Mycology Research Center, Faculty of Veterinary Medicine, University of Tehran, Azadi Sreet, Tehran, Iran.
J Mycol Med. 2013 Jun;23(2):105-12. doi: 10.1016/j.mycmed.2013.02.001. Epub 2013 May 27.
The purpose of this study was to determine the prevalence of oral microflora and association of oral candidiasis and multiple risk factors in HIV(+) patients.
The present study included 100 HIV-infected patients participated in Imam Khomeini Hospital, Tehran, Iran for Oropharyngeal candidiasis (OPC) and HIV. We assessed the presence or absence of OPC, and samples were obtained from the oral cavity and direct microscopic examination, gram staining and culture on standard microbiological media were performed in all patients. CD4(+) cell count/CD4(+) percentage were also calculated.
The demographic characteristics showed that the patients had a mean age of 32.3 years old, 78% male and 22% female. Patients belonging to 'O(+)' blood group (27%) were more prone to develop OPC. A total of 460 bacterial colonies were obtained and Streptococcus mutans (15.4%) was the most frequently isolated species in the HIV(+) patients, followed by Staphylococcus epidermidis (12.8%) and Corynebacterium (8.7%). In addition, 254 yeasts (from four different genera) were isolated from the patient under study. Candida species (94.4%) were the most frequently obtained genera, followed by Saccharomyces (2.4%), Kluyveromyces and Cryptococcus (1.6% for both) species. Candida albicans (37.2%) was the most common species isolated from HIV(+) patients with OPC and its frequency was significantly higher than that of other Candida species (P<0.05). Candida glabrata, C. dubliniensis, C. tropicalis, C. parapsilosis, C. krusei, C. lusitaniae, C. guilliermondii and C. norvegensis were also identified. Forty percent of the patients had angular cheilitis as the most frequent clinical variant. The mean CD4(+) cell counts were 154.5 cells/μL, with a range of 8 to 611 cells/μL. Thirty percent patients had a CD4(+) cell count between 101 and 200 cells/μL (28.7% of total yeasts isolated). Yeast and bacteria counts did not differ statistically among HIV(+) patients' subgroups with different levels of CD4(+) cells counts.
Our results showed that yeasts of the genus Candida were isolated at a comparable rate from the oral cavity of HIV(+) patients and there was no significant difference of the variables CD4(+) cell count and yeast counts. The findings of this study would be helpful in any further study, which, if done prospectively on a large cohort, can be confirmatory.
本研究旨在确定 HIV（+）患者口腔微生物群的流行情况以及口腔念珠菌病和多种危险因素之间的关联。
本研究纳入了 100 名在伊朗德黑兰伊玛目霍梅尼医院接受口腔念珠菌病（OPC）和 HIV 治疗的 HIV 感染患者。我们评估了 OPC 的存在与否，并从口腔中采集样本，对所有患者进行直接显微镜检查、革兰氏染色和标准微生物培养基培养。还计算了 CD4（+）细胞计数/CD4（+）百分比。
人口统计学特征显示，患者的平均年龄为 32.3 岁，男性占 78%，女性占 22%。属于“O（+）”血型的患者（27%）更容易发生 OPC。共获得 460 个细菌菌落，其中变形链球菌（15.4%）是 HIV（+）患者中最常分离的菌种，其次是表皮葡萄球菌（12.8%）和棒状杆菌（8.7%）。此外，从研究中的患者中分离出 254 株酵母（来自四个不同属）。念珠菌属（94.4%）是最常获得的属，其次是酿酒酵母（2.4%）、克鲁维酵母和隐球菌（各 1.6%）。从 HIV（+）并发 OPC 的患者中分离出的白色念珠菌（37.2%）是最常见的菌种，其频率明显高于其他念珠菌属（P<0.05）。还鉴定出近平滑念珠菌、都柏林念珠菌、热带念珠菌、近平滑念珠菌、光滑念珠菌、葡萄牙念珠菌、脆壁克鲁维酵母和挪威念珠菌。40%的患者出现口角炎，是最常见的临床变异。平均 CD4（+）细胞计数为 154.5 个/μL，范围为 8 至 611 个/μL。30%的患者 CD4（+）细胞计数在 101 至 200 个/μL 之间（占总分离出的酵母的 28.7%）。不同 CD4（+）细胞计数亚组的 HIV（+）患者中，酵母和细菌计数无统计学差异。
我们的结果表明，从 HIV（+）患者的口腔中以相当的比率分离出念珠菌属的酵母，并且 CD4（+）细胞计数和酵母计数没有显著差异。本研究的结果有助于任何进一步的研究，如果对大样本进行前瞻性研究，可以得到证实。
