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喀麦隆西南地区昆巴区医院艾滋病毒/艾滋病患者口腔念珠菌病的患病率、危险因素及抗真菌药敏模式

The prevalence, risk factors and antifungal sensitivity pattern of oral candidiasis in HIV/AIDS patients in Kumba District Hospital, South West Region, Cameroon.

作者信息

Ambe Ngwa Fabrice, Longdoh Njunda Anna, Tebid Patience, Bobga Tanyi Pride, Nkfusai Claude Ngwayu, Ngwa Sangwe Bertrand, Nsai Frankline Sanyuy, Cumber Samuel Nambile

机构信息

Department of Medical Laboratory Sciences, Faculty Health Sciences, University of Buea, Buea, Cameroon.

Department of Microbiology and Parasitology, Faculty of Science, University of Buea, Buea, Cameroon.

出版信息

Pan Afr Med J. 2020 May 19;36:23. doi: 10.11604/pamj.2020.36.23.18202. eCollection 2020.

Abstract

INTRODUCTION

Oral candidiasis is one of the most common opportunistic infection in HIV/AIDS patient and it is caused by species. The low absolute CD4+T-lymphocyte count has traditionally been cited as the greatest risk factor for the development of Oral Candidiasis. The aim of this study was to identify species isolated from the oral cavity of HIV/AIDS patients, to determine their in vitro antifungal susceptibility and to investigate the possible risk factors associated with oral candidiasis.

METHODS

This was a hospital based cross sectional study that was carried out for a period of 3 months amongst HIV/AIDS patients in Kumba District Hospital, whether on HAART or not. Mouth swabs were collected from 378 participants using sterile cotton wool swabs and 5ml venous blood were collected for determination of CD4 cell. species were isolated and identified. Antifungal sensitivity testing was performed using modified kirby-bauer susceptibility testing technique.

RESULTS

species were present in 42.86% of the samples and was the most prevalent (60.2%) amongst the six isolates identified, followed by (16.9%), (12.3%), (6.4%), (2.3%) and (1.8%). Pregnancy, oral hygiene and antibiotic usage were significantly associated with oral candidiasis in HIV/AIDS patients (P<0.05). Oral candidiasis was mostly frequent in HIV/AIDS patients between 21-40 years. A CD4 cell count less than 200 cells/μl was a significant risk factor for acquiring oral candidiasis in HIV/AIDS patients (P<0.001). Nystatin was the most sensitive drug (83.6%) meanwhile ketonazole was the most resistant drug (29.2%), followed by fluconazole (24.6%) to all oral isolates.

CONCLUSION

Oral colonization occurs more frequently in HIV/AIDS patients and the is a need for the government to implement regular checks for opportunistic infections in HIV/AIDS patients, including oral candidiasis in HIV/AIDS patients to monitor disease progression and prevent subsequent complications such as candidemia and diarrhea.

摘要

引言

口腔念珠菌病是艾滋病患者最常见的机会性感染之一,由多种念珠菌引起。传统上,CD4+T淋巴细胞绝对计数低被认为是发生口腔念珠菌病的最大危险因素。本研究的目的是鉴定从艾滋病患者口腔分离出的念珠菌种类,确定其体外抗真菌药敏性,并调查与口腔念珠菌病相关的可能危险因素。

方法

这是一项基于医院的横断面研究,在昆巴地区医院对艾滋病患者进行了为期3个月的研究,无论患者是否接受高效抗逆转录病毒治疗(HAART)。使用无菌棉拭子从378名参与者中采集口腔拭子,并采集5ml静脉血用于测定CD4细胞。分离并鉴定念珠菌种类。采用改良的 Kirby-Bauer 药敏试验技术进行抗真菌药敏试验。

结果

42.86%的样本中存在念珠菌,在所鉴定的6种念珠菌分离株中,白色念珠菌最为常见(60.2%),其次是热带念珠菌(16.9%)、光滑念珠菌(12.3%)、近平滑念珠菌(6.4%)、季也蒙念珠菌(2.3%)和葡萄牙念珠菌(1.8%)。妊娠、口腔卫生和抗生素使用与艾滋病患者的口腔念珠菌病显著相关(P<0.05)。口腔念珠菌病在21至40岁的艾滋病患者中最为常见。CD4细胞计数低于200个/μl是艾滋病患者发生口腔念珠菌病的显著危险因素(P<0.001)。制霉菌素是最敏感的药物(83.6%),而酮康唑是最耐药的药物(29.2%),其次是氟康唑(24.6%),对所有口腔念珠菌分离株均如此。

结论

口腔念珠菌定植在艾滋病患者中更为常见,政府需要对艾滋病患者的机会性感染进行定期检查,包括艾滋病患者的口腔念珠菌病,以监测疾病进展并预防随后的并发症,如念珠菌血症和腹泻。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f70e/7392032/999ec3d6aafe/PAMJ-36-23-g001.jpg

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