Benson Musinguzi, Turyamuhika Laban, Mwesigwa Alex, Nalumaga Pauline Petra, Kabajulizi Immaculate, Njovu Israel Kiiza, Mwebesa Edson, Luggya Tonny, Ocheng Francis, Kateete David Patrick, Itabangi Herbert, Mboowa Gerald, Sande Obondo James, Achan Beatrice
Department of Immunology and Molecular Biology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda.
Department of Medical Laboratory Sciences, Faculty of Health Sciences, Muni University, Arua, Uganda.
Ther Adv Infect Dis. 2024 May 28;11:20499361241255261. doi: 10.1177/20499361241255261. eCollection 2024 Jan-Dec.
Despite the increased frequency of oropharyngeal candidiasis among people living with human immunodeficiency virus (HIV), its management is no longer effective due to empirical treatment and emergence of antifungal resistance (AFR). This study sought to investigate the prevalence of oropharyngeal candidiasis and assess the antifungal susceptibility profile of oropharyngeal species isolated from people living with human immunodeficiency virus. Additionally, we evaluated the correlation between oropharyngeal candidiasis and CD4 T cell as well as viral load counts.
A descriptive cross-sectional study was carried out from April to October 2023 in which 384 people living with HIV underwent clinical examination for oral lesions. Oropharyngeal swabs were collected and cultured on Sabouraud Dextrose agar to isolate species which were identified using the matrix assisted laser desorption ionization time of flight mass spectrometry. Additionally, the antifungal susceptibility profile of isolates to six antifungal drugs was determined using VITEK® (Marcy-l'Étoile, France) compact system. Data on viral load were retrieved from records, and CD4 T cell count test was performed using Becton Dickinson Biosciences fluorescent antibody cell sorter presto.
The prevalence of oropharyngeal candidiasis was 7.6%. Oropharyngeal candidiasis was significantly associated with low CD4 T cell count and high viral load. A total of 35 isolates were obtained out of which comprised of 20 (57.1%) while and comprised 4 (11.4%) each. , and accounted for 2 (5.7%) each. Additionally, 7 (20%) isolates were resistant to fluconazole, 1 (2.9%) to flucytocine and 0.2 (5.7%) isolates were intermediate to caspofungin. However, specific specie isolates like showed 20% (4/20), 50% (2/4) and 50% (1/2) resistance to fluconazole. Additionally, showed 50% resistance to flucytosine.
The prevalence of oropharyngeal candidiasis (OPC) among people living with HIV was low, and there was a significant association between OPC and CD4 T cell count as well as viral load. was the most frequently isolated oropharyngeal species. and exhibited the highest AFR among the non- species. The highest resistance was demonstrated to fluconazole.
尽管人类免疫缺陷病毒（HIV）感染者中口咽念珠菌病的发病率有所增加，但由于经验性治疗和抗真菌耐药性（AFR）的出现，其治疗不再有效。本研究旨在调查口咽念珠菌病的患病率，并评估从HIV感染者中分离出的口咽菌种的抗真菌药敏谱。此外，我们还评估了口咽念珠菌病与CD4 T细胞以及病毒载量计数之间的相关性。
2023年4月至10月进行了一项描述性横断面研究，对384名HIV感染者进行了口腔病变的临床检查。采集口咽拭子，在沙氏葡萄糖琼脂上培养以分离菌种，使用基质辅助激光解吸电离飞行时间质谱法进行鉴定。此外，使用VITEK®（法国马西 - 勒图瓦勒）紧凑型系统测定分离株对六种抗真菌药物的抗真菌药敏谱。从记录中获取病毒载量数据，并使用贝克曼库尔特生物科学公司的荧光抗体细胞分选仪presto进行CD4 T细胞计数检测。
口咽念珠菌病的患病率为7.6%。口咽念珠菌病与低CD4 T细胞计数和高病毒载量显著相关。共获得35株分离株，其中白色念珠菌占20株（57.1%），热带念珠菌和光滑念珠菌各占4株（11.4%）。近平滑念珠菌、季也蒙念珠菌和葡萄牙念珠菌各占2株（5.7%）。此外，7株（20%）分离株对氟康唑耐药，1株（2.9%）对氟胞嘧啶耐药，0.2株（5.7%）分离株对卡泊芬净中介。然而，特定菌种分离株如白色念珠菌对氟康唑的耐药率为20%（4/20），热带念珠菌为50%（2/4），光滑念珠菌为50%（1/2）。此外，光滑念珠菌对氟胞嘧啶的耐药率为50%。
HIV感染者中口咽念珠菌病（OPC）的患病率较低，OPC与CD4 T细胞计数以及病毒载量之间存在显著关联。白色念珠菌是最常分离出的口咽菌种。在非白色念珠菌菌种中，热带念珠菌和光滑念珠菌表现出最高的AFR。对氟康唑的耐药性最高。
