Barasch Andrei, Safford Monika M, Dapkute-Marcus Ingrida, Fine Daniel H
Department of Diagnostic Sciences, University of Detroit Mercy School of Dentistry, Detroit, MI 48219-0900, USA.
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2004 Feb;97(2):204-7. doi: 10.1016/j.tripleo.2003.09.005.
We evaluated the effect of chlorhexidine (CHX) 0.12% rinses on the clinical and microbiologic manifestations of oral candidiasis in HIV-infected children.
This was a cross-sectional, clinical intervention study of 38 HIV-positive children. Inclusion in the study was based on oral examination and positive oral culture for Candida. At baseline, subjects with no clinical lesions but who were culture-positive for Candida (N = 9) were placed on preventive therapy of CHX q.d. for 90 days. Subjects with clinical oral candidiasis (N = 9) were placed on therapeutic CHX b.i.d. All 38 subjects received oral exams at monthly intervals. At 90 days oral mucosal samples were again taken for Candida. Colony-forming units (CFU) were determined before and after CHX treatment.
Of 18 culture-positive subjects, 12 were included in the CFU analyses. After 3 months of CHX oral rinse therapy, Candida was undetectable in 3 children; another 8 showed an average 2-fold reduction in CFU. In 1 child the number of CFU increased modestly. Overall, the average pre- and posttreatment mean CFU was 6.18 +/- 2.19 and 2.73 +/- 3.15, respectively (P = .009). Five patients with clinical oral candidiasis at baseline, including all 3 who had pseudomembranous candidiasis, were free of signs of disease at the end of the study.
This study suggests that the topical disinfectant CHX may be a promising agent for treating and preventing oral candidiasis in HIV-infected children.
我们评估了0.12%洗必泰（CHX）漱口液对HIV感染儿童口腔念珠菌病临床及微生物学表现的影响。
这是一项针对38名HIV阳性儿童的横断面临床干预研究。纳入研究基于口腔检查及念珠菌口腔培养阳性。基线时，无临床损害但念珠菌培养阳性的受试者（N = 9）接受CHX每日一次预防性治疗，为期90天。有口腔念珠菌病临床症状的受试者（N = 9）接受CHX每日两次治疗。所有38名受试者每月进行一次口腔检查。90天时再次采集口腔黏膜样本检测念珠菌。在CHX治疗前后测定菌落形成单位（CFU）。
18名培养阳性受试者中，12名纳入CFU分析。CHX口腔漱口液治疗3个月后，3名儿童念珠菌检测不到；另外8名CFU平均降低2倍。1名儿童CFU数量略有增加。总体而言，治疗前和治疗后平均CFU分别为6.18±2.19和2.73±3.15（P = 0.009）。基线时有口腔念珠菌病临床症状的5名患者，包括所有3名患有假膜性念珠菌病的患者，在研究结束时无疾病体征。
本研究表明，局部消毒剂CHX可能是治疗和预防HIV感染儿童口腔念珠菌病的一种有前景的药物。
