RELATED FACTORS FOR COLONIZATION BY Candida SPECIES IN THE ORAL CAVITY OF HIV-INFECTED INDIVIDUALS

Abstract

The colonization of the oral cavity is a prerequisite to the development of oropharyngeal candidiasis.Aims: The aims of this study were: to evaluate colonization and quantify Candida spp. in the oral cavity; to determine the predisposing factors for colonization; and to correlate the levels of CD4+ cells and viral load with the yeast count of colony forming units per milliliter (CFU/mL) in HIV-positive individuals treated at a University Hospital. Saliva samples were collected from 147 HIV patients and were plated on Sabouraud Dextrose Agar (SDA) and chromogenic agar, and incubated at 30 ºC for 72 h. Colonies with similar morphology in both media were counted and the result expressed in CFU/mL. Results: Of the 147 HIV patients, 89 had positive cultures for Candida spp., with a total of 111 isolates, of which C. albicans was the most frequent species (67.6%), and the mean of colonies counted was 8.8 × 10³ CFU/mL. The main predisposing factors for oral colonization by Candida spp. were the use of antibiotics and oral prostheses. The use of reverse transcriptase inhibitors appears to have a greater protective effect for colonization. A low CD4+ T lymphocyte count is associated with a higher density of yeast in the saliva of HIV patients.

Differences by Resistotyping Between C. albicans Strains Isolated from the Oral Cavity of HIV+ and Seronegative Patients

“…In a study of sixteen different resistograms from 198 oral isolates from 22 normal subjects (24), it was found that a particular strain tends to persist in the oral cavity of normal subjects although some changes can occur in these C. albicans biotypes. Differences in oral colonization by Candida species may be strongly influenced by ethnic, geographical and sociodemographic factors (19,25,26).…”

<i>In vivo</i> study of antifungal effects of low-molecular-weight chitosan against <i>Candida albicans </i>

“…Other members of the Candida species are C. guilliermondii, C. parapsilosis, C. krusei, and C. tropicalis; these are found in the oral cavity but rarely cause disease (1)(2)(3). C. albicans exists in a yeast form that is relatively safe and a hyphae form that is usually associated with invasion of host tissue (2)(3)(4).…”

“…Other members of the Candida species are C. guilliermondii, C. parapsilosis, C. krusei, and C. tropicalis; these are found in the oral cavity but rarely cause disease (1)(2)(3). C. albicans exists in a yeast form that is relatively safe and a hyphae form that is usually associated with invasion of host tissue (2)(3)(4). At least three factors determine the clinical existence of a fungal infection: the immune status of the host (1,2,5), the status of the oral cavity (1,2), and the fungal species involved (1,3).…”

“…C. albicans exists in a yeast form that is relatively safe and a hyphae form that is usually associated with invasion of host tissue (2)(3)(4). At least three factors determine the clinical existence of a fungal infection: the immune status of the host (1,2,5), the status of the oral cavity (1,2), and the fungal species involved (1,3). Candida infections have various clinical forms based on interactions between the host and the organism; these range from superficial mild involvement of the mucosa to a disseminated fatal disease in immune-compromised patients (1,2).…”

“…However, topical use of nystatin produces an unpleasant taste in the mouth and, if swallowed, can cause symptoms such as nausea, vomiting, and diarrhea. Azoles may be systemically used for primary deep candidosis such as denture stomatitis and chronic hyperplastic candidosis; however, one harmful effect of the topical application of azoles is their absorption through the gastrointestinal tract (1)(2)(3)9).…”