Oropharyngeal Colonization of HIV-Infected Outpatients in Taiwan by Yeast Pathogens

Yang, Yun-Liang; Hung, Chien‐Ching; Wang, An-Huei; Tseng, Fan-Chen; Leaw, Shiang Ning; Tseng, Yu-Tzu; Su, Chia-Li; Chen, Huiting; Lauderdale, Tsai‐Ling; Lo, Hsiu‐Jung

doi:10.1128/jcm.00500-10

Cited by 18 publications

(24 citation statements)

References 26 publications

(26 reference statements)

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“…These results support previous studies performed in the oral cavity of HIV-positive patients 3,13,27,40 . Even though C. albicans was the most common species recovered, the non-albicans Candida species have become more recognized as a major source of infection.…”

supporting

confidence: 93%

“…Other studies have also found no correlation between CD4+ T-lymphocyte counts and yeast colonization 2,7,19,20 . On the other hand, BACK-BRITO et al 2 and YANG et al 40 observed significantly lower yeast counts in patients with a lower viral load (< 400 copies/mL), suggesting that viral load might be a higher risk factor for the occurrence of candidiasis as compared to the CD4+ T-lymphocyte count. …”

Section: Discussionmentioning

confidence: 95%

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Oral colonization by yeasts in HIV-positive patients in Brazil

Junqueira

Vilela

Rossoni

et al. 2012

Rev. Inst. Med. trop. S. Paulo

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INTRODUCTION: In HIV-infected patients, colonization of the oral cavity by potential pathogenic yeast may lead to development of systemic fungemia. We evaluated the prevalence of yeast in the oral cavity of Brazilian HIV-positive patients and verified whether or not the species characterized were enzymatically active. Furthermore, the species identified were tested for their susceptibility to antifungal treatment. METHODS: Patient saliva and oropharyngeal candidiasis samples were collected from 60 seropositive HIV patients and identified by the API20C system. Enzymatic activity was evaluated by the production of proteinase and phospholipase. Susceptibility to antifungal treatments were determined using the broth microdilution method. RESULTS: the most commonly isolated species were C. albicans (51.56%) followed by non-albicans Candida species (43.73%), Trichosporon mucoides (3.12%) and Kodamaea ohmeri (1.56%). Oral colonization by association of different species was observed in 42% of the patients. Enzymatic activity was verified in most of species isolated, except for C. glabrata, C. lusitaniae and C. guilliermondii. Resistance to Fluconazole and Amphotericin B was observed in isolates of C. albicans, C. glabrata, C. parapsilosis, C. krusei, and K. ohmeri. CONCLUSION: HIV-positive patients are orally colonized by single or multiple species of yeast that are occasionally resistant to Fluconazole or Amphotericin B.

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supporting

confidence: 93%

Section: Discussionmentioning

confidence: 95%

Oral colonization by yeasts in HIV-positive patients in Brazil

Junqueira

Vilela

Rossoni

et al. 2012

Rev. Inst. Med. trop. S. Paulo

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“…The demographic and microbiological characteristics of oropharyngeal yeast colonization in HIV‐infected and non‐HIV‐infected populations in our previous reports [1,6,15] and the present study were compared. With the introduction of HAART, the mean CD4 cell counts gradually increased over time (from 208 cells/mm 3 in 1999–2002 to 478 cells/mm 3 in 2009–2010, respectively), which coincided with a reduced rate of patients with recent or current oral thrush (from 12.9% in 1999–2002 to 4.7% in 2009–2010).…”

Section: Discussionmentioning

confidence: 99%

“…Consequently, the number of patients receiving HAART has increased in the recent decade. Although the risk factors and species distribution of oropharyngeal yeast colonization in HIV‐infected patients had been discussed in our previous studies conducted in 1999–2002 and 2005 [1,6], the effect of different antiretroviral agents on colonization was not addressed. Moreover, there was a dramatic increase in the population of HIV‐infected intravenous drug users (IDUs) between 2004 and 2006 in Taiwan [11].…”

Section: Introductionmentioning

confidence: 99%

Oropharyngeal yeast colonization in HIV-infected outpatients in southern Taiwan: CD4 count, efavirenz therapy and intravenous drug use matter

Lee

Yang

et al. 2012

Clinical Microbiology and Infection

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To understand the status of oropharyngeal yeast colonization in human immunodeficiency virus (HIV) -infected outpatients in the era of highly active antiretroviral therapy (HAART), we conducted a prospective, cross-sectional study from October 2009 to January 2010 at a medical centre in southern Taiwan. Fungal cultures of the oropharyngeal swabs were performed on 327 enrolled patients. At enrolment, 258 (79%) patients had been receiving HAART, and 42 (12.8%), 73 (22.3%) and 212 (64.8%) patients had CD4 cell counts ≤200, 201-350, and >350 cells/mm(3) , respectively. Oral yeast colonization was detected in 193 (59%) patients, among whom 157 (81.3%), 25 (13.0%), and 11 (5.7%) were colonized by a single, two and more than two species, respectively. Multivariate analysis showed that receipt of efavirenz-containing regiments and CD4 cell counts >200 cells/mm(3) were associated with lower risks of oral yeast colonization, while intravenous drug users were at a higher risk. Among the 241 isolates recovered, Candida albicans accounted for 69.7%, followed by C. dubliniensis (9.5%), C. glabrata (8.3%), C. tropicalis (3.3%), C. intermedia (2.1%), C. parapsilosis (1.7%), and 11 other species (5.4%). Overall, 230 (95.4%), 236 (97.9%) and 240 (99.6%) isolates were susceptible to fluconazole, voriconazole and amphotericin B, respectively. In conclusion, colonization by C. dubliniensis has emerged in recent years. In addition to a CD4 cell count ≤200 cells/mm(3) , which is a known risk factor for oropharyngeal yeast colonization in HIV-infected patients that was identified in our previous studies, two risk factors, non-receipt of efavirenz-based combinations and intravenous drug use, were first identified in the present study. Fluconazole remained effective in vitro against the yeasts colonizing the oropharynx in this population.

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“…In (HIV)-infected patients, oropharyngeal colonization by Candida causes subsequent development of yeast infections; however, long-term therapy might lead to resistance development [6]. According to the literature, the investigation for natural products to be used against Candida species increased significantly in the last 10 years examining approximately 258 plant species from 94 families [2,7].…”

Section: Introductionmentioning

confidence: 99%

In vitro Antifungal Activity of Cucumis melo on Candida albicans

Azizi

Rouhi

Yahyayi

2015

Zahedan J Res Med Sci

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Background: With respect to the emergence of susceptibility of some fungi to antifungal agents, making use of medicinal plants is progressing. Objectives: The aim of this study was to verify the anti-fungal characteristics of mature and immature Cucumis melo fruit on Candida albicans. Materials and Methods: In this descriptive study, antifungal activity of aqueous, ethnolic and methanolic extracts of C. melo fruits were tested on C. albicans; also results were obtained by disc and well diffusion methods. Results: Minimum inhibitory concentration (MIC) and minimum fungicidal concentration (MFC) of mature C. melo fruit methanolic extract were 25 × 10 3 and 5 × 10 4 μg/mL, respectively. MIC and MFC of immature fruit methanolic extract was 25 × 10 3 . For mature fruit ethanolic extract, MIC and MFC was 25 × 10 3 μg/mL and for immature C. melo fruit ethanolic extract MIC was 25 × 10 3 and MFC was 5 × 10 4 μg/mL. Gas chromatography/mass spectrometry (GC/MS) results showed that hexadecanoic acid was present in all of the extracts. The maximum size of inhibition zone for mature and immature methanolic extact in the disc method was 12 mm and in well method were 15 and 17 mm, respectively. In the disc method, for mature and immature ethanolic extracts maximum size of inhibition zones were 35 and 36 mm and in the well method, maximum size of inhibition zones for mature and immature ethanolic extracts were 28 and 15 mm, respectively. Conclusions: These results indicated that C. melo extracts contain compounds with therapeutic potential and anti-fungal characteristics against C. albicans.

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Oropharyngeal Colonization of HIV-Infected Outpatients in Taiwan by Yeast Pathogens

Cited by 18 publications

References 26 publications

Oral colonization by yeasts in HIV-positive patients in Brazil

Oral colonization by yeasts in HIV-positive patients in Brazil

Oropharyngeal yeast colonization in HIV-infected outpatients in southern Taiwan: CD4 count, efavirenz therapy and intravenous drug use matter

In vitro Antifungal Activity of Cucumis melo on Candida albicans

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