Spectrum and the In Vitro Antifungal Susceptibility Pattern of Yeast Isolates in Ethiopian HIV Patients with Oropharyngeal Candidiasis (original) (raw)
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2014
Background: Oropharyngeal Candidiasis (OPC) is the most frequent opportunistic fungal infection of the oral cavity in HIV infected patients. OPC is associated with increased morbidity and mortality in immunosuppressed patients. However, data on Species distribution and antifungal susceptibility profiles of yeast isolated from HIV-infected patients in Ethiopia is limited. Objective: The aim of the study was to determine the spectrum of Oropharyngeal yeast isolates from HIV patients and to evaluate antifungal drug susceptibility profile of yeast isolates to commonly used antifungal drugs. Method: A cross sectional study was conducted in Zewditu Memorial Hospital, Addis Ababa. Oral swabs were collected from 224 HIV patients and cultured on Sabouraud Dextrose Agar with chloramphenicol. All the isolates were characterized to a species level following standard microbiological techniques. The antifungal susceptibility profiles of all yeast were determined using disk diffusion method. Result: Of 224 HIV patients screened, 139 (62.1%) were colonized by yeasts. The rate of colonization is higher in patients that non HAART than HAART initiated (72.3% versus 51.8%). A total of 155 yeasts were isolated of which 153 (98.7%) were accounted by Candida consisting of five species and 2(1.3%) non-candida yeasts. Out of all isolates C. albicans was the most frequently isolated species accounting 68.4% followed by C. glabrata (15.5%) and C. tropicalis (11%). The Antifungal susceptibility pattern of the yeast isolates for Fluconazole, ketoconazole, Amphotericin B, Clotrimazole, Nystatin and Miconazole showed a resistance of 12.3%, 8.4%, 5.8%, 2.6%, 1.3%, and 0.6% respectively. C. albicans were 5.7% resistant to ketoconazole and 6.6% resistant to Fluconazole. C. glabrata and C. tropicalis were 12.5% and 17.6% resistant to ketoconazole and 16.6% and 35.3% resistant to fluconazole respectively. viii Conclusion: The spectrum of yeast isolated in the present study was relatively high even if C. albicans was the predominantly isolated yeast. The results of this study also revealed that development of drug resistance by yeast isolates were considerable. Isolation, characterization and evaluating drug susceptibility pattern of the isolates in this hospital in particular and in health institutions through out of the country in general is recommended. Annexes Annex I. English Versions of Participant Information Sheet My name is BIRHAN MOGES. I am a laboratory technologist postgraduate student at Addis Ababa University. Now I am conducting a study entitled Species distribution and in vitro antifungal susceptibility of Oropharyngeal yeast isolates from HIV patients in
Research Square (Research Square), 2024
Background: Oropharyngeal candidiasis (OPC) is the most common opportunistic infection encountered among human immunode ciency virus infected patients and is considered as an independent predictor of immunode ciency in patients with Acquired Immunode ciency Syndrome (AIDS).Though Candida albican is the most frequently isolated species from the oropharyngeal lesions, the change in spectrum of Candida species as causative agent of oropharyngeal candidiasis and increased antifungal drug resistance among HIV infected individuals has made the identi cation of Candida species and determination of its drug resistance pattern is necessary for the routine patient care. Therefore, the aim of the study was to determine the the prevalence, antifungal susceptibility pattern and associated factors of Candida species among HIV positive individuals having oropharyngeal legions in Mekelle health Facilities of Tigray, Ethiopia Method: A cross-sectional study was conducted among 381 HIV positive individuals with oropharyngeal lesion from September 2017 to May 2018 Socio demographic and clinical data and oral swabs were collected from the study participants. Collected swab samples were transported to Microbiology laboratory, College of Health Sciences, Mekelle Universityand were cultured on to Sabouraud dextrose agar having chloramphenicol. All the isolates were characterized using germ tube and HiCrome Candida agar tests. The antifungal susceptibility patterns of all Candida species were determined using disk diffusion method and data were analyzed using STATA version 13.0. Result: Among the 381 study participants, the overall Candida species were isolated from 228(59.8%). A total of 240 Candidaspecies were isolated, of which C. albican was the most predominant 151(62.9%). Among the non-albican Candida species, the most predominant species were Candida glabrata 47(19.6%) followed by Candida tropicalis 26 (10.8%) and Candida krusei 16 (6.7%), and majority of theisolates were from HAART naïve 127(52.9%) and those on HAART were 113 (47.1%). Age group 40-49 years (p = 0.019), previous history of antifungal drug treatment (p=0.039), CD4 counts < 200 cells/mm3 (p=0.003), HAART naïve (p=0.000), body mass indices <15.9 kg/m2 (p=0.002), WHO clinical stage III (p=0.023) and TB co-infection (0.041) were found signi cantly associated with Candida species isolation. Of the isolates, 12.9% and 9.2% of were showed resistance to uconazole and ketoconazole respectively. Least rate of resistance was found to nystatin, 0.8%. Conclusion: Nearly two-third (37.1%) of the Candida species that cause oropharyngeal legion among HIV positive individuals in the study area was non-candidia albicans. The non-candidia albicans groups showed an increasing
Therapeutic Advances in Infectious Disease, 2024
Background: Despite the increased frequency of oropharyngeal candidiasis among people living with human immunodeficiency virus (HIV), its management is no longer effective due to empirical treatment and emergence of antifungal resistance (AFR). This study sought to investigate the prevalence of oropharyngeal candidiasis and assess the antifungal susceptibility profile of oropharyngeal Candida species isolated from people living with human immunodeficiency virus. Additionally, we evaluated the correlation between oropharyngeal candidiasis and CD4 T cell as well as viral load counts. Methods: A descriptive cross-sectional study was carried out from April to October 2023 in which 384 people living with HIV underwent clinical examination for oral lesions. Oropharyngeal swabs were collected and cultured on Sabouraud Dextrose agar to isolate Candida species which were identified using the matrix assisted laser desorption ionization time of flight mass spectrometry. Additionally, the antifungal susceptibility profile of Candida isolates to six antifungal drugs was determined using VITEK® (Marcy-l'Étoile, France) compact system. Data on viral load were retrieved from records, and CD4 T cell count test was performed using Becton Dickinson Biosciences fluorescent antibody cell sorter presto. Results: The prevalence of oropharyngeal candidiasis was 7.6%. Oropharyngeal candidiasis was significantly associated with low CD4 T cell count and high viral load. A total of 35 isolates were obtained out of which Candida albicans comprised of 20 (57.1%) while C. tropicalis and C. glabrata comprised 4 (11.4%) each. C. parapsilosis, C. dubliniensis and C. krusei accounted for 2 (5.7%) each. Additionally, 7 (20%) isolates were resistant to fluconazole, 1 (2.9%) to flucytocine and 0.2 (5.7%) isolates were intermediate to caspofungin. However, specific specie isolates like C. albicans showed 20% (4/20), C. glabrata 50% (2/4) and C. krusei 50% (1/2) resistance to fluconazole. Additionally, C. krusei showed 50% resistance to flucytosine. Conclusion: The prevalence of oropharyngeal candidiasis (OPC) among people living with HIV was low, and there was a significant association between OPC and CD4 T cell count as well as viral load. C. albicans was the most frequently isolated oropharyngeal Candida species. C. glabrata and C. krusei exhibited the highest AFR among the non-albicans Candida species. The highest resistance was demonstrated to fluconazole.
2012
There are several different manifestations of OPC in AIDS patients, including. pseudomembranous candidiasis (PC) which is characterized by white pseudomembrane-like lesions that are mainly composed of fungal and host cells. In addition, there is erythematous candidiasis (EC) which is distinguished by red lesions and angular cheilitis which is an infection affecting the angles of the mouth [3]. Candida albicans is widely recognized as the most pathogenic yeast in humans and is the most common cause of fungal infections [1]. However, other Candida species, such as Candida glabrata , Candida parapsilosis and Candida tropicalis are also commonly identifi ed in samples from patients with OPC [8]. During the 1990s a new species, Candida dubliniensis , was identifi ed for the fi rst time in Irish HIV-infected individuals [9]. Despite the high prevalence of OPC in African HIV-infected and AIDS patients there have been relatively few comprehensive studies investigating the aetiology of these infections in countries where HAART is relatively rarely prescribed. In
Asymptomatic oral yeast carriage among HIV and non-HIV individuals in Benin City, Nigeria
Background: Asymptomatic carriage of yeast especially Candida species is a common finding in HIV infected individuals. However, it has been shown that persistent asymptomatic carriage of Candida species is a possible risk factor for subsequent oral infection. Aim: The aim of this study is to determine the spectrum of oral yeast carriage among HIV and non-HIV individuals in a tertiary hospital and their susceptibility to fluconazole and voriconazole. Materials and Methods: A total of 300 subjects comprising of 200 HIV patients and 100 non-HIV subjects were included for this study. Oral swab samples were collected from each individual. The specimen was processed by conventional microbiological methods and Candida isolates were identified with germ tube test and CHROMagar Candida (CHROMagar Paris, France) Results: The overall prevalence of oral yeast carriage among HIV patients was 25%. HAART-naive patiens had higher prevalence (28%) than their counterpart on highly active antiretroviral therapy (HAART) (22%). Female gender had higher yeast carriage (HAART-naive=28.99%; On HAART =23.08%) than their male counterpart (HAART-naive= 25.81%; On HAART= 18.18%). HAART-naive HIV patients with CD4 counts <200cells/μl had higher yeast colonization (30.88%) than their counterpart on HAART (16.67%). Of the 3 species of Candida recovered in this study, Candida albicans was the most prevalent. Other yeast recovered includes Rhodoturula rubra and Saccharomyces cerevisiae. The prevalence of fluconazole resistance among Candida isolates from non-HIV subjects, HIV patients on HAART and those that are HAART-naive were 11.77%, 62.50% and 51.72% respectively. While for vericonazole, the prevelence were 5.88%, 54.17% and 48.48% for non-HIV subjects, HIV patients on HAART and those that are HAART-naive respctively. Conclusion: The prevalence of oral colonization of yeasts do not differ significantly between non-HIV and HIV subjects. C. albicans was the most predominant yeast recovered from all subjects. The yeasts isolates from HIV patients were more resistant to fluconazole and vericonazole than the isolates from non-HIV subjects and their susceptibility to fluconazole and voriconazole
2015
Background: The widespread use of the antifungal agent fluconazole for therapy and prophylaxis in HIV infected patients has resulted in fluconazole resistant strains of C. albicans and an increased frequency of non-albicans Candida strains, especially among patients with late-stage AIDS. Aim: To isolate, identify and to do the antifungal susceptibility testing Candida species (oropharyngeal and oesophageal) in HIV infected patients. Method:Two hundred HIV positive cases were selected for this study. Identification of Candida species was done by conventional standard techniques and the Kirby Bauer disk diffusion method was used to test the susceptibility of Candida isolates. Findings: The resistance pattern of C. albicans was 34.07 % resistant to Fluconazole,10.99 % resistant to Voriconazole, 7.69 % resistant to Ketoconazole, 6.59 % resistant to Itraconazole, 2.19 % resistant to Clotrimazole and 1.09 % resistant to Amphotericin B. While resistance pattern of Non Candida albicans was ...
Journal of Microbiology, Immunology and Infection, 2013
Background: Oropharyngeal candidiasis continues to be a major opportunistic infection in human immunodeficiency virus (HIV)-infected patients. The objectives of this study were to investigate the prevalence, associated factors, and microbiologic features for oropharyngeal yeast colonization in HIV-infected patients. Methods: From October to December 2009, consecutive HIV-infected patients older than 18 years were recruited in this study. Demographic information, underlying conditions, and clinical histories were collected. Oropharyngeal swab cultures for yeasts and antifungal drug susceptibilities of the isolates were performed. Results: Of the 105 HIV-infected patients, 54 (51.4%) were colonized with yeasts, including 11 patients (20.4%) with more than one species. Among the 68 isolates, Candida albicans accounted for 73.5%, followed by Candida tropicalis (5.9%), Candida glabrata (5.9%), and Candida dubliniensis (4.4%). There were 7.5% and 6% Candida isolates resistant to fluconazole and voriconazole, respectively. All of the Candida isolates were susceptible to amphotericin B. A higher prevalence of yeast colonization was noted in patients with a CD4 cell count
Mycoses, 2003
The present investigation represents the first study of oropharyngeal carriage of Candida and other yeasts in HIV-infected patients in India. One hundred and fifty HIVpositive patients were investigated by culturing their swish samples on plates of CHROMagar Candida. Ninety-eight patients (65.3%) were positive for Candida and four (2.7%) were positive for other yeasts. Among them, the first Indian C. dubliniensis isolate has been recovered. Molecular typing of selected C. albicans isolates by AP-PCR revealed two major genotypes based on the banding patterns. The susceptibilities of 30 Candida isolates to five antifungal agents including the new triazole voriconazole were determined in a micro-dilution test, according to the NCCLS protocol M 27. All the 22 C. albicans isolates were susceptible to five antimycotic agents (flucytosine, amphotericin B, fluconazole, voriconazole and itraconazole) except one isolate (VPCI-122), which was resistant to flucytosine (MIC ‡ 64 mg l )1 ). The azole-resistant isolates reported here endorse the role of antifungal susceptibility testing whenever antifungal treatment with azoles is planned.