Coleman D C, Bennett D E, Sullivan D J, Gallagher P J, Henman M C, Shanley D B, Russell R J
University of Dublin, Moyne Institute, Department of Microbiology, Republic of Ireland.
Crit Rev Microbiol. 1993;19(2):61-82. doi: 10.3109/10408419309113523.
Oral candidosis has become an increasingly important problem in HIV-infected individuals. At present, the small body of published literature on the characterization of the Candida strains and species found in HIV+ patients is full of confusion and contradictions. Some of these difficulties are the result of the methodological shortcomings of a number of the techniques that have been used. Examples of the problems that may be encountered on primary isolation and subculture are described and the drawbacks associated with the systems used to date for phenotyping Candida are quoted. While molecular characterization techniques would appear to offer a reliable and objective alternative, they too have their strengths and weaknesses. An attempt is made to summarize the progress that has been made recently in the detection and identification of Candida albicans and also the non-albicans species from HIV-infected individuals. What emerges is that the commensal Candida species that inhabit the oral cavities of HIV+ patients are subjected to a number of significant pressures that probably promote the selection of organisms with unusual phenotypes and genotypes. These Candida are more difficult to characterize and behave differently compared to their counterparts in HIV- individuals. It is clear that uncovering the factors that are important for the selection of treatment regimens and will be predictive of outcome will not be easy. Candida organisms are neither as benign nor as simple as once thought.
口腔念珠菌病在HIV感染者中已成为一个日益重要的问题。目前，关于在HIV阳性患者中发现的念珠菌菌株和种类特征的已发表文献数量不多且充满混乱和矛盾。其中一些困难是由于所使用的一些技术存在方法学缺陷导致的。描述了在初次分离和传代培养时可能遇到的问题实例，并列举了迄今用于念珠菌表型分析的系统存在的缺点。虽然分子特征分析技术似乎提供了一种可靠且客观的替代方法，但它们也有其优点和缺点。本文试图总结最近在检测和鉴定HIV感染者中的白色念珠菌以及非白色念珠菌种类方面取得的进展。结果发现，居住在HIV阳性患者口腔中的共生念珠菌种类受到多种重大压力，这些压力可能促使具有异常表型和基因型的生物体被选择出来。与HIV阴性个体中的念珠菌相比，这些念珠菌更难鉴定且表现不同。显然，要找出对选择治疗方案很重要且能预测治疗结果的因素并非易事。念珠菌生物体既不像曾经认为的那样无害，也不像曾经认为的那样简单。
