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撒哈拉以南非洲地区10年系统评价与荟萃分析:非洲人类免疫缺陷病毒感染者的口腔念珠菌病

Oral candidiasis among African human immunodeficiency virus-infected individuals: 10 years of systematic review and meta-analysis from sub-Saharan Africa.

作者信息

Mushi Martha F, Bader Oliver, Taverne-Ghadwal Liliane, Bii Christine, Groß Uwe, Mshana Stephen E

机构信息

Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Heath and Allied Sciences, Mwanza, Tanzania.

Institute of Medical Microbiology, University Medical Center, Göttingen, Germany.

出版信息

J Oral Microbiol. 2017 Jun 21;9(1):1317579. doi: 10.1080/20002297.2017.1317579. eCollection 2017.

Abstract

Oral candidiasis (OC) is the most common opportunistic fungal infection among immunocompromised individuals. This systematic review and meta-analysis reports on the contribution of non- species in causing OC among human immunodeficiency virus (HIV)-infected individuals in sub-Saharan Africa between 2005 and 2015. Thirteen original research articles on oral infection/colonization among HIV-infected African populations were reviewed. The prevalence of OC ranged from 7.6% to 75.3%. Pseudomembranous candidiasis was found to range from 12.1% to 66.7%. The prevalence of non- species causing OC was 33.5% [95% confidence interval (CI) 30.9-36.39%]. Of 458 non- species detected, . (23.8%; 109/458) was the most common, followed by . (22%; 101/458) and . (10.7%; 49/458). The overall fluconazole resistance was 39.3% (95% CI 34.4-44.1%). was significantly more resistant than non-albicans species to fluconazole (44.7% vs 21.9%;  < 0.001). One-quarter of the cases of OC among HIV-infected individuals in sub-Saharan Africa were due to non- species. isolates were more resistant than the non- species to fluconazole and voriconazole. Strengthening the capacity for fungal diagnosis and antifungal susceptibility testing in sub-Saharan Africa is mandatory in order to track the azole resistance trend.

摘要

口腔念珠菌病(OC)是免疫功能低下个体中最常见的机会性真菌感染。本系统评价和荟萃分析报告了2005年至2015年期间,在撒哈拉以南非洲地区感染人类免疫缺陷病毒(HIV)的个体中,非白色念珠菌属在引起OC方面的作用。对13篇关于非洲HIV感染人群口腔感染/定植的原始研究文章进行了综述。OC的患病率在7.6%至75.3%之间。发现假膜性念珠菌病的患病率在12.1%至66.7%之间。引起OC的非白色念珠菌属的患病率为33.5%[95%置信区间(CI)30.9 - 36.39%]。在检测到的458株非白色念珠菌属中,热带念珠菌(23.8%;109/458)最为常见,其次是光滑念珠菌(22%;101/458)和近平滑念珠菌(10.7%;49/458)。氟康唑总体耐药率为39.3%(95%CI 34.4 - 44.1%)。热带念珠菌对氟康唑的耐药性显著高于非白色念珠菌属(44.7%对21.9%;P<0.001)。在撒哈拉以南非洲地区,四分之一的HIV感染个体的OC病例是由非白色念珠菌属引起的。热带念珠菌分离株对氟康唑和伏立康唑的耐药性高于非白色念珠菌属。为了追踪唑类耐药趋势,加强撒哈拉以南非洲地区的真菌诊断和抗真菌药敏试验能力是必不可少的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/933c/5508360/75b0c2b8389e/zjom_a_1317579_f0001_b.jpg

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