Kaur Ravinder, Mehra Bhanu, Dhakad Megh Singh, Goyal Ritu, Bhalla Preena, Dewan Richa
Department of Microbiology, Lady Hardinge Medical College and Kalawati Saran Children Hospital, New Delhi, India.
Department of Microbiology, Dr. Baba Saheb Ambedkar Medical College and Hospital, New Delhi, India.
Indian J Sex Transm Dis AIDS. 2018 Jul-Dec;39(2):111-119. doi: 10.4103/ijstd.IJSTD_89_17.
Candidiasis is a common human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome-associated opportunistic mycoses. The present study ascertained the species spectrum of strains recovered from different clinical samples from symptomatic HIV-positive individuals and determined the antifungal susceptibility profile of the isolates.
A variety of specimens were collected from 234 symptomatic HIV seropositive individuals depending on their clinical manifestations and subjected to direct microscopic examination. Blood samples were inoculated in biphasic blood culture medium and all other specimens on Sabouraud dextrose agar with chloramphenicol and incubated at 35°C-37°C. Species identification of the recovered isolates was attempted on the basis of germ tube production, micromorphology on corn meal agar, color and morphology on HiCrome Candida Differential agar, and carbohydrate fermentation and assimilation tests. Susceptibility testing of the isolates was performed employing the VITEK 2 system.
A total of 167 isolates were obtained; (136), (13), (8), (5), (4), and (1). Fluconazole resistance was more frequent among nonalbicans species, and significantly higher 5-fluorocytosine resistance compared to was also observed. Eight strains (six , one , and one ) were multidrug resistant.
Although continues to be the leading etiological agent of candidiasis, the incidence of nonalbicans species among HIV-positive Indian individuals is rising. Antifungal resistance was higher among nonalbicans species. Another issue of therapeutic concern is the possible emergence of multidrug-resistant strains among these patients.
念珠菌病是一种常见的人类免疫缺陷病毒（HIV）/获得性免疫缺陷综合征相关的机会性真菌病。本研究确定了从有症状的HIV阳性个体的不同临床样本中分离出的菌株的种类谱，并测定了分离株的抗真菌药敏谱。
根据234例有症状的HIV血清阳性个体的临床表现采集了多种标本，并进行直接显微镜检查。将血样接种于双相血培养基中，将所有其他标本接种于含氯霉素的沙氏葡萄糖琼脂上，于35℃-37℃孵育。根据芽管产生情况、玉米粉琼脂上的微观形态、HiCrome念珠菌鉴别琼脂上的颜色和形态以及碳水化合物发酵和同化试验，对回收的分离株进行菌种鉴定。采用VITEK 2系统对分离株进行药敏试验。
共获得167株分离株；白色念珠菌（136株）、光滑念珠菌（13株）、热带念珠菌（8株）、近平滑念珠菌（5株）、克柔念珠菌（4株）和季也蒙念珠菌（1株）。非白色念珠菌属中氟康唑耐药更为常见，与白色念珠菌相比，5-氟胞嘧啶耐药也显著更高。8株念珠菌菌株（6株白色念珠菌、1株光滑念珠菌和1株热带念珠菌）为多重耐药。
虽然白色念珠菌仍然是念珠菌病的主要病原体，但在HIV阳性的印度个体中，非白色念珠菌属的发病率正在上升。非白色念珠菌属的抗真菌耐药性较高。另一个治疗方面令人担忧的问题是这些患者中可能出现多重耐药念珠菌菌株。
