Identify Candida Species Research Articles

Identification of Candida Species Using MP65 Gene and Evaluation of the Candida albicans MP65 Gene Expression in BALB/C Mice.

Background:Systemic candidiasis is a major public health concern. In particular, in immunocompromised people, such as patients with neutropenia, patients with Acquired Immune Deficiency Syndrome (AIDS) and cancer who are undergoing antiballistic chemotherapy or bone marrow transplants, and people with diabetes. Since the clinical signs and symptoms are nonspecific, early diagnosis is often difficult. The 65-kDa mannoprotein (MP65) gene of Candida albicans is appropriate for detection and identification of systemic candidiasis. This gene encodes a putative b-glucanase mannoprotein of 65 kDa, which plays a major role in the host-fungus relationship, morphogenesis and pathogenicity.Objectives:The current study aimed to identify different species of Candida (C. albicans, C. glabrata and C. parapsilosis) using the Polymerase Chain Reaction (PCR) technique and also to evaluate C. albicans MP65 gene expression in BALB/C mice.Materials and Methods:All yeast isolates were identified on cornmeal agar supplemented with tween-80, germ tube formation in serum, and assimilation of carbon sources in the API 20 C AUX yeast identification system. Polymerase Chain Reaction was performed on all samples using species-specific primers for the MP65 65 kDa gene. After RNA extraction, cDNA synthesis was performed by the Maxime RT Pre Mix kit. Candida albicans MP65 gene expression was evaluated by quantitative Real-Time (q Real-Time) and Real-Time (RT) PCR techniques. The 2-ΔΔCT method was used to analyze relative changes in gene expression of MP65. For statistical analysis, nonparametric Wilcoxon test was applied using the SPSS version 16 software.Results:Using biochemical methods, one hundred, six and one isolates of clinical samples were determined as C. albicans, C. glabrata and C. parapsilosis, respectively. Species-specific primers for PCR experiments were applied to clinical specimens, and in all cases a single expected band for C. albicans, C. glabrata and C. parapsilosis was obtained (475, 361 and 124 base pairs, respectively). All species isolated by culture methods (100% positivity) were evaluated with PCR using species-specific primers to identify Candida species. Relative expression of Mp65 genes increased significantly after C. albicans injection into the mice (P < 0.05).Conclusions:The results of the current study showed that the PCR method is reproducible for rapid identification of Candida species with specific primers. Mp65 gene expression of C. albicans after injection into the mice was 2.3 folds higher than before injection, with this difference being significant. These results indicated that increase of Mp65 gene expression might be an early stage of infection; however definitive conclusions require further studies.

Oral carriage of Candida species in HIV-infected patients during highly active antiretroviral therapy (HAART) in Belém, Brazil

To identify the oral carriage of Candida spp in patients infected by human immunodeficiency virus (HIV) and the possible correlation with clinical characteristics. Mucosal swab samples collected from 246 patients who were infected by HIV, did not have oral candidiasis, and were being treated with highly active antiretroviral therapy were analyzed. Yeast colonies that developed were identified by using the VITEK 2 automated system. Candida yeasts were present in 41.87% of the samples, and Candida albicans was the most prevalent (32.52%). Other identified Candida species were C tropicalis (4.88%), C parapsilosis (2.85%), C dubliniensis (0.81%), and C famata (0.81%). There was low rate of oral Candida carriage in patients infected by HIV who were on highly active antiretroviral therapy. A greater prevalence of C albicans than non-albicans Candida species was found at the species level. Prior candidiasis predicted the oral carriage of C albicans; however, it did not influence the carriage of non-albicans species. This is the first report of oral carriage of C famata in patients with HIV infection.

Use of restriction fragment length polymorphism to identify Candida species, related to onychomycosis.

Background:Onychomycosis is one of the most common clinical forms of fungal infections due to both filamentous fungi and yeasts. The genus of Candida is one of the most prominent causes of onychomycosis in all around the world. Although Candida albicans is still the most frequent cause of nail infections, use of broad-spectrum antifungal agents has led to a shift in the etiology of C. albicans to non-albicans species. The aim of the present study is rapid and precise identification of candida species isolated from nail infection by using of PCR-RFLP technique.Materials and Methods:A total of 360 clinical yeast strains were collected from nail infections in Iran. Genomic DNA was extracted using FTA; cards. ITS1-5.8SrDNA-ITS2 region was amplified using universal primers and subsequently products were digested with the restriction enzyme MspI. For identification of newly described species (C. parapsilosis complex), the SADH gene was amplified, followed by digestion with Nla III restriction enzyme.Results:Candida albicans was the most commonly isolated species (41.1%), followed by C. parapsilosis (21.4%), C. tropicalis (12.8%), C. kefyr (9.4%), C. krusei (5.5%), C. orthopsilosis (4.1%), C. glabrata (2.8%), C. guilliermondii (1.4%), C. rugosa (0.8%), and C. lusitaniae (0.5%). Patients in the age groups of 51-60 and 81-90 years had the highest and lowest distribution of positive specimens, respectively.Conclusion:Rapid and precise identification of Candida species from clinical specimens lead to appropriate therapeutic plans.

Candida glabrata candidemia.

Candida glabrata candidemia.

Digestive fungal flora in asymptomatic subjects in Bobo-Dioulasso, Burkina Faso

To identify Candida species in asymptomatic subjects in Bobo-Dioulasso (Burkina Faso) by the matrix-assisted laser desorption ionization-time of flight mass spectrometry. A cross-sectional study was conducted from January to February 2013 in Bobo-Dioulasso to collect fecal and urine specimens from voluntary donors. Fungal strains were isolated on Sabouraud dextrose agar and analyzed using matrix-assisted laser desorption ionisation-time-of-flight mass spectrometry. A total of 135 samples including stools (78.5%, 106/135) and urine (21.5%, 29/135) were analyzed. The results revealed that fecal specimens contained mainly Candida krusei (C. krusei) (42.5%) followed by Candida albicans (29.3%), Candida glabrata (18.0%) and Candida tropicalis (C. tropicalis) (4.7%). C. krusei (34.6%) was also found to be the most frequently identified in urine samples followed by Candida albicans (27.0%), C. tropicalis (15.4%) and Candida parapsilosis. However, uncommon species such as Candida nivariensis, Candida kefyr, Candida norvegensis, Candida parapsilosis, Candida lusitaniae and Candida robusta were also identified from fecal and urines samples. This study noted the emergence of species such as C. krusei, Candida glabrata, Candida parapsiolosis, C. tropicalis, Candida nivariensis, Candida norvegensis, and others. It is an imperative to take into account the existence of these species in the therapeutic management of patients in Bobo-Dioulasso.

A multiplex nested PCR for the detection and identification of Candida species in blood samples of critically ill paediatric patients.

BackgroundNosocomial candidaemia is associated with high mortality rates in critically ill paediatric patients; thus, the early detection and identification of the infectious agent is crucial for successful medical intervention. The PCR-based techniques have significantly increased the detection of Candida species in bloodstream infections. In this study, a multiplex nested PCR approach was developed for candidaemia detection in neonatal and paediatric intensive care patients.MethodsDNA samples from the blood of 54 neonates and children hospitalised in intensive care units with suspected candidaemia were evaluated by multiplex nested PCR with specific primers designed to identify seven Candida species, and the results were compared with those obtained from blood cultures.ResultsThe multiplex nested PCR had a detection limit of four Candida genomes/mL of blood for all Candida species. Blood cultures were positive in 14.8% of patients, whereas the multiplex nested PCR was positive in 24.0% of patients, including all culture-positive patients. The results obtained with the molecular technique were available within 24 hours, and the assay was able to identify Candida species with 100% of concordance with blood cultures. Additionally, the multiplex nested PCR detected dual candidaemia in three patients.ConclusionsOur proposed PCR method may represent an effective tool for the detection and identification of Candida species in the context of candidaemia diagnosis in children, showing highly sensitive detection and the ability to identify the major species involved in this infection.

Isolamento de Candida no esfregaço cérvico-vaginal de mulheres não gestantes residentes em área ribeirinha do Estado do Maranhão, Brasil, 2012

Este estudio evaluo la prevalencia da candidiasis vaginal y los factores asociados en mujeres no embarazadas, residentes en las costas del rio Tocantins, atendidas por el Programa de Atencion a la Salud de la Mujer, en el Municipio de Imperatriz, Estado de Maranhao, Brasil. Se consideraron los datos demograficos, epidemiologicos, clinicos y citohistologicos oriundos de examen Papanicolau y de cultivo microbiologico para hongos. Para el aislado del hongo se utilizo cultivo en agar selectivo y diferencial para Candida, ademas de placas de Petri. La prevalencia de hongos del genero Candida en el frotis cervicovaginal fue de 42,86%, con mas de 50% de casos sintomaticos. Fue verificado que un 28% de las mujeres con candidiasis vaginal tenia entre 20 y 29 anos de edad, un 37,4% habia cursado ensenanza primaria incompleta, 66,4% era de color pardo, la mayoria (63,6%) era ama de casa, 58% vivia con una renta mensual de uno a tres sueldos minimos y 63,5% relato tener companeros fijos (considerando las casadas y con union estable). Entre las especies de Candida aisladas e identificadas, la C. albicans fue la mas prevalente. Se concluye que la poblacion estudiada no tiene conocimientos suficientes sobre la candidiasis vaginal sugiriendose la necesidad de fortalecerse las practicas educativas, de orientacion y tomada de consciencia de habitos que favorezcan el control y la prevencion de esa infeccion

Oral candidal colonization in immunocompromised patients

Objective: 1. To identify Candida species isolated from saliva of predicatively immunocompromised (cancer, diabetic) patients and control group. 2. To test the susceptibility of all the isolated yeasts against 6 antifungal agents, namely amphotericin B, nystatin, fluconazole, ketoconazole, voriconazole and itraconazole. 3. Then to compare the growth and density of yeasts from immunocompromised patients to those from healthy control group. Patients and Methods: This study included 120 saliva samples from immunocompromised patients, 60 of them with cancer and under treatment, the other 60 patients have uncontrolled diabetes mellitus, attending the Al-Wafa'a Center for diabetic patients and the consultative clinic of Oncology and Nuclear Medicine Hospital. The clinical specimens were collected during the period from January-June 2011. In addition to 60 saliva samples from a healthy individuals. The identification of the isolated yeasts was carried by fluorescent and/or light microscope, culture on different types of media, biochemical tests and API-20 C system. Susceptibility test to six antifungal agents was prepared for each isolate. Results: Eighty seven (72.5%) patients showed the presence of yeasts in their saliva in comparison to 18(30%) from the control group. Eighty four isolates from genus Candida identified into 8 species mainly C. albicans. The isolates showed the best susceptibility to amphotericin B. Conclusions: A higher frequency of yeasts were detected in the immunocompromised patients in comparison to the control group. This is considered a risk factor for infection. Candida albicans is the main isolate but there was a shift to non –albicans Candida spp. in immunocompromised patients. This means that are more resistant to antifungal agents.

English

&nbsp; This work aimed at identifying&nbsp;Candida&nbsp;species isolated from blood stream infection in non-neutropenic cancer patients by conventional and molecular methods. Out of 200 blood samples from cancer patients with blood stream infection, 89 were positive forCandida&nbsp;which were identified using chromogenic medium (CHROMagar&nbsp;Candida), and real-time polymerase chain reaction (RT-PCR) assays targeting the fungal ITS2 region using a LightCycler instrument. The present study revealed that non-albicans Candidaspecies caused most of the cases of candidaemia in the cancer patients. A total of 89Candida&nbsp;isolates were obtained, Candida albicans&nbsp;represent 15/89 patients (16.85%) and non-albicans Candida&nbsp;species accounts for 74/89 patients (83.1 %)&nbsp;of which&nbsp;Candida tropicalis&nbsp;represent 32.6% followed by&nbsp;Candida parapsiliosis&nbsp;23.6%, and then&nbsp;Candida rugosa&nbsp;(21,4%) and the lowest percentage was in&nbsp;Candida glabrata&nbsp;(5.6%).&nbsp;The results of the study revealed that real time-PCR could detect 81 out of 89 cases of candidaemia with sensitivity of 91.01%, specificity of 95.6%, PPV of 94.18% and NPV of 92.30%. The high prevalence of non-albicans&nbsp;candidaemia should be considered prior to antimicrobical therapy in non-neutropenic cancer patients with candidaemia. Real-time PCR represents a rapid and accurate method for diagnosis of candidaemia. &nbsp; Key words:&nbsp;Candidaemia,&nbsp;Candida albicans, real-time polymerase chain reaction (RT-PCR).

Prevalance of Vulvovaginal Candidiasis in women of reproductive age group

Background : Vulvovaginal Candidiasis is a common problem in women of reproductive age group with overgrowth of fungus Candida due to loss of imbalance between normal vaginal flora, Candida and immune defense mechanisms. Most common Candida species is C. albicans. However, the incidence of non-albicans species is on the rise. Direct microscopy and vaginal cultures are a valuable tool for identifying Candida species so that appropriate therapy may be given to eliminate the vaginal source of infection rather than treating vulval symptoms. Objectives :The main objectives of the present study were to estimate the incidence of Candida infections in women of reproductive age and identify the species of Candida causing such infections. 150 women were subjected to speculum examination and vaginal swabs were collected for culture, direct microscopy and candida isolation. Results : 53.3% of women in their early reproductive years were found to suffer from Candida infections of which 86% were Candida albicans species. Conclusion : Culture for Candida species routinely maybe a valuable tool not only to treat vaginal symptoms effectively but also to avoid usage of unnecessary antifungal agents.

Distribution of Candida species among HIV-positive patients with oropharyngeal candidiasis in Accra, Ghana

Oropharyngeal candidiasis is a common occurrence in the course of human immunodeficiency virus (HIV) disease progression. Changes in the clinical severity of oropharyngeal candidiasis and type of Candida species profile may be a reflection of immunological changes in patients. The aim of this study was to undertake a baseline Candida species identification for future reference. Oral swabs of 267 HIV-infected patients with oropharyngeal candidiasis were cultured and Candida species were identified by API 32 C. A total of 201 (75.3%) Candida species and 10 (3.7%) non candida fungi were identified. Twenty different Candida species were isolated. Candida albicans was the most prevalent species (68.5%) followed by C. tropicalis (7.4%), C. krusei (6.4%), C. parapsilosis (3.0%) and C. sake (2.5%). Other species ranged from 0.5% to 1.5%. Positive culture was independent of whether patients were on anti-retroviral therapy or not. Of all Candida isolates, 68.5% were identified as C. albicans. Since other uncommon species were also isolated, it may be necessary in this group of patients to identify Candida species causing severe infections.

Distribution of Candida in the oral cavity and its differentiation based on the internally transcribed spacer (ITS) regions of rDNA

This study aimed to determine the distribution of Candida species in the oral cavity and differentiate the species based on PCR amplification, including HinfI and MspI digestion, in order to assess the effectiveness of using the rDNA region for species identification. Samples from saliva as well as palate, tongue and cheek mucosa surfaces were collected from 45 individuals, consisting of three groups: periodontal disease patients; denture-wearers; and the control group. The samples were serially diluted, spread on BHI and YPD agar plates and scored for colony-forming units (CFUs). Fifteen random candidal colonies were isolated and subjected to genomic DNA extraction, based on glass beads disruption. Four primers were used to amplify regions in the rDNA, and the ITSI-5.8S-ITSII PCR product was digested by HinfI and MspI restriction enzymes. The microbial loads on all sites of the denture-wearers were found to be significantly higher than control, while in the periodontal disease group only the microbial loads on the tongue were significantly higher than control. Meanwhile, there was no significant difference at other sites. The restriction fragment lengths of the clinical samples were compared to those of seven control species, allowing the differentiation of all seven species and the identification of 14 species from the clinical samples. The MspI restriction digest was not able to distinguish between C. albicans and C. dubliniensis, whereas the HinfI digest could not distinguish between C. tropicalis and C. parapsilosis. It was concluded that PCR-RFLP of the candidal rDNA region has potential for species identification. This study demonstrates the potential use of candidal rDNA as a means for identifying Candida species, based on genotype. The results also indicate the possibility of constructing genetic probes that target specific restriction fragments in the ITSI-5.8S-ITSII region, enabling swift and precise identification of Candida species.

Impact of a rapid peptide nucleic acid fluorescence in situ hybridization assay on treatment of Candida infections

The impact of a rapid peptide nucleic acid fluorescence in situ hybridization (PNA FISH) assay with an antimicrobial stewardship intervention on the treatment of Candida infections was studied. The utility of implementing the PNA FISH assay with an antimicrobial stewardship intervention in hospitalized patients with candidemia was evaluated by measuring the median time to Candida species identification, time to targeted therapy, and clinical outcomes, including time to culture clearance, hospital length of stay, and hospital mortality. Secondary objectives included determining the cost-effectiveness of the PNA FISH assay by assessing estimated antifungal drug costs (as average wholesale price) before (June 26, 2009-September 19, 2010) and after (September 20, 2010-June 13, 2011) test implementation and confirming test accuracy. For both groups, laboratory personnel notified the physician of the results of Gram's stain from blood culture. Time to targeted therapy significantly decreased after the implementation of the PNA FISH assay (p = 0.0016). The postimplementation group had a higher rate of culture clearance (p = 0.01). Median time to species identification was 0.2 day with the PNA FISH test versus 4 days with routine methods (p < 0.001). Accounting for the cost of the test itself and the cases in which patients were switched to more-expensive therapy on the basis of the test, we estimated that the PNA FISH test resulted in savings of approximately $415 per patient. Implementing a PNA FISH test to identify Candida species from yeast-positive blood cultures in conjunction with a pharmacy-driven antimicrobial stewardship protocol decreased the time to targeted antifungal therapy and the time to culture clearance.

Identification of Candida species associated with vulvovaginal candidiasis by multiplex PCR.

Background. Vulvovaginal candidiasis is a common infection. The aim of this study was to identify the species of vaginal Candida isolates by using multiplex PCR technique. Methods. 191 isolates from patients admitted to Mahdieh hospital were identified. The vaginal swab specimens were cultured on Sabouraud Dextrose Agar. The ITS1 region between the 18S and 5.8S rRNA genes and a specific DNA fragment within the ITS2 region were amplified. The multiplex PCR products were separated by electrophoresis in 2% agarose gel, visualized by staining with ethidium bromide, and photographed. Descriptive statistics, Chi-square test, and Spearman correlation were used to summarize the findings. Results. C. albicans and C. glabrata were the most common species isolated from the specimens. A mix of C. glabrata and C. albicans was the most common mixed infection isolated from the samples. The analysis revealed a significant positive association between older age and infection with C. glabrata isolates (Spearman's rho = 0.89, P = 0.015). Conclusion. Multiplex PCR is a fast, yet reliable method to identify Candida species. C. albicans and then C. glabrata are the two most common causes of vulvovaginal candidiasis. The number of mixed fungal infections is higher among Iranian population compared to international reports.

Detection of Candida albicans DNA from blood samples using a novel electrochemical assay

The genus Candida contains a number of yeast species which are opportunistic pathogens and are associated with life-threatening infections in immunocompromised individuals. Provision of appropriate therapy relies on the rapid identification of the infecting species, and existing methods of identifying Candida species in clinical samples are time and resource intensive and are not always specific enough to differentiate between drug-susceptible and drug-resistant species. We have previously developed a system for the rapid detection of yeast pathogens in clinical samples using PCR followed by hybridization with a suite of five species-specific, electrochemically labelled DNA probes. The limit of detection of the assay was shown to be 37 fg (∼1 genome) per reaction using extracted genomic DNA. We carried out a study to test the limit of detection of one of the probes, CA PR3, using blood samples from a healthy donor that were spiked with genomic DNA or with C. albicans cells. Our results demonstrated a limit of detection of 37 fg (ml blood)(-1) (∼1 genome ml(-1)) using extracted DNA or 10 c.f.u. (ml blood)(-1) using C. albicans cells, indicating that the assay is capable of detecting C. albicans nucleic acid at levels that are encountered in clinical samples.

Candida glabrata and Candida albicans co‐infection of an in vitro oral epithelium

Candida albicans is regarded as the leading of candidosis. However, Candida glabrata has emerged as an important pathogen of oral mucosa, occurring both singly or in mixed species infections, often with C. albicans. Compared with C. albicans, little is known about the role of C. glabrata in oral infection. The aim of this study was to examine single and mixed species infection of oral epithelium involving C. glabrata and establish its ability to invade and damage tissue. A reconstituted human oral epithelium (RHOE) was infected only with C. glabrata, or simultaneously with C. glabrata and C. albicans. The ability of both species to invade the tissue was examined using species specific peptide nucleic acid (PNA) probe hybridization and confocal laser scanning microscopy. Epithelial damage was assessed by measuring lactate dehydrogenase (LDH) activity. Candida glabrata strains were able to colonize the RHOE, in a strain dependent manner. Candida glabrata single infection after 12 h, generally revealed no invasion of the RHOE, which contrasted with extensive tissue invasion demonstrated by C. albicans. Mixed infection showed that C. albicans enhanced the invasiveness of C. glabrata, and led to increased LDH release by the RHOE, which paralleled the observed histological damage. The results obtained demonstrating enhanced invasion and increased tissue damage caused by mixed C. glabrata and C. albicans infections have important clinical significance and highlight the need to identify Candida species involved in oral candidosis.

ENDOGENOUS ENDOPHTHALMITIS ASSOCIATED WITH INTRAVENOUS DRUG ABUSE

Intravenous drug use (IVDU) is a known risk factor for endogenous endophthalmitis. Endogenous fungal endophthalmitis (EFE) is emerging as a common problem among this community. We describe the management and visual outcomes of acute IVDU-associated EFE. A prospective consecutive case series of 19 patients presenting with presumed acute IVDU-associated EFE from 2001 to 2007 to the Royal Victorian Eye and Ear Hospital was included. All data were collected in a standardized manner. Outcome measures included visual acuity, microbial profiles, and vitrectomy rate. Nineteen cases of IVDU-associated EFE were identified. Eight of these (42%) were men, and the mean age was 32.7 years (SD ± 8.0 years). Presenting visual acuity ranged from 6/6 to perception of light, with 58% having a visual acuity of 6/48 or less at presentation. Thirteen (68.4%) were culture positive with all cultures identifying Candida species, and 52.7% underwent vitrectomy. Fifty percent of subjects overall achieved a final visual acuity of 6/18 or better. Men demonstrated improved visual acuity when compared with women (P = 0.04). Age had no effect on final acuity. Intravenous drug use is a significant risk factor for developing EFE. Good visual outcomes can be achieved with early treatment, often with intravitreal therapy alone.

Flucytosine for treatment of Candida albicans in H1N1-positive patient

A 17-year-old H1N1-positive patient was successfully extubated after 25 days of ventilatory support for treatment of viral pneumonia which was complicated by empyema thoracis due to Candida albicans. Hematogenous spread was suspected as simultaneous culture of ascitic fluid identified Candida species sensitive to flucytosine but resistant to amphotericin B and azole group of antifungals. Monotherapy with flucytosine led to clinical and radiological improvement.

Characterization of biofilms formed by Candida parapsilosis, C. metapsilosis, and C. orthopsilosis

Infections due to Candida parapsilosis have been associated with the ability of this fungus to form biofilms on indwelling medical devices. Recently, C. parapsilosis isolates were reclassified into 3 genetically non-identical classes: C. parapsilosis, C. orthopsilosis, and C. metapsilosis. Little information is available regarding the ability of these newly reclassified species to form biofilms on biomedical substrates. In this study, we characterized biofilm formation by 10 clinical isolates each of C. parapsilosis, C. orthopsilosis, and C. metapsilosis. Biofilms were allowed to form on silicone elastomer discs to early (6 h) or mature (48 h) phases and quantified by tetrazolium (XTT) and dry weight assays. Surface topography and three-dimensional architecture of the biofilms were visualized using scanning electron microscopy (SEM) and confocal laser scanning microscopy (CLSM), respectively. Metabolic activity assay revealed strain-dependent biofilm forming ability of the 3 species tested, while biomass determination revealed that all 3 species formed equivalent biofilms ( P>0.05 for all comparisons). SEM analyses of representative isolates of these species showed biofilms with clusters of yeast cells adherent to the catheter surface. Additionally, confocal microscopy analyses showed the presence of cells embedded in biofilms ranging in thickness between 62 and 85 μm. These results demonstrate that similar to C. parapsilosis, the 2 newly identified Candida species ( C. orthopsilosis and C. metapsilosis) were able to form biofilms.

The resistance to fluconazole in patients with esophageal candidiasis

Esophageal candidiasis is often observed in patients with risk factors for its development and fluconazole is the therapeutic choice for the treatment of this disease. To determine its frequency, by performing upper digestive endoscopy; to determine Candida species involved in its pathogenesis and verify their distribution according with the predisposing factors and to determine susceptibility to fluconazole in the samples. From March 2006 to April 2007, all patients submitted to esophagogastroduodenoscopy at the Digestive Endoscopy Unit in the Oswaldo Cruz University Hospital, Recife, PE, Brazil, were eligible for the study. Samples were collected from patients who presented lesions consistent with esophageal candidiasis in order to identify Candida species and verify their susceptibility to fluconazole. The predisposing factors for the occurrence of esophageal candidiasis were described. Of 2,672 patients referred to upper endoscopy at the Digestive Endoscopy Unit, 40 (1.5%) had endoscopic findings compatible with esophageal candidiasis. The average age was 49.1 years. Twenty one patients (52.5%) were less than 50 years old, of which 82.6% were infected with HIV. Most of them (52.5%) were males and 65.0% were inpatients. Diseases were identified in 90% of the patients and 21 (52.5%) were HIV positive. Concerning endoscopic findings, severe forms of esophagitis were found in 50% of the patients with CD4 count <200. Non-albicans Candida species were isolated in 22.7% of HIV positive and in 45% HIV negative patients. A total of 6 (14.28%) samples were resistant to fluconazole, while 2 (4.76%) samples had dose depending susceptibility to this drug. Esophageal candidiasis prevalence was low, although within the results described by other authors. Male and inpatients were the most affected. The species isolated varied according to the characteristics of each group studied. Both, resistance and dose-depending susceptibility to fluconazole were considered high.