in nature. The relative growth test revealed colony variability more readily than conventional susceptibility testing.

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Selected References

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  • Anderson J, Srikantha T, Morrow B, Miyasaki SH, White TC, Agabian N, Schmid J, Soll DR. Characterization and partial nucleotide sequence of the DNA fingerprinting probe Ca3 of Candida albicans. J Clin Microbiol. 1993 Jun;31(6):1472–1480. [PMC free article] [PubMed]
  • Cartledge JD, Midgley J, Gazzard BG. Relative growth measurement of Candida species in a single concentration of fluconazole predicts the clinical response to fluconazole in HIV infected patients with oral candidosis. J Antimicrob Chemother. 1996 Feb;37(2):275–283. [PubMed]
  • Daikos GL, Jackson GG, Lolans VT, Livermore DM. Adaptive resistance to aminoglycoside antibiotics from first-exposure down-regulation. J Infect Dis. 1990 Aug;162(2):414–420. [PubMed]
  • Engler-Blum G, Meier M, Frank J, Müller GA. Reduction of background problems in nonradioactive northern and Southern blot analyses enables higher sensitivity than 32P-based hybridizations. Anal Biochem. 1993 May 1;210(2):235–244. [PubMed]
  • Johnson EM, Warnock DW, Luker J, Porter SR, Scully C. Emergence of azole drug resistance in Candida species from HIV-infected patients receiving prolonged fluconazole therapy for oral candidosis. J Antimicrob Chemother. 1995 Jan;35(1):103–114. [PubMed]
  • Karlowsky JA, Saunders MH, Harding GA, Hoban DJ, Zhanel GG. In vitro characterization of aminoglycoside adaptive resistance in Pseudomonas aeruginosa. Antimicrob Agents Chemother. 1996 Jun;40(6):1387–1393. [PMC free article] [PubMed]
  • Le Guennec R, Reynes J, Mallié M, Pujol C, Janbon F, Bastide JM. Fluconazole- and itraconazole-resistant Candida albicans strains from AIDS patients: multilocus enzyme electrophoresis analysis and antifungal susceptibilities. J Clin Microbiol. 1995 Oct;33(10):2732–2737. [PMC free article] [PubMed]
  • Lockhart SR, Fritch JJ, Meier AS, Schröppel K, Srikantha T, Galask R, Soll DR. Colonizing populations of Candida albicans are clonal in origin but undergo microevolution through C1 fragment reorganization as demonstrated by DNA fingerprinting and C1 sequencing. J Clin Microbiol. 1995 Jun;33(6):1501–1509. [PMC free article] [PubMed]
  • Louwagie B, Surmont I, Verhaegen J, Odds F. Differential and enrichment media for selective culture and recognition of yeast species from clinical material. Eur J Clin Microbiol Infect Dis. 1995 May;14(5):406–411. [PubMed]
  • Odds FC. Quantitative microculture system with standardized inocula for strain typing, susceptibility testing, and other physiologic measurements with Candida albicans and other yeasts. J Clin Microbiol. 1991 Dec;29(12):2735–2740. [PMC free article] [PubMed]
  • Odds FC. Antifungal susceptibility testing of Candida spp. by relative growth measurement at single concentrations of antifungal agents. Antimicrob Agents Chemother. 1992 Aug;36(8):1727–1737. [PMC free article] [PubMed]
  • Odds FC, Dams G, Just G, Lewi P. Susceptibilities of Candida spp. to antifungal agents visualized by two-dimensional scatterplots of relative growth. Antimicrob Agents Chemother. 1996 Mar;40(3):588–594. [PMC free article] [PubMed]
  • Odds FC, Vranckx L, Woestenborghs F. Antifungal susceptibility testing of yeasts: evaluation of technical variables for test automation. Antimicrob Agents Chemother. 1995 Sep;39(9):2051–2060. [PMC free article] [PubMed]
  • Patterson TF, Revankar SG, Kirkpatrick WR, Dib O, Fothergill AW, Redding SW, Sutton DA, Rinaldi MG. Simple method for detecting fluconazole-resistant yeasts with chromogenic agar. J Clin Microbiol. 1996 Jul;34(7):1794–1797. [PMC free article] [PubMed]
  • Scherer S, Stevens DA. A Candida albicans dispersed, repeated gene family and its epidemiologic applications. Proc Natl Acad Sci U S A. 1988 Mar;85(5):1452–1456. [PMC free article] [PubMed]
  • Schmid J, Voss E, Soll DR. Computer-assisted methods for assessing strain relatedness in Candida albicans by fingerprinting with the moderately repetitive sequence Ca3. J Clin Microbiol. 1990 Jun;28(6):1236–1243. [PMC free article] [PubMed]
  • Schröppel K, Rotman M, Galask R, Mac K, Soll DR. Evolution and replacement of Candida albicans strains during recurrent vaginitis demonstrated by DNA fingerprinting. J Clin Microbiol. 1994 Nov;32(11):2646–2654. [PMC free article] [PubMed]
  • Soll DR. High-frequency switching in Candida albicans. Clin Microbiol Rev. 1992 Apr;5(2):183–203. [PMC free article] [PubMed]

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