Candidaspecies diversity and antifungal susceptibility patterns in oral samples of HIV/AIDS patients in Baja California, Mexico

Abstract

Candidiasis is the most common opportunistic fungal infection in HIV patients. The aims of this study were to identify the prevalence of carriers of Candida, Candida species diversity, and in vitro susceptibility to antifungal drugs. In 297 HIV/AIDS patients in Baja California, Mexico, Candida strains were identified by molecular methods (PCR-RFLP) from isolates of oral rinses of patients in Tijuana, Mexicali, and Ensenada. 56.3% of patients were colonized or infected with Candida. In Tijuana, there was a significantly higher percentage of carriers (75.5%). Out of the 181 strains that were isolated, 71.8% were Candida albicans and 28.2% were non-albicans species. The most common non-albicans species was Candida tropicalis (12.2%), followed by Candida glabrata (8.3%), Candida parapsilosis (2.2%), Candida krusei (1.7%), and Candida guilliermondii (1.1%). Candida dubliniensis was not isolated. Two associated species were found in 11 patients. In Mexicali and Ensenada, there was a lower proportion of Candida carriers compared to other regions in Mexico and worldwide, however, in Tijuana, a border town with many peculiarities, a higher carrier rate was found. In this population, only a high viral load was associated with oral Candida carriers. Other factors such as gender, use of antiretroviral therapy, CD4+ T-lymphocyte levels, time since diagnosis, and alcohol/ tobacco consumption, were not associated with Candida carriers.

The prevalence, risk factors and antifungal sensitivity pattern of oral candidiasis in HIV/AIDS patients in Kumba District Hospital, South West Region, Cameroon

“…Consequently, increase resistance to the drug poses a threat not only to the treatment of oral candidiasis HIV/AIDS patient, but also to the management of systemic fungi infections HIV/AIDS patients. The other azoles recorded resistance which was closely similar to fluconazole; this is in contrary to previous study [ 28 ]. This is probably due to cross resistance to fluconazole, since all azoles exert the same mechanism of action and fluconazole was routinely administered to HIV/AIDS patients with clinical symptoms of candidiasis without prior antifungal susceptibility testing in these center.…”

“…Our finding indicated that amongst all Candida isolates tested, nystatin was the most sensitive antifungal drug (83.6%), followed by amphotericin (76%) and miconazole (74.3%). This finding partly agree with a similar study carried out in Mexico [ 28 ], where nystatin and amphotericin were the most sensitive antifungal tested. This finding is in contrast with a similar study carried out in Cameroon by Njunda et al [ 15 ], where ketonazole was found to be the most sensitive antifungal drug (85.5%).…”

“…The carriage rate was found to be more in women (30.69%) than in men (12.17%), but these different in prevalence was not statistically significant (P=0.598). This difference in prevalence is in conformity with studies carried out in Cameroon [ 15 ] and Mexico [ 28 ]. This difference is probably because most men rarely go for routine checkups until the disease has reached symptomatic stage and as at the time of this study only a few men consented.…”

“…Participants around the age group of 21-40 year accounted for the highest prevalence rate (21.43%), but the difference in prevalence rate among age groups was not observed to be statistically significant (P=0.755). This result is in line with a study carryout in Cameroon [ 15 ], but contrary to study carried out in Mexico [ 28 ] which shows that Candida colonization was age dependent. This highest prevalence rate between these age group (21-40 year) is probably due to the fact that, they represent majority of the study participants and which constituted the highest active sex group which may also spread oral candidiasis exogenously.…”

Interactions between Candida albicans and Candida glabrata in biofilms: Influence of the strain type, culture medium and glucose supplementation

“…In this sense, it was recently demonstrated a higher prevalence of Candida species in the oral cavity of diabetic patients compared to non‐diabetics, being Candida albicans the most frequently isolated microorganism from the two groups of patients . This species was also the most found in the oral cavity of individuals carrying the human immunodeficiency virus …”