Multiple Candida strains in the course of a single systemic infection

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Multiple Candida strains in the course of a single systemic

infection.

D R Soll, M Staebell, C Langtimm, M Pfaller, J Hicks, and T V Rao

Department of Biology, University of Iowa, Iowa City 52242.

This article has been cited by other articles in PMC.

Abstract

Species and strain variabilities have been monitored during the

history of a prolonged Candida infection in a single compromised

bone marrow transplant patient by analyzing sugar assimilation

patterns, high-frequency switching repertoires, and Southern blot

hybridization patterns with two cloned mid-repeat sequences (Ca3 and

Ca7) which are species specific for Candida albicans and one cloned

mid-repeat sequence (Ct13-8) which is species specific for Candida

tropicalis. Evidence is presented that during the course of this

infection (i) two strains of C. albicans and three strains of C.

tropicalis were distinguished by their switching repertoires,

Southern blot hybridization patterns, and sugar assimilation

patterns; (ii) the three C. tropicalis strains were in a high-

frequency mode of switching; (iii) two C. tropicalis strains

coexisted in the blood and three C. tropicalis strains coexisted in

the throat at different times during the history of the infection;

(iv) amphotericin B treatment selectively removed one of two C.

tropicalis strains coexisting in the blood and this strain exhibited

greater susceptibility to amphotericin B in vitro (the remaining

strain was subsequently removed from the blood by flucytosine

treatment); and (v) both the strain removed from the blood by

amphotericin B and the strain removed from the blood by flucytosine

reappeared several days later at another site of infection. It is

demonstrated for the first time that C. tropicalis is capable of

high-frequency switching of colony morphology just as C. albicans

is, that there is more than one strain-specific switching repertoire

in C. tropicalis, and that a C. tropicalis mid-repeat sequence can

be used for discriminating species and assessing strain relatedness,

as previously demonstrated for C. albicans mid-repeat sequences.

http://www.pubmedcentral.gov/articlerender.fcgi?artid=266641