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Antimicrobial Agents and Chemotherapy, May 2002, p. 1325-1328, Vol. 46, No. 5
0066-4804/02/$04.00+0     DOI: 10.1128/AAC.46.5.1325-1328.2002
Copyright © 2002, American Society for Microbiology. All Rights Reserved.

Change in Colony Morphology of Candida lusitaniae in Association with Development of Amphotericin B Resistance

Nancy B. McClenny,1* Haihua Fei,2,{dagger} Ellen J. Baron,1 Ana C. Gales,3 Allison Houston,3 Richard J. Hollis,3 and Michael A. Pfaller3

Clinical Microbiology/Virology Laboratory,1 Department of Pathology,2 Stanford University Medical Center, Stanford, California 94305, and University of Iowa College of Medicine, Iowa City, Iowa 522423

Received 8 June 2001/ Returned for modification 14 August 2001/ Accepted 5 October 2001

It is not uncommon to see amphotericin B treatment failure in patients with systemic infection caused by Candida lusitaniae. We report a patient with stage IV ovarian carcinoma and C. lusitaniae sepsis whose treatment with amphotericin B failed. The initial blood isolate was susceptible to amphotericin B in vitro; however, the MIC for a blood isolate recovered 7 weeks after treatment began showed a fourfold increase. Direct subculture of two positive blood samples obtained within a week of the patient's death showed the coexistence of two distinct colony color variants on CHROMagar Candida (CAC). One variant was susceptible to amphotericin B, and one was resistant. These results emphasize the importance of repeat amphotericin B susceptibility testing for patients with persistent C. lusitaniae infection. The presence of colony variants on CAC may signal the emergence of amphotericin B resistance in C. lusitaniae and should be investigated.

* Corresponding author. Mailing address: Clinical Microbiology Laboratory, Stanford University Medical Center, 300 Pasteur Dr., Stanford, CA 94305-5250. Phone: (650) 723-6671. Fax: (650) 725-5671. E-mail: nancy.mcclenny{at}medcenter.stanford.edu.

{dagger} Present address: Quest Diagnostics, Portland, Oreg.

Antimicrobial Agents and Chemotherapy, May 2002, p. 1325-1328, Vol. 46, No. 5
0066-4804/02/$04.00+0     DOI: 10.1128/AAC.46.5.1325-1328.2002
Copyright © 2002, American Society for Microbiology. All Rights Reserved.



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