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

Abstract

Introduction Oral candidiasis is one of the most common opportunistic infection in HIV/AIDS patient and it is caused by Candida species. The low absolute CD4+T-lymphocyte count has traditionally been cited as the greatest risk factor for the development of Oral Candidiasis. The aim of this study was to identify Candida species isolated from the oral cavity of HIV/AIDS patients, to determine their in vitro antifungal susceptibility and to investigate the possible risk factors associated with oral candidiasis. Methods This was a hospital based cross sectional study that was carried out for a period of 3 months amongst HIV/AIDS patients in Kumba District Hospital, whether on HAART or not. Mouth swabs were collected from 378 participants using sterile cotton wool swabs and 5ml venous blood were collected for determination of CD4 cell. Candida species were isolated and identified. Antifungal sensitivity testing was performed using modified kirby-bauer susceptibility testing technique. Results Candida species were present in 42.86% of the samples and Candida albicans was the most prevalent (60.2%) amongst the six Candida isolates identified, followed by Candida glabrata (16.9%), Candida krusei (12.3%), Candida tropicalis (6.4%), Candida parapsilosis (2.3%) and Candida pseudotropicalis (1.8%). Pregnancy, oral hygiene and antibiotic usage were significantly associated with oral candidiasis in HIV/AIDS patients (P<0.05). Oral candidiasis was mostly frequent in HIV/AIDS patients between 21-40 years. A CD4 cell count less than 200 cells/μl was a significant risk factor for acquiring oral candidiasis in HIV/AIDS patients (P<0.001). Nystatin was the most sensitive drug (83.6%) meanwhile ketonazole was the most resistant drug (29.2%), followed by fluconazole (24.6%) to all oral Candida isolates. Conclusion Oral Candida colonization occurs more frequently in HIV/AIDS patients and the is a need for the government to implement regular checks for opportunistic infections in HIV/AIDS patients, including oral candidiasis in HIV/AIDS patients to monitor disease progression and prevent subsequent complications such as candidemia and diarrhea.

Immune Sensing of Candida albicans

“…Oral candidiasis is prevalent in immunosuppressed individuals such as HIV patients, mouth and throat cancer patients, and patients taking oral steroids making them highly susceptible to infection. Although the surveillance for oral candidiasis is limited, it is estimated that 20–50% of HIV patients develop oral candidiasis [ 85 , 86 ]. The prevalence of oral candidiasis in HIV/AIDS patients suggests that CD4 + cells play an essential role in combating oral colonisation, which is in contrast to the case for other Candida infections.…”

The structure of the oropharyngeal genus Candida fungi community in HIVinfected patients

“…В ходе исследования микотической части микробиоты ротоглотки ВИЧ-инфицированных пациентов с клиническими проявлениями орофарингеального кандидоза мы подтвердили разнообразие видов грибов рода Candida, вовлеченных в патогенез заболевания, и доминирующую позицию C. albicans [5,6,7,8,9,10,11,12,13,14,15,16,18,21,22]. При этом было обнаружено, что сообщество грибов данного рода имеет разнообразную архитектуру.…”

“…При этом было обнаружено, что сообщество грибов данного рода имеет разнообразную архитектуру. Микроб может присутствовать в биотопе ротоглотки ВИЧинфицированных пациентов как монокультура или ассоциация коизолятов, что согласуется с ранее полученными данными [10,19] [6,8,9,10,11,12,14,17,18,20,21].…”

“…Кандидоз обусловлен массивным разрастанием популяции грибов рода Candida на поверхности слизистых ротоглотки, что становится заметно невооруженным глазом [15]. Сегодня известно о разнообразии видового спектра грибов рода Candida, которые могут одновременно поразить организм ВИЧ-инфицированного пациента [5,6,7,8,9,10,11,12,13,14,15,16,18,21,22]. Однако практичес ки отсутствует информация о структуре сообщества этих грибов у данного контингента пациентов.…”

Candida glabrata Antifungal Resistance and Virulence Factors, a Perfect Pathogenic Combination

“…Since the late 20th century, a progressive increase in the incidence of invasive fungal infections (IFIs) has been observed, with those caused by species of the genus Candida being more frequent (43–75%) [ 1 ]. Candida albicans is the most frequent causative agent of IFIs [ 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 ]; however, C. glabrata is increasingly being isolated in cases of invasive candidiasis [ 5 , 6 , 9 , 11 , 12 , 18 , 20 , 23 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 ] and is associated with increased mortality in patients [ 4 , 5 ]. This increase in the...…”