Dieng Y, Faye-Niang M A, Ndour-Diop A, Sow P S, Dieng T, Soumare M, Bah I B, Faye O, Diop B M, Gaye O, Ndir O, Diallo S
Service de de parasitologie et Mycologie de la Faculté de Médecien de Dakar - UCAD (Sénégal).
Dakar Med. 2001;46(1):4-7.
Candidiasis are very usual infections of HIV infected patients. By medicine pressure, susceptibility to antifungal drugs decrease in some Candida strains. This study carded out in 1997 at hospital, aimed to identify the yeast species isolated from HIV infected patients with oropharyngeal candidiasis, test their susceptibility to antifungal drugs and a previous antifungal treatment impact. Thus, 60 patients yielded to questionnary were recruited. Isolated yeast colonies from buccal tract after culture on Sabouraud medium with chloramphenicol were identified with the API 20 C AUX (BioMérieux) system by assimilation of different sugars. Susceptibility was evaluated by ATB FUNGUS (BioMérieux) system. 55 from the 60 isolated yeasts were identified and among them C. albicans and C. tropicalis were the main species with 75% and 11,7% respectively rates. In HIV1 infected patients, all specieswere isolated and C. albicans predominated (80,4%) on the other hand, C. albicans and C. tropicalis were the only isolated yeasts from the HIV2 infected patients with 83,3% and 16,6% respectively rates. Susceptibility of C. albicans was 72,2% to nystatine, 58,3% to amphotericin B, 83,3% to flucytosin, 12,8% to miconazole, 8,5% to econazole and 10,6% to ketoconazole. Susceptibility of C. albicans to polyenes was modified by a previous antifungal treatment. This study indicated emergence of saprophytic yeasts of the buccal mucosa and seemed to be more fostered by HIV1 serotype than HIV2. So, C. albicans's susceptibility to polyenes decreased by untimely use of antifungal drugs and by controlling it one could improve the clinic conditions of HIV infected patients.
念珠菌病是HIV感染患者非常常见的感染。由于药物压力,一些念珠菌菌株对抗真菌药物的敏感性降低。这项于1997年在医院进行的研究旨在鉴定从患有口咽念珠菌病的HIV感染患者中分离出的酵母菌种,测试它们对抗真菌药物的敏感性以及先前抗真菌治疗的影响。因此,招募了60名接受问卷调查的患者。在含有氯霉素的沙氏培养基上培养后,从颊部分离出的酵母菌落通过对不同糖类的同化作用,用API 20 C AUX(生物梅里埃公司)系统进行鉴定。敏感性通过ATB FUNGUS(生物梅里埃公司)系统进行评估。60株分离出的酵母中有55株被鉴定出来,其中白色念珠菌和热带念珠菌是主要菌种,分别占75%和11.7%。在HIV-1感染患者中,分离出了所有菌种,白色念珠菌占主导(80.4%);另一方面,白色念珠菌和热带念珠菌是从HIV-2感染患者中分离出的仅有的酵母菌种,分别占83.3%和16.6%。白色念珠菌对制霉菌素的敏感性为72.2%,对两性霉素B为58.3%,对氟胞嘧啶为83.3%,对咪康唑为12.8%,对益康唑为8.5%,对酮康唑为10.6%。先前的抗真菌治疗改变了白色念珠菌对多烯类药物的敏感性。这项研究表明颊黏膜腐生酵母出现,并且似乎HIV-1血清型比HIV-2更易促进其出现。所以,白色念珠菌对多烯类药物的敏感性因抗真菌药物的不当使用而降低,通过控制这一点可以改善HIV感染患者的临床状况。