Paula Suelen Balero de, Morey Alexandre Tadachi, Santos Jussevania Pereira, Santos Pollyanna M C dos, Gameiro Danielle G, Kerbauy Gilselena, Sena Ester M, Ueda Luiz T, Carneiro Marcelo, Pinge-Filho Phileno, Yamauchi Lucy Megumi, Yamada-Ogatta Sueli Fumie
Universidade Estadual de Londrina, Londrina, Paraná (PR), Brasil.
J Infect Dev Ctries. 2015 Dec 30;9(12):1350-9. doi: 10.3855/jidc.6970.
Host colonization by Candida species is an important predisposing factor to candidiasis, which seems to be more frequent in human immunodeficiency virus (HIV)-infected patients. Knowledge about the distribution, antifungal susceptibility, and virulence of oral Candida isolates is important for effective management of candidiasis.
Oral rinses were collected from 242 HIV-infected patients without clinical evidence of candidiasis seen at the AIDS referral center in Londrina, Brazil. Species were identified by standard phenotypic and molecular methods, and characterized in vitro according to antifungal susceptibility, cell surface hydrophobicity, biofilm formation, and enzyme activities.
Oral Candida colonization was detected in 50.4% of patients and combined use of antiretroviral therapy and protease inhibitor had a protective effect against colonization. Candida albicans (75.2%) was the most prevalent species. A high proportion of Candida spp. (39.9%) showed decreased susceptibility to fluconazole. Five isolates were resistant to nystatin. Protease and phospholipase activities were detected in 100% and 36.8% of isolates, respectively. Most isolates displayed a hydrophobic property that was associated with biofilm formation ability.
A significant number of oral Candida species exhibiting decreased susceptibility to fluconazole were isolated from colonized HIV-infected individuals. Furthermore, all isolates expressed potential virulence attributes in vitro. Given the high incidence and severity of fungal infections in HIV-infected individuals, the results of this study reinforce the importance of antifungal susceptibility testing, which contributes to therapeutic strategies and highlights the need for continuous surveillance of Candida colonization in this population.
念珠菌属在宿主体内的定植是念珠菌病的一个重要易感因素，在人类免疫缺陷病毒（HIV）感染患者中似乎更为常见。了解口腔念珠菌分离株的分布、抗真菌药敏性和毒力对于念珠菌病的有效管理至关重要。
从巴西隆德里纳艾滋病转诊中心的242例无念珠菌病临床证据的HIV感染患者中收集口腔冲洗液。通过标准的表型和分子方法鉴定菌种，并根据抗真菌药敏性、细胞表面疏水性、生物膜形成和酶活性在体外进行表征。
50.4%的患者检测到口腔念珠菌定植，联合使用抗逆转录病毒疗法和蛋白酶抑制剂对定植有保护作用。白色念珠菌（75.2%）是最常见的菌种。高比例的念珠菌属（39.9%）对氟康唑敏感性降低。5株分离株对制霉菌素耐药。分别在100%和36.8%的分离株中检测到蛋白酶和磷脂酶活性。大多数分离株表现出与生物膜形成能力相关的疏水性。
从定植的HIV感染个体中分离出大量对氟康唑敏感性降低的口腔念珠菌菌种。此外，所有分离株在体外均表达潜在的毒力属性。鉴于HIV感染个体中真菌感染的高发病率和严重性，本研究结果强化了抗真菌药敏试验的重要性，其有助于制定治疗策略，并突出了对该人群念珠菌定植进行持续监测的必要性。
