ArticleAntimicrobial agents and chemotherapy1998
Fluconazole versus Candida albicans: a complex relationship.
Article in Antimicrobial agents and chemotherapy, 1998. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
22 citing papers in PubMed, 60 citations in OpenAlex.
- Randomized, double-blind, multicenter study of caspofungin versus amphotericin B for treatment of oropharyngeal and esophageal candidiases.Antimicrobial agents and chemotherapy · 2002Trial
- Article
- Vaginal Transcriptional Signatures of the Neutrophil-Driven Immune Response Correlate With Clinical Severity During Recurrent Vulvovaginal Candidiasis.American journal of reproductive immunology (New York, N.Y. : 1989) · 2025Article
- Upregulation of secreted aspartyl proteinase genes of fluconazole-sensitive Candida albicans isolates.Molecular biology reports · 2019Article
- Preliminary study on the inhibitory effect of seaweedF1000Research · 2018Article
- Cell Wall Changes in Amphotericin B-Resistant Strains from Candida tropicalis and Relationship with the Immune Responses Elicited by the Host.Antimicrobial agents and chemotherapy · 2016Article
- Fitness Studies of Azole-Resistant Strains of Aspergillus fumigatus.Antimicrobial agents and chemotherapy · 2015Article
- Distinct roles of Candida albicans drug resistance transcription factors TAC1, MRR1, and UPC2 in virulence.Eukaryotic cell · 2014Article
- Comparison of fluconazole renal penetration levels in healthy and Candida albicans-infected Wistar rats.Antimicrobial agents and chemotherapy · 2012Article
- The potential impact of antifungal drug resistance mechanisms on the host immune response to Candida.Virulence · 2012Review
- Gain of function mutations in CgPDR1 of Candida glabrata not only mediate antifungal resistance but also enhance virulence.PLoS pathogens · 2009Article
- Role of AFR1, an ABC transporter-encoding gene, in the in vivo response to fluconazole and virulence of Cryptococcus neoformans.Infection and immunity · 2006Article
- Functional analysis of CaIPT1, a sphingolipid biosynthetic gene involved in multidrug resistance and morphogenesis of Candida albicans.Antimicrobial agents and chemotherapy · 2005Article
- Functional similarities and differences between Candida albicans Cdr1p and Cdr2p transporters.Antimicrobial agents and chemotherapy · 2003Article
- Comparison of a new colorimetric assay with the NCCLS broth microdilution method (M-27A) for antifungal drug MIC determination.Journal of clinical microbiology · 2000Article
- Experimental induction of fluconazole resistance in Candida tropicalis ATCC 750.Antimicrobial agents and chemotherapy · 2000Article
- Candida albicans and Candida krusei differentially induce human blood mononuclear cell interleukin-12 and gamma interferon production.Infection and immunity · 2000Article
- Enhanced extracellular production of aspartyl proteinase, a virulence factor, by Candida albicans isolates following growth in subinhibitory concentrations of fluconazole.Antimicrobial agents and chemotherapy · 2000Article
- Potential role of phospholipases in virulence and fungal pathogenesis.Clinical microbiology reviews · 2000Review
- Antifungal agents: mode of action, mechanisms of resistance, and correlation of these mechanisms with bacterial resistance.Clinical microbiology reviews · 1999Review
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
Abstract
A murine model of systemic candidiasis was used to assess the virulence of serial Candida albicans strains for which fluconazole MICs were increasing. Serial isolates from five patients with 17 episodes of oropharyngeal candidiasis were evaluated. The MICs for these isolates exhibited at least an eightfold progressive increase from susceptible (MIC < 8 microg/ml; range, 0.25 to 4 microg/ml) to resistant (MIC >/= 16 microg/ml; range, 16 to >/=128 microg/ml). Virulence of the serial isolates from three of five patients showed a more than fivefold progressive decrease in the dose accounting for 50% mortality and was associated with development of fluconazole resistance. Low doses of fluconazole prolonged survival of mice infected with susceptible yeasts but failed to prolong survival following challenge with a resistant strain. In addition, a decreased burden of renal infection was noted in mice challenged with two of the three resistant strains. This was consistent with reduced virulence. Fluconazole did not further decrease the level of infection. In the isolates with a decrease in virulence, two exhibited overexpression of CDR, which encodes an ABC drug efflux pump. In contrast, serial isolates from the remaining two patients with the development of resistance did not demonstrate a change in virulence and fluconazole remained effective in prolonging survival, although significantly higher doses of fluconazole were required for efficacy. Resistant isolates from both of these patients exhibited overexpression of MDR. This study demonstrates that decreased virulence of serial C. albicans isolates is associated with increasing fluconazole MICs in some cases but not in others and shows that these low-virulence strains may not consistently cause infection.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.