Anil S, Ellepola A N, Samaranayake L P
Oral Bio-Sciences, Faculty of Dentistry, University of Hong Kong.
J Oral Pathol Med. 2001 Sep;30(8):481-8. doi: 10.1034/j.1600-0714.2001.030008481.x.
Oropharyngeal candidiasis (OPC) is the most frequent AIDS-associated opportunistic infection, as up to 90% of HIV-infected individuals suffer at least one episode during the course of their disease. Various in vivo and in vitro procedures have been used to assess the effectiveness of antifungal agents used in HIV infection. In the present study, we evaluated in vitro the minimum inhibitory concentration (MIC) and the post-antifungal effect (PAFE) of two polyenes, two azoles and one DNA-analogue against 10 oral isolates of Candida albicans and 10 of Candida tropicalis, all from HIV-infected individuals, in order to obtain basic data on the pharmacodynamics of these drugs. One-hour exposure to twice the MIC of all the drugs, except fluconazole, elicited a consistently high PAFE in both Candida species. Furthermore, the PAFE elicited by the antifungals (except fluconazole) was significantly prolonged for C. tropicalis compared with C. albicans. This speedy recovery of C. albicans isolates exposed to transient low concentrations of antifungals appeared to reflect its virulence compared with lesser potent species, such as C. tropicalis. Taken together, the current data, while confirming the existence of PAFE in a non-albicans species of Candida, also provide further clues for the recalcitrance of C. albicans species in the face of antifungal therapy for oropharyngeal candidiasis.
口腔念珠菌病（OPC）是最常见的艾滋病相关机会性感染，高达90%的HIV感染者在病程中至少经历一次发作。已采用各种体内和体外方法来评估用于HIV感染的抗真菌药物的有效性。在本研究中，我们在体外评估了两种多烯类、两种唑类和一种DNA类似物对10株来自HIV感染者的白色念珠菌口腔分离株和10株热带念珠菌的最低抑菌浓度（MIC）和抗真菌后效应（PAFE），以便获得这些药物药效学的基础数据。除氟康唑外，所有药物在两倍MIC浓度下暴露1小时，在两种念珠菌中均产生持续较高的PAFE。此外，与白色念珠菌相比，抗真菌药物（除氟康唑外）对热带念珠菌产生的PAFE显著延长。与毒力较弱的菌种如热带念珠菌相比，暴露于短暂低浓度抗真菌药物的白色念珠菌分离株的这种快速恢复似乎反映了其毒力。综上所述，目前的数据在证实非白色念珠菌种存在PAFE的同时，也为白色念珠菌种在口腔念珠菌病抗真菌治疗中难治性提供了进一步线索。
