Powderly W G, Robinson K, Keath E J
Division of Infectious Diseases, St. Louis VA Medical Center, Missouri.
J Infect Dis. 1993 Aug;168(2):463-6. doi: 10.1093/infdis/168.2.463.
The causative strains in 22 patients with recurrent oral candidiasis were examined using two DNA probes (a Histoplasma capsulatum DNA probe that cross-hybridizes with Candida albicans and a C. albicans strain-specific probe derived from repetitive sequence DNA). C. albicans was the causative organism in all 22 initial episodes of infection and was also obtained from 17 patients with recurrent oral disease. Molecular analysis showed that in 11 cases, the same isolate was identified in each episode. Six patients had a clearly different isolate of C. albicans causing a later episode of candidiasis. Five patients had different Candida species causing recurrent disease: 4, Torulopsis glabrata; 1, Candida parapsilosis. Patients with a new isolate (either new species or a new C. albicans strain) were more immunosuppressed and were significantly more likely (P < .001) than patients with the same recurrent strain to have received suppressive azole antifungal agents. These data indicate that the epidemiology of recurrent candidiasis in individual patients seropositive for the human immunodeficiency virus is complex and that both failure of eradication of Candida from the oral cavity and new infection occur.
使用两种DNA探针（一种与白色念珠菌交叉杂交的荚膜组织胞浆菌DNA探针和一种源自重复序列DNA的白色念珠菌菌株特异性探针）对22例复发性口腔念珠菌病患者的致病菌株进行了检测。白色念珠菌是所有22例初始感染发作的致病微生物，并且也从17例复发性口腔疾病患者中分离得到。分子分析显示，11例患者在每次发作中鉴定出相同的分离株。6例患者有明显不同的白色念珠菌分离株引起随后的念珠菌病发作。5例患者有不同的念珠菌属引起复发性疾病：4例为光滑念珠菌，1例为近平滑念珠菌。有新分离株（新物种或新的白色念珠菌菌株）的患者免疫抑制程度更高，并且比有相同复发性菌株的患者更有可能（P <.001）接受过唑类抗真菌药物的预防性治疗。这些数据表明，人类免疫缺陷病毒血清学阳性个体中复发性念珠菌病的流行病学情况复杂，存在口腔念珠菌根除失败和新感染的情况。
