Melo Nadja R, Taguchi Hideaki, Culhari Vitoria P, Kamei Katsuhiko, Mikami Yuzuru, Smith Stephen N, Vilela Marluce S
Center of Pediatric Investigation, University of Campinas State, Brazil.
Med Mycol. 2009 Mar;47(2):149-56. doi: 10.1080/13693780802195315.
Candida oral flora from 52 Brazilian HIV-infected children was characterized while they received antiviral monotherapy therapy and subsequently, HAART with the use of protease inhibitor. There was a significant increase in non-C. albicans Candida isolates from 9.6-28.8% (P=0.005) after the children were placed on protease inhibitor therapy. Although Candida albicans still remained the most commonly isolated species, relative presence of C. tropicalis (n=9) followed by C. parapsilosis (n=8) markedly increased in association with protease inhibitor therapy. Furthermore, rare Candida species including C. dubliniensis, C. norvegensis, C. humicula and C. rugosa also appeared after the onset of protease inhibitor therapy. Subsequent investigation of the antifungal sensitivity of these diverse isolates, derived during protease inhibitor therapy, demonstrated some variation in antifungal sensitivity. With notable exceptions, the majority were sensitive to amphotericin B while most C. albicans and non-C. albicans Candida isolates were also susceptible to fluconazole, itraconazole and ketoconazole. Amongst exceptions was a single C. tropicalis isolates which was resistant to fluconazole (MIC>64 microl/ml) and one C. albicans-B isolate which showed cross-resistance to all azoles and amphotericin.
对52名接受抗逆转录病毒单药治疗以及随后使用蛋白酶抑制剂进行高效抗逆转录病毒治疗（HAART）的巴西HIV感染儿童的口腔念珠菌菌群进行了特征分析。在儿童接受蛋白酶抑制剂治疗后，非白色念珠菌分离株从9.6%显著增加至28.8%（P=0.005）。尽管白色念珠菌仍然是最常分离出的菌种，但热带念珠菌（n=9）和近平滑念珠菌（n=8）的相对占比在蛋白酶抑制剂治疗后显著增加。此外，包括都柏林念珠菌、挪威念珠菌、腐皮念珠菌和皱落念珠菌在内的罕见念珠菌种在蛋白酶抑制剂治疗开始后也出现了。随后对这些在蛋白酶抑制剂治疗期间分离出的不同菌株进行抗真菌敏感性研究，结果显示抗真菌敏感性存在一些差异。除了显著的例外情况，大多数菌株对两性霉素B敏感，而大多数白色念珠菌和非白色念珠菌分离株也对氟康唑、伊曲康唑和酮康唑敏感。例外情况包括一株对氟康唑耐药（MIC>64微克/毫升）的热带念珠菌分离株和一株对所有唑类药物和两性霉素均表现出交叉耐药性的白色念珠菌-B分离株。
