Abstract
Non-albicans Candida (NAC) spp. in immunocompromised patients are linked to invasive infections with narrow treatment choice. This study aimed at comparing the oral colonization of NAC spp. between HIV and non-HIV infected individuals in Mwanza, Tanzania. Oral rinse of 351 HIV-infected and 639 non-HIV infected individuals were collected between March and July 2015. Phenotypic identifications of Candida spp. was done using Candida Chromogenic agar and confirmed by MALDI-TOF MS. NAC spp. were detected in 36/351 (10.3%) HIV-infected individuals compared to 28/639 (4.4%) of non-HIV infected individuals; P=0.0003. In HIV infected individuals, commonly isolated NAC spp. were Candida tropicalis, 10(2.8%), C. krusei (Issatschenki orientalis) 9(2.6%) and C. glabrata 8(2.3%). While for non-HIV infected individuals C. dubliniensis 8(1.3%) and C. tropicalis 5(0.9%) were commonly detected. As CD4 count/μl decreases by one unit the risk of being colonized by NAC spp. among HIV infected individuals increases by 1% (OR 1.01, 95% CI; 1.001-1.004, P=0.001). The prevalence of NAC spp. is high among HIV-infected individuals with low CD4 count placing them at higher risk of invasive infections. Further studies to investigate the role of NAC spp. in causing invasive infections among immunocompromised patients are recommended.
Highlights
Non-albicans Candida (NAC) spp. in immunocompromised patients are linked to invasive infections with narrow treatment choice
CD4 count/ml decreases by one unit the risk of being colonized by NAC spp. among HIV infected individuals increases by 1%
The emergence of non-albicans Candida (NAC) spp. which are more resistant to azoles causing oral candidiasis is of public health concern especially in resource constrained settings.[2,3]
Summary
Non-albicans Candida (NAC) spp. in immunocompromised patients are linked to invasive infections with narrow treatment choice. Results: NAC spp. were detected in 36/351 (10.3%) HIV-infected individuals compared to 28/639 (4.4%) of non-HIV infected individuals; P=0.0003. As. Oral candidiasis (OC) is one of the major opportunistic fungal infections that occur in over 90% of the HIV-infected individuals during the cause of their illness.[1] It is one of the Acquired Immune Deficiency Syndromes (AIDS) prognostic indicators and a major predisposing factor to invasive fungal diseases like blood-stream Candida infections.[2,3] Oral cavity colonization by Candida spp. in the healthy population ranges from 17%-75% worldwide.[4] For decades, Candida albicans has been the major Candida spp. isolated from oral cavity of both immunocompromised and immunocompetent individuals, accounting for 60%-80% of cases.[5,6] The emergence of non-albicans Candida (NAC) spp. which are more resistant to azoles causing oral candidiasis is of public health concern especially in resource constrained settings.[2,3] The common NAC spp. associated with oral candidiasis includes C
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