In vitro Sensitivity to Fluconazole through Vitek II Systems, of Strains of Candida Spp. In Patients with Oropharyngeal Candidiasis and HIV/AIDS

Abstract

Background: Candida albicans is a commensal fungus of the mucosa in humans that may become an opportunistic pathogen causing recurrent infections in immunocompromised hosts. In individuals with HIV/AIDS, Histatin-5 levels are significantly reduced, causing oropharyngeal candidiasis to become a pathological process. Clinical and in vitro resistance to azoles is common whether by selection or acquisition of Candida-resistant strains. In 2008, the Clinical and Laboratory Standards Institute (CLSI) defined the cutoff point for active agents against the isolates of Candida species. The objective of this study was to determine the frequency of fungal isolates of C. albicans through VITEK II system and their susceptibility pattern in patients with HIV/AIDS and oropharyngeal candidiasis treated at the Hospital for Infectious Diseases in Mexico City. Methods: From June 2011-December 2012, there were 96 patients with HIV/AIDS and oropharyngeal candidiasis who were included in the study. Oral and esophageal specimens were directly examined to identify fungal structures. Cultures and sensitivity testing were done with the Vitek II method. Descriptive statistics and bivariate analysis were carried out. Results: Of 96 patients, 87 had C. albicans oral isolates identified and 73 esophageal isolates. Non-albicans Candida (NAC) was identified in three and ten patients (oral and esophageal) respectively, and Cryptococcus neoformans was isolated in both sites. Sensitivity of C. albicans to fluconazole was demonstrated in 87/90 strains. Conclusions: The fungal pathogen isolated was C. albicans followed by C. glabrata and C. parapsilopsis. C. albicans was identified through VITEK II in 90% of cases susceptible to fluconazole.