Identification of candida species isolated from oropharyngeal candidiasis of human immunodeficiency virus infected patients

Abstract

Abstract Introduction: Oropharyngeal candidiasis (OC) is the most common opportunistic infection occurring in HIV infected individuals. Inappropriate use of antibiotics, antifungal agents and poor infection control practices has led to shift in spectrum towards non albicans candida species. Materials and Methods: This is a prospective study for 6 months conducted at K.R Hospital, Mysore. HIV seropositive cases with oral candidiasis were included in the study. After informed consent, detailed demographic data was obtained from the study participants and two swabs were collected. One swab was used for gram staining and KOH mount. The second swab was immediately inoculated on two Sabouraud’s Dextrose Agar (SDA) supplemented with antibiotics and incubated at 37oC and 25oC. Cream pasty yeast colonies on SDA were subjected to Germ tube test, morphology on Corn meal agar, sugar assimilation test and fermentation tests. Results: Total of 67 patients were included in the study. Pseudomembranous type of OC was common. All the samples yielded the growth of Candida. Candida albicans was the commonest spp isolated but 68.1% of the isolates were non albicans candida. C. tropicalis, C. guillermondii, C. dublinensis, C. parapsilosis, C. krusei and C. kefyr were the non albicans candida spp isolated. Conclusion: As some of the non albicans candida are intrinsically resistant to antifungal agents identification up to species level is important. Inappropriate treatment will lead to increased morbidity and mortality among these patients. Keywords: Oropharyngeal candidiasis, HIV, Non albicans candida, C. tropicalis, AIDS, CD4 count. Introduction Acquired Immunodeficiency Syndrome (AIDS) the modern pandemic has been a public threat since its discovery in 1981. Human Immunodeficiency Virus (HIV) infection prevalence among adults (15 – 49 yrs) of India is estimated to be 0.26% i.e. 21.17 lakh people are living with HIV in India while incidence is around 8