Patel Payal K, Erlandsen Joshua E, Kirkpatrick William R, Berg Deborah K, Westbrook Steven D, Louden Christopher, Cornell John E, Thompson George R, Vallor Ana C, Wickes Brian L, Wiederhold Nathan P, Redding Spencer W, Patterson Thomas F
Department of Internal Medicine, The University of Texas Health Science Center at San Antonio, San Antonio, TX 78229-3900, USA.
AIDS Res Treat. 2012;2012:262471. doi: 10.1155/2012/262471. Epub 2012 Aug 28.
The impact of antiretroviral therapy (ART) on opportunistic conditions in HIV patients continues to evolve. We specifically studied the changing epidemiology of oropharyngeal candidiasis (OPC) in 215 HIV/AIDS patients. Status of yeast colonization was assessed from oral rinse samples, and preliminary yeast identification was made using CHROMagar Candida and confirmed with standard microbiological techniques and/or molecular sequencing. Susceptibility to fluconazole was determined by CHROMagar Candida agar dilution screening and CLSI broth microdilution. 176 (82%) patients were colonized and 59 (27%) patients had symptomatic OPC. Candida albicans was the most prevalent species, though C. glabrata and C. dubliniensis were detected in 29% of isolates. Decreased fluconazole susceptibility occurred in 10% of isolates. Previous ART reduced the risk of OPC, while smoking increased the risk of colonization. Oral yeast colonization and symptomatic infection remain common even with advances in HIV therapy. C. albicans is the most common species, but other yeasts are prevalent and may have decreased susceptibility to fluconazole.
抗逆转录病毒疗法（ART）对HIV患者机会性感染的影响仍在不断演变。我们专门研究了215例HIV/AIDS患者口腔念珠菌病（OPC）流行病学的变化。通过口腔冲洗样本评估酵母菌定植情况，并使用科玛嘉念珠菌显色培养基进行初步酵母菌鉴定，再用标准微生物技术和/或分子测序加以确认。通过科玛嘉念珠菌琼脂稀释筛选法和美国临床和实验室标准协会（CLSI）肉汤微量稀释法测定对氟康唑的敏感性。176例（82%）患者存在酵母菌定植，59例（27%）患者有症状性OPC。白色念珠菌是最常见的菌种，不过在29%的分离株中检测到了光滑念珠菌和都柏林念珠菌。10%的分离株对氟康唑的敏感性降低。既往接受ART可降低OPC风险，而吸烟会增加定植风险。即便HIV治疗取得进展，口腔酵母菌定植和症状性感染仍然常见。白色念珠菌是最常见的菌种，但其他酵母菌也很普遍，且可能对氟康唑的敏感性降低。
