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Fluconazole resistant opportunistic oro-pharyngeal Candida and non-Candida yeast-like isolates from HIV infected patients attending ARV clinics in Lagos, Nigeria.
Afr Health Sci. 2008 Sep; 8(3):142-8.AH

Abstract

BACKGROUND

Oro-Pharyngeal Candidiasis (OPC) continues to be considered the most common opportunistic fungal disease in HIV/AIDS patients globally. Azole antifungal agent has become important in the treatment of mucosal candidiasis in HIV patients. Presently, antifungal drug resistance is fast becoming a major problem particularly with the immune depleted population.

OBJECTIVES

This study was designed to investigate the: existence of OPC, species distribution fluconazole susceptibility profile of yeast cells isolated from oral specimens of HIV/AIDS patients from Lagos Nigeria, between Oct. 2004 and June, 2005.

METHODOLOGY

The venous blood samples were screened for HIV antibodies using the Cappillus HIV I and II test kit (Trinity Biotech Plc UK), and Genie II HIV I and II EIA kit (Bio-Rad France). The positive results were subsequently confirmed at the laboratory attached to each of the clinics, using the Nigerian Federal Ministry of Health approved algorithm. The samples from 213 (108 females and 105 males) HIV positive patients were plated onto SD agar. The isolates were identified by morphotyping, microscopy and speciated using germ tube test and battery of biochemical sugar fermentation and assimilation tests. Fluconazole agar diffusion susceptibility testing was carried out on each isolates.

RESULTS

Seventy-four (34.7%) isolates were recovered including one person with double isolates. Only 70 (94.6%) of the isolates could be adequately speciated. Candida albicans 30 (40.5%) was the most frequently isolated species, the rest were non-albicans species, with the frequency of C. tropicalis > C. Krusei > C. glabrata and C. neoformans for species for species having up to 4 isolates. Four (30.8%) out of 13 isolates of C. tropicalis showed germ tube formation. While one C. albicans was germ-tube negative. Out of the 74 isolates tested for fluconazole sensitivity, 58 (78.4%) were sensitive, MIC d'' 8 microg/ml, 9 (12.1%) were susceptible Dose Dependent (SDD), MIC 16-32 microg/ml and 7 (9.5%) were resistant, MICs e'' 64 microg/ml. Among the C. albicans isolates, 26 (86.7%) were sensitive to fluconazole. The rank of susceptibility was C. albicans > C. tropicalis > C. Krusei for the most prevalent species.

CONCLUSION

We conclude that fluconazole resistant strains of oro-pharyngeal yeast-like cells exist in about 9.5% of HIV/AIDS patients with the above stated species distribution. We therefore, highlight the need for routine antifungal susceptibility testing on HIV patients with cases of initial or repeat episodes of OPC.

Authors+Show Affiliations

Microbiology Division, Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria. enwuru100@yahoo.caNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19357740

Citation

Enwuru, C A., et al. "Fluconazole Resistant Opportunistic Oro-pharyngeal Candida and non-Candida Yeast-like Isolates From HIV Infected Patients Attending ARV Clinics in Lagos, Nigeria." African Health Sciences, vol. 8, no. 3, 2008, pp. 142-8.
Enwuru CA, Ogunledun A, Idika N, et al. Fluconazole resistant opportunistic oro-pharyngeal Candida and non-Candida yeast-like isolates from HIV infected patients attending ARV clinics in Lagos, Nigeria. Afr Health Sci. 2008;8(3):142-8.
Enwuru, C. A., Ogunledun, A., Idika, N., Enwuru, N. V., Ogbonna, F., Aniedobe, M., & Adeiga, A. (2008). Fluconazole resistant opportunistic oro-pharyngeal Candida and non-Candida yeast-like isolates from HIV infected patients attending ARV clinics in Lagos, Nigeria. African Health Sciences, 8(3), 142-8.
Enwuru CA, et al. Fluconazole Resistant Opportunistic Oro-pharyngeal Candida and non-Candida Yeast-like Isolates From HIV Infected Patients Attending ARV Clinics in Lagos, Nigeria. Afr Health Sci. 2008;8(3):142-8. PubMed PMID: 19357740.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Fluconazole resistant opportunistic oro-pharyngeal Candida and non-Candida yeast-like isolates from HIV infected patients attending ARV clinics in Lagos, Nigeria. AU - Enwuru,C A, AU - Ogunledun,A, AU - Idika,N, AU - Enwuru,N V, AU - Ogbonna,F, AU - Aniedobe,M, AU - Adeiga,A, PY - 2009/4/10/entrez PY - 2009/4/10/pubmed PY - 2009/5/2/medline SP - 142 EP - 8 JF - African health sciences JO - Afr Health Sci VL - 8 IS - 3 N2 - BACKGROUND: Oro-Pharyngeal Candidiasis (OPC) continues to be considered the most common opportunistic fungal disease in HIV/AIDS patients globally. Azole antifungal agent has become important in the treatment of mucosal candidiasis in HIV patients. Presently, antifungal drug resistance is fast becoming a major problem particularly with the immune depleted population. OBJECTIVES: This study was designed to investigate the: existence of OPC, species distribution fluconazole susceptibility profile of yeast cells isolated from oral specimens of HIV/AIDS patients from Lagos Nigeria, between Oct. 2004 and June, 2005. METHODOLOGY: The venous blood samples were screened for HIV antibodies using the Cappillus HIV I and II test kit (Trinity Biotech Plc UK), and Genie II HIV I and II EIA kit (Bio-Rad France). The positive results were subsequently confirmed at the laboratory attached to each of the clinics, using the Nigerian Federal Ministry of Health approved algorithm. The samples from 213 (108 females and 105 males) HIV positive patients were plated onto SD agar. The isolates were identified by morphotyping, microscopy and speciated using germ tube test and battery of biochemical sugar fermentation and assimilation tests. Fluconazole agar diffusion susceptibility testing was carried out on each isolates. RESULTS: Seventy-four (34.7%) isolates were recovered including one person with double isolates. Only 70 (94.6%) of the isolates could be adequately speciated. Candida albicans 30 (40.5%) was the most frequently isolated species, the rest were non-albicans species, with the frequency of C. tropicalis > C. Krusei > C. glabrata and C. neoformans for species for species having up to 4 isolates. Four (30.8%) out of 13 isolates of C. tropicalis showed germ tube formation. While one C. albicans was germ-tube negative. Out of the 74 isolates tested for fluconazole sensitivity, 58 (78.4%) were sensitive, MIC d'' 8 microg/ml, 9 (12.1%) were susceptible Dose Dependent (SDD), MIC 16-32 microg/ml and 7 (9.5%) were resistant, MICs e'' 64 microg/ml. Among the C. albicans isolates, 26 (86.7%) were sensitive to fluconazole. The rank of susceptibility was C. albicans > C. tropicalis > C. Krusei for the most prevalent species. CONCLUSION: We conclude that fluconazole resistant strains of oro-pharyngeal yeast-like cells exist in about 9.5% of HIV/AIDS patients with the above stated species distribution. We therefore, highlight the need for routine antifungal susceptibility testing on HIV patients with cases of initial or repeat episodes of OPC. SN - 1729-0503 UR - https://www.unboundmedicine.com/medline/citation/19357740/Fluconazole_resistant_opportunistic_oro_pharyngeal_Candida_and_non_Candida_yeast_like_isolates_from_HIV_infected_patients_attending_ARV_clinics_in_Lagos_Nigeria_ L2 - https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/19357740/ DB - PRIME DP - Unbound Medicine ER -