Species Identification And Antifungal Susceptibility Pattern Of Candida Isolates From Oropharyngeal Lesions Of HIV Infected Patients.
Species Identification And Antifungal Susceptibility Pattern Of Candida
DOI:
https://doi.org/10.70284/njirm.v3i4.2077Keywords:
Antifungal susceptibility testing, candidiasis, glucose methylene blue Mueller Hinton agar, NAC species, Oropharyngeal lesionsAbstract
Background &Objective: Oropharyngeal candidiasis (OPC) is a common feature associated with HIV infection. Over the past decade, reports have documented a shift away from C. albicans as a major cause of infection to non albicans Candida (NAC) species. Several NAC spp are inherently resistant to commonly used antifungal drugs. The objective of the present study was to investigate the distribution pattern of Candida spp. from HIV infected patients with OPC and evaluate its antifungal susceptibility pattern. Methods: A total of 192 HIV infected patients with oropharyngeal lesions (OPL) suggestive of candidiasis and 60 non HIV infected healthy individuals presenting without any OPL were included in the study.Swabs collected from the site of lesions were used for the demonstration and isolation of Candida. Speciation of Candida isolates was done and antifungal susceptibility testing was performed by the disc diffusion method. Results: Out of 192 HIV-infected patients with OPL, 179(93.2%) showed growth of Candida. Isolation of NAC species was higher than C. albicans. Azole resistance was more in NAC species as compared to C. albicans.Conclusions: NAC species has emerged as an important cause of OPC in HIV infected patients. The increased isolation rates of NAC species and a gradual shift in the antifungal susceptibility profile underlines the need of early and accurate diagnosis of infecting Candida spp along with antifungal susceptibility testing for selecting the most appropriate antifungal agent for therapy.
References
2. Sen S, Mandal S, Bhattacharya S, Halder S, Bhaumik P. Oral manifestation in Human Immunodeficiency Virus infected patients. Indian J Dermatol 2010; 55: 116-118.
3. Bruatto M,Vidotto V,Marinuzzi G, Raiteri R, Sinicco A. Candida albicans biotypes in Human Immunodefiency Virus type 1 infected patients with oral candidiasis before and after antifungal therapy. J Clin Microbiol 1991; 29: 726-730.
4. Schelenz S, Adallah S Gray G, et al. Epidemiology of oral yeast colonization and infection in patients with hematogicalmalignancies, head neck and solid tumors. J Oral Pathol Med 2011; 40:83-89.
5. Lyon GM, Karatela S, Sunay S, Adiei Y. Antifungal susceptibility testing of Candida isolates from Candida surveillance study J. Clin Microbiol 2010; 48: 1270-1275.
6. Graf B, Adam T, Zill E, Gobel U. Evalution of the VITEK 2 system for rapid identification of yeast and yeast like organisms. J Clin. Microbiol 2000; 38: 1782-1785.
7. UNAIDS/WHO.UNAIDS/WHO Recommendations. The importance of simple/rapid assays in HIV testing. Weekly Epidemiological Record 1998; 73:321-328.
8. National Committee for Clinical Laboratory Standards. Methods for antifungal disk diffusion susceptibility testing of yeast. Approved guidelines M-44A. Wayne, PA: NCCLS; 2004.
9. Gugnani HC, Becker K, Fegeler W,Basu S, Chattopadhya D, Baveja U, et al. Oropharyngeal carriage of candida species in HIV-infected patients in India. Mycoses 2003; 46: 299-306.
10. Weinberger M, Sacks T, Sulkes J, Shapiro M, Polacheck I. Increasing fungal isolation from clinical specimens: experience in a university hospital over a decade. J Hosp Infect 1997; 35: 185-195.
11. Ng KP, Madasamy M, Saw TL, Baki A, He J, Soo-Hoo TS. Candida biotypes isolated from clinical specimens in Malaysia. Mycopathologia 1998; 144: 135-140.
12. Kothavade RJ, Kura MM, Valand AG, Panthaki MH. Candida tropicalis: its prevalence, Pathogenicity and increasing resistance to fluconazole. J Med Microbiol 2010; 59: 873-880.
13. Chunchanur S, Nadgir S, Halesh L, Patil B, Kausar Y, Chandrashekar. Detection and antifungal susceptibility testing of oral Candida dubliniensis from human immunodeficiency virus-infected patients. Indian J Pathol Microbiol 2009; 52: 501-504.
14. Myoken Y, Kyo T, Fujihara M, Sugata T, Mikami Y. Clinical significance of breakthrough fungemia caused by azole resistant Candida tropicalis in patients with hematologic
malignancies. Haematologica 2004; 89: 378-380.
15. Tortorano AM, Rigoni AL, Biraghi E, Prigitano A, Viviani MA & FIMUA-ECMM study group (2003). The European Conferderation of Medical Mycology (ECMM) survey of candidemia in Italy: antifungal susceptibility patterns of 261 non-albicans Candida isolates from blood. J Antimicrob Chemother 2003; 52: 679-682.
