Bussaratid Valai, Tansupasawasdikul Somsit, Simpson Andrew, Pitisuttithum Punnee, Phonrat Benjaluck, Howe Paul, White Nicholas J
Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
J Med Assoc Thai. 2002 Jul;85(7):757-64.
OPC is a common opportunistic infection in HIV-infected patients. Although some patients are asymptomatic, progression of the disease may occur leading to esophageal candidiasis. Fluconazole resistant candidiasis has been reported in several international studies.
This study aimed to test the MICs (minimal inhibitory concentrations) to fluconazole of Candida species isolated from mouthwash specimens of 54 HIV positive patients with oral candidiasis. Clinical and mycological responses to fluconazole were also assessed in 16 patients.
This was a prospective study. Mouthwash specimens were cultured on sabouraud dextrose agar twice. Candida species identification was performed and MICs for fluconazole were obtained using NCCLS guidelines. Clinical and mycological responses were assessed on day 14 and 42 in 16 patients who received a 14-day course of fluconazole.
48/54 patients (88.89%) were found to carry pure C. albicans. The other 6 patients (11.11%) had mixed Candida species on cultures. Among these 6 patients, 5 patients had mixed C. albicans and C. glabrata, and 1 patient had C. albicans and C. krusei. Fluconazole MICs of C. albicans, C. glabrata, and C. krusei ranged from 0.125-32 (median=0.250), 4-64 (median=2), and 8 g/L respectively. This study showed that the MICs to fluconazole of oropharyngeal Candida was a good predictor of the therapeutic responses.
口腔念珠菌病是HIV感染患者常见的机会性感染。尽管一些患者无症状，但疾病仍可能进展并导致食管念珠菌病。多项国际研究报告了氟康唑耐药念珠菌病。
本研究旨在检测从54例患有口腔念珠菌病的HIV阳性患者漱口液标本中分离出的念珠菌属对氟康唑的最低抑菌浓度（MIC）。还对16例患者使用氟康唑后的临床和真菌学反应进行了评估。
这是一项前瞻性研究。漱口液标本在沙氏葡萄糖琼脂上培养两次。进行念珠菌属鉴定，并根据美国国家临床实验室标准委员会（NCCLS）指南获得氟康唑的MIC。对接受14天氟康唑疗程的16例患者在第14天和第42天评估临床和真菌学反应。
54例患者中有48例（88.89%）被发现携带单纯白色念珠菌。其他6例患者（11.11%）培养结果为念珠菌属混合感染。在这6例患者中，5例为白色念珠菌和光滑念珠菌混合感染，1例为白色念珠菌和克柔念珠菌混合感染。白色念珠菌、光滑念珠菌和克柔念珠菌的氟康唑MIC范围分别为0.125 - 32（中位数 = 0.250）、4 - 64（中位数 = 2）和8 g/L。本研究表明，口咽念珠菌对氟康唑的MIC是治疗反应的良好预测指标。
