Dos Santos Abrantes Pedro Miguel, McArthur Carole P, Africa Charlene Wilma Joyce
Oral Microbiology Group, Department of Medical Biosciences, University of the Western Cape, Cape Town, South Africa.
Department of Oral and Craniofacial Science, School of Dentistry, University of Missouri-Kansas City, Kansas City, USA.
Diagn Microbiol Infect Dis. 2014 Jun;79(2):222-7. doi: 10.1016/j.diagmicrobio.2013.09.016. Epub 2013 Nov 26.
Candida species are a common cause of infection in immune-compromised HIV-positive individuals, who are usually treated with the antifungal drug, fluconazole, in public hospitals in Africa. However, information about the prevalence of drug resistance to fluconazole and other antifungal agents on Candida species is very limited. This study examined 128 Candida isolates from South Africa and 126 Cameroonian Candida isolates for determination of species prevalence and antifungal drug susceptibility. The isolates were characterized by growth on chromogenic and selective media and by their susceptibility to 9 antifungal drugs tested using the TREK™ YeastOne9 drug panel (Thermo Scientific, USA). Eighty-three percent (82.8%) of South African isolates were Candida albicans (106 isolates), 9.4% were Candida glabrata (12 isolates), and 7.8% were Candida dubliniensis (10 isolates). Of the Cameroonian isolates, 73.02% were C. albicans (92 isolates); 19.05% C. glabrata (24 isolates); 3.2% Candida tropicalis (4 isolates); 2.4% Candida krusei (3 isolates); 1.59% either Candida kefyr, Candida parapsilopsis, or Candida lusitaneae (2 isolates); and 0.79% C. dubliniensis (1 isolate). Widespread C. albicans resistance to azoles was detected phenotypically in both populations. Differences in drug resistance were seen within C. glabrata found in both populations. Echinocandin drugs were more effective on isolates obtained from the Cameroon than in South Africa. A multiple-drug resistant C. dubliniensis strain isolated from the South African samples was inhibited only by 5-flucytosine in vitro on the YO9 panel. Drug resistance among oral Candida species is common among African HIV patients in these 2 countries. Regional surveillance of Candida species drug susceptibility should be undertaken to ensure effective treatment for HIV-positive patients.
念珠菌属是免疫功能低下的HIV阳性个体感染的常见原因，在非洲的公立医院，这些患者通常接受抗真菌药物氟康唑治疗。然而，关于念珠菌属对氟康唑和其他抗真菌药物耐药性流行情况的信息非常有限。本研究检测了来自南非的128株念珠菌分离株和喀麦隆的126株念珠菌分离株，以确定菌种流行情况和抗真菌药物敏感性。通过在显色和选择性培养基上生长以及使用TREK™ YeastOne9药物板（美国赛默飞世尔科技公司）测试其对9种抗真菌药物的敏感性来对分离株进行鉴定。南非分离株中83%（82.8%）为白色念珠菌（106株），9.4%为光滑念珠菌（12株），7.8%为都柏林念珠菌（10株）。喀麦隆分离株中，73.02%为白色念珠菌（92株）；19.05%为光滑念珠菌（24株）；3.2%为热带念珠菌（4株）；2.4%为克柔念珠菌（3株）；1.59%为凯菲念珠菌、近平滑念珠菌或葡萄牙念珠菌（2株）；0.79%为都柏林念珠菌（1株）。在这两个群体中均从表型上检测到白色念珠菌对唑类药物的广泛耐药性。在两个群体中分离出的光滑念珠菌内均发现了耐药性差异。棘白菌素类药物对从喀麦隆获得的分离株比对南非的分离株更有效。从南非样本中分离出的一株多重耐药都柏林念珠菌菌株在YO9板上体外仅被5-氟胞嘧啶抑制。在这两个国家的非洲HIV患者中，口腔念珠菌属的耐药情况很常见。应开展念珠菌属药物敏感性的区域监测，以确保对HIV阳性患者进行有效治疗。
