High Oral Carriage of Non- albicans Candida spp. among HIV-infected individuals

Mushi, Martha F.; Mtemisika, Conjester I.; Bader, Oliver; Bii, Christine; Mirambo, Mariam M.; Groß, Uwe; Mshana, Stephen E.

doi:10.1016/j.ijid.2016.07.001

Cited by 51 publications

(62 citation statements)

References 26 publications

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“…The most frequently isolated species in our study as shown by others was C albicans in both HIV + and HIV − groups reflecting the universally higher occurrence of this species as commensal and a pathogen. C tropicalis was the most frequent non‐ albicans Candida species isolated in both groups, and has been seen with similar frequency in other studies, which report a high prevalence of this species in tropical climates . The other non‐ albicans Candida species isolated from the HIV + population were C parapsilosis , Candida lusitaniae , Candida guilliermondii and C krusei , a species distribution resembling those previously reported .…”

Section: Discussionsupporting

confidence: 87%

Oral candidal carriage correlates with CD4⁺ cell count but not with HIV and highly active antiretroviral therapy status

Sah

Patel

Chandrashekar

et al. 2019

J of Invest & Clin Dent

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Aim The occurrence of oropharyngeal candidiasis (OPC) may be influenced by oral candidal carriage (OCC). Although OPC is strongly associated with low CD4+ cell count (400‐700 cells/mm3) and a lack of highly active antiretroviral therapy (HAART), the effect of these two parameters on OCC is debatable. We investigated the oral candidal carriage, species diversity, antifungal susceptibility and the association of OCC with CD4+ cell count and HAART. Methods Oral candidal isolates from 120 HIV+ patients (60 receiving and 60 not receiving HAART) and 60 healthy controls were quantified, and their species determined using standard culture and biochemical methods, followed by antifungal susceptibility testing using the agar dilution method. Results The OCC was significantly higher in HIV+ patients; Candida albicans was the most frequently isolated species in both groups, followed by Candida tropicalis. Candidal density carriage correlated significantly with CD4+ cell count, but not with HIV and HAART status. Among the isolates from HIV+ patients, 35.4% showed reduced susceptibility to fluconazole. Conclusion HIV status results in significantly elevated rates of OCC C albicans remains the predominant pathogen, although other species are emerging rapidly. Resistance to fluconazole is on the rise, and more efficient treatment strategies need to be implemented.

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Section: Discussionsupporting

confidence: 87%

Oral candidal carriage correlates with CD4⁺ cell count but not with HIV and highly active antiretroviral therapy status

Sah

Patel

Chandrashekar

et al. 2019

J of Invest & Clin Dent

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“…Yeast isolates were identified as growth of creamy to white colonies while moulds were identified as the filamentous colonies of various appearances [23]. CHROM agar (OXOID, England) was used as previously described for preliminary identifications of yeast in case of mixed growth [23]. …”

Section: Methodsmentioning

confidence: 99%

Aspergillus fumigatus carrying TR34/L98H resistance allele causing complicated suppurative otitis media in Tanzania: Call for improved diagnosis of fungi in sub-Saharan Africa

et al. 2016

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Background: Suppurative otitis media (SOM) is a major public health concern worldwide and is associated with increased morbidity. Cases of fungal suppurative otitis media were studied to establish the effect of fungi in otitis media. Methods: Ear swabs from 410 patients were collected aseptically using sterile cotton swabs from discharging ear through perforated tympanic membrane. Swabs were subjected to microscopic and culture investigations. The species of fungal growing on Sabouraud's agar were identified using MALDI-TOF MS. For moulds broth micro dilution method following EUCAST guidelines was employed to determine susceptibility patterns against itraconazole, voriconazole and posaconazole. Results: A total of 44 (10.74 %) cases with positive fungal culture growth were studied. The median age of patients with fungal infection was 29.5 (IQR 16-43) years. Of 44 patients; 35 (79.6 %) had pure growth of one type of fungal. Candida albicans was the most common fungus isolated (n = 13; 29.6 %) followed by Aspergillus versicolor (n = 8; 18.2 %). A total of 7 (15.9 %) patients had disease complication at time of enrollment; of them 6 (13.6 %) had hearing loss. On follow up 7 (15.9 %) had poor treatment outcome. All five Aspergillus fumigatus strains resistant itraconazole with reduced susceptibility to voriconazole and posaconazole carried carrying TR34/L98H resistance allele. In addition, all Penicillium citrinum isolates were resistant to voriconazole while all Penicillium sumatrense were resistant to both itraconazole and voriconazole. There were non-significant association of poor treatment outcome and female gender, being HIV positive and being infected with moulds. Conclusion: Fungal infections play a significant role in SOM pathology in our setting. Diagnosis of fungal infections in developing countries should be improved so that appropriate management can be initiated on time to prevent associated complications.

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“…It is documented that between 17% and 75% of healthy individuals can be colonized by Candida species [9,10]. However, non- albicans Candida species have been implicated in colonization of the oral cavity, eventually causing infection in 20–40% of immunocompromised individuals [10–12]. …”

Section: Introductionmentioning

confidence: 99%

Oral candidiasis among African human immunodeficiency virus-infected individuals: 10 years of systematic review and meta-analysis from sub-Saharan Africa

Mushi

Bader

Taverne-Ghadwal

et al. 2017

Journal of Oral Microbiology

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Oral candidiasis (OC) is the most common opportunistic fungal infection among immunocompromised individuals. This systematic review and meta-analysis reports on the contribution of non-albicans Candida species in causing OC among human immunodeficiency virus (HIV)-infected individuals in sub-Saharan Africa between 2005 and 2015. Thirteen original research articles on oral Candida infection/colonization among HIV-infected African populations were reviewed. The prevalence of OC ranged from 7.6% to 75.3%. Pseudomembranous candidiasis was found to range from 12.1% to 66.7%. The prevalence of non-albicans Candida species causing OC was 33.5% [95% confidence interval (CI) 30.9–36.39%]. Of 458 non-albicans Candida species detected, C. glabrata (23.8%; 109/458) was the most common, followed by C. tropicalis (22%; 101/458) and C. krusei (10.7%; 49/458). The overall fluconazole resistance was 39.3% (95% CI 34.4–44.1%). Candida albicans was significantly more resistant than non-albicans Candida species to fluconazole (44.7% vs 21.9%; p < 0.001). One-quarter of the cases of OC among HIV-infected individuals in sub-Saharan Africa were due to non-albicans Candida species. Candida albicans isolates were more resistant than the non-albicans Candida species to fluconazole and voriconazole. Strengthening the capacity for fungal diagnosis and antifungal susceptibility testing in sub-Saharan Africa is mandatory in order to track the azole resistance trend.

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High Oral Carriage of Non- albicans Candida spp. among HIV-infected individuals

Abstract: The prevalence of NAC spp. is high among HIV-infected individuals with low CD4 count placing them at higher risk of invasive infections. Further studies to investigate the role of NAC spp. in causing invasive infections among immunocompromised patients are recommended.

Cited by 51 publications

References 26 publications

Oral candidal carriage correlates with CD4⁺ cell count but not with HIV and highly active antiretroviral therapy status

Oral candidal carriage correlates with CD4⁺ cell count but not with HIV and highly active antiretroviral therapy status

Aspergillus fumigatus carrying TR34/L98H resistance allele causing complicated suppurative otitis media in Tanzania: Call for improved diagnosis of fungi in sub-Saharan Africa

Oral candidiasis among African human immunodeficiency virus-infected individuals: 10 years of systematic review and meta-analysis from sub-Saharan Africa

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High Oral Carriage of Non- albicans Candida spp. among HIV-infected individuals

Abstract: The prevalence of NAC spp. is high among HIV-infected individuals with low CD4 count placing them at higher risk of invasive infections. Further studies to investigate the role of NAC spp. in causing invasive infections among immunocompromised patients are recommended.

Cited by 51 publications

References 26 publications

Oral candidal carriage correlates with CD4+ cell count but not with HIV and highly active antiretroviral therapy status

Oral candidal carriage correlates with CD4+ cell count but not with HIV and highly active antiretroviral therapy status

Aspergillus fumigatus carrying TR34/L98H resistance allele causing complicated suppurative otitis media in Tanzania: Call for improved diagnosis of fungi in sub-Saharan Africa

Oral candidiasis among African human immunodeficiency virus-infected individuals: 10 years of systematic review and meta-analysis from sub-Saharan Africa

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Oral candidal carriage correlates with CD4⁺ cell count but not with HIV and highly active antiretroviral therapy status

Oral candidal carriage correlates with CD4⁺ cell count but not with HIV and highly active antiretroviral therapy status