Immune-compromised Patients Research Articles

Post-COVID pulmonary mucormycosis- A case report

The fungal infection clinically referred as mycormycosis also zygomycosis are common infections to human where causative agent i.e., Mucoromycotina is member of mucorales. The causative agent mucoromycotina habitats in soil and decaying organic matter. The mycoromycotina infection remains associated with wide array of human disease including septic arthritis, dialysis-associated peritonitis, renal disorders, gastritis, and pulmonary diseases. These infections are closely associated with mucous layer of skin precisely cutaneous layer. These infections are also seen in clinical samples to nasal and upper respiratory tract. The higher prevalence of nasal cerebral i.e. rhinocerebral mycormycosis reported in case of immune compromised patients that trigger colonization of R. oryzae. In chronic state as infection reaches to lower respiratory tract these infection are difficult to diagnose and treat due to lack of precise methods. It has been reported neutropenia patients are more prone for mycormycosis infections due to extensive use of chemotherapy resulting impaired immunity. In recent time, necrotizing pneumonia is major symptoms reported in case of pulmonary mycormycosis. The common antifungal medication based clinical symptoms such as dyspnea, congestion and chest pain with rise in body temperature itraconozole is highly recommended. Further, a combination of antifungal and antimicrobial agents had shown a significant higher clinical recovery in mycormycosis case. Keywords: Amphotericin B, Hyponatremia, Itraconazole, Voriconazole, Oral Posaconazole.

Fecal Microbiota Transplantation in Allogeneic Hematopoietic Stem Cell Transplantation Recipients: A Systematic Review.

The disruption of gut microbiota eubiosis has been linked to major complications in allogeneic hematopoietic stem cell transplantation (allo-HSCT) recipients. Various strategies have been developed to reduce dysbiosis and related complications. Fecal microbiota transplantation (FMT) consists of the infusion of fecal matter from a healthy donor to restore impaired intestinal homeostasis, and could be applied in the allo-HSCT setting. We conducted a systematic review of studies addressing the use of FMT in allo-HSCT patients. In the 23 papers included in the qualitative synthesis, FMT was used for the treatment of recurrent Clostridioides difficile infections or as a therapeutic strategy for steroid-resistant gut aGvHD. FMT was also performed with a preventive aim (e.g., to decolonize from antibiotic-resistant bacteria). Additional knowledge on the biological mechanisms underlying clinical findings is needed in order to employ FMT in clinical practice. There is also concern regarding the administration of microbial consortia in immune-compromised patients with altered gut permeability. Therefore, the safety profile and efficacy of the procedure must be determined to better assess the role of FMT in allo-HSCT recipients.

Hepatitis C Virus Infection among HIV-Infected Patients Attending Dessie Referral Hospital, Northeastern Ethiopia.

Objective Hepatitis C Virus (HCV) and Human Immunodeficiency Virus (HIV) coinfection increases the incidence of end-stage liver disease which is more severe in immune-compromised HIV-infected patients than HCV infection alone. The aim of this study was to assess HCV infection and the associated risk factors among HIV/AIDS patients attending Dessie Referral Hospital, Northeastern Ethiopia. Methods A hospital-based cross-sectional study was conducted among 249 HIV-infected adults selected by a systematic random sampling technique from January to March 2018. A structured questionnaire was used to collect sociodemographic and risk factor data. Moreover, the blood specimen was collected and tested for CD4 count and anti-HCV antibody detection according to standard operating procedures. The data obtained were entered into SPSS version 20, and descriptive statistics, bivariate and multivariate logistic regression analyses were performed. A P value ≤0.05 with a corresponding 95% confidence interval was considered as statistically significant. Result Of a total of 249 HIV-infected study subjects, 120 (48.2%) were male and 129 (51.8%) were females, while the mean (±SD) age and CD4+ cells/mm3 were 39.10 (±11.507) years and 316.08 + 290.607 cells/mm3, respectively. Anti-HCV antibody was detected in 13 (5.2%) patients with higher prevalence rate found in males (P=0.078) and elders >50 years of age (P=0.013) than their counterparts. Age group of >50 years of age (AOR = 9.070, 95% CI: 1.578, 52.117, P=0.013), longer duration of HIV treatment (AOR = 5.490, 95% CI: 1.341, 34.458, P=0.041), WHO clinical stage III/IV (AOR = 12.768, 95% CI: 2.293, 71.106, P=0.004), previous history of hospitalization (AOR = 10.234, 95% CI: 2.049, 51.118, P=0.005), tooth extraction (AOR = 6.016, 95% CI: 1.137, 36.837, P=0.048), and liver disease (AOR = 11.398, 95% CI: 1.275, 101.930, P=0.029) were statistically significant predictors of HCV infection. Conclusion The prevalence of HCV infection is still higher and causes concern. Therefore, screening of these high-risk groups should be critical to reduce mortality and to improve clinical outcomes.

The Efficacy of Citrus maxima Peels Aqueous Extract Against Cryptosporidiosis in Immunecompromised Mice.

Cryptosporidiosis is an opportunistic globally distributed parasitic disease caused by protozoan Cryptosporidium where its development is closely related to the host's immune status. New therapeutic agents are a high priority as chemotherapeutics are impractical and vaccines are unavailable for young as well as immune-compromised patients or animals. The current study was designed to evaluate the therapeutic effect of the internal white (albedo) and external yellow (flavedo) peels of Citrus maxima (C. maxima) as an alternative medicinal plant. MATERIALS AND METHODS: Parasitological examination for oocysts in the stool was determined. Histopathological alterations and immunohistochemical expression of APC and cyclin D1 as well as an assessment of interferon-γ (IFN-γ) and interleukin 1β (IL-1β) in ileal tissues was carried out. In addition, the biochemical examination of serum albumin, globulin and liver enzymes were evaluated. Results revealed a significant decrease of oocysts count correlated with an amelioration of histopathological and immunohistochemical changes in ileal tissue with an enhancement of liver enzymes and inflammatory cytokines levels. It could be concluded that treatment with C. maxima peel extracts have a potential therapeutic and an immunoregulatory efficacy against Cryptosporidiosis. Obtained results showed that the white peel was found to have more immunological effect that could significantly enhance inflammatory cytokines response towards normal status. Hence, it can be used in the daily animal diet to give protective effects against infection.

Molecular detection and genotyping of β-human papillomavirus and it's association with epithelial skin neoplasms.

Epidemiological and molecular biological data suggest that β-human papillomavirus (HPV) can cause epithelial skin tumors, but the relationship remains unclear. A new approach to the diagnosis of HPV is based on the measurement of viral consistence. We examined 52 immune-compromised and immune-competent patients in order to identify the association of epithelial neoplasms with β-HPV. Determination of HPV was performed by polymerase chain reaction with hybridization-fluorescence detection in real-time. Amplification and detection were carried out with "Rotor-Gene" 3000 ("Corbett Research," Australia). To quantify the beta HPV genus, we used recombinant plasmid positive controls as well as control plasmid of β-globin fragments taken from human genes (Central Scientific Institute of Epidemiology Rospotrebnadzor). We have found that β-HPV DNA predominated in fibroepithelial polyps (64%) and in the apparently healthy skin (54%) of immune-compromised patients versus 47% in the skin of healthy donors. Mixed infection was detected in fibroepithelial polyps of 57% in the immune-compromised patients. Viral consistence in the fibroepithelial polyps was higher than in the apparently normal donors' skin. The high detection of HPV DNA was found in fibroepithelial polyps and in the apparently healthy skin of immune-compromised patients whereas a high level of HPV DNA was only found in fibroepithelial polyps.

LIG1 syndrome mutations remodel a cooperative network of ligand binding interactions to compromise ligation efficiency.

Human DNA ligase I (LIG1) is the main replicative ligase and it also seals DNA breaks to complete DNA repair and recombination pathways. Immune compromised patients harbor hypomorphic LIG1 alleles encoding substitutions of conserved arginine residues, R771W and R641L, that compromise LIG1 activity through poorly defined mechanisms. To understand the molecular basis of LIG1 syndrome mutations, we determined high resolution X-ray structures and performed systematic biochemical characterization of LIG1 mutants using steady-state and pre-steady state kinetic approaches. Our results unveil a cooperative network of plastic DNA-LIG1 interactions that connect DNA substrate engagement with productive binding of Mg2+ cofactors for catalysis. LIG1 syndrome mutations destabilize this network, compromising Mg2+ binding affinity, decreasing ligation efficiency, and leading to elevated abortive ligation that may underlie the disease pathology. These findings provide novel insights into the fundamental mechanism by which DNA ligases engage with a nicked DNA substrate, and they suggest that disease pathology of LIG1 syndrome could be modulated by Mg2+ levels.

An outbreak of Ralstonia pickettii bloodstream infection among pediatric leukemia patients.

Ralstonia pickettii is an opportunistic waterborne microbe which can survive in many kinds of solutions. Contamination of these solutions may result as outbreaks, which can be mortal for immuncompromised patients. Herein we report an outbreak of R. pickettii related to contaminated saline infusion in our center. This study was conducted in Ankara Pediatric City Hospital. An outbreak occured in Pediatric Hematology and Oncology Unit between August 28, 2019 and September 13, 2019. When the outbreak occured, infection control team began an investigation. Environmental samples were collected in order to find the source of the outbreak. A total of 11 patients with catheter related blood stream infection caused by R. pickettii who were diagnosed with leukemia were affected. None of the patients infected with R. pickettii died during the outbreak. A total of seventy environmental samples were cultured with the purpose of finding the source of outbreak. R. pickettii grew in normal saline solution culture and all isolates had the same clone of R. pickettii. The outbreak lasted two weeks and was controlled by stopping the usage and sending back the saline solutions belonging to the same manufacturing batch. We reported an outbreak of R. pickettii BSIs in highly immunocompromised patients due to contaminated intravascular solution, which was rapidly controlled by infection control measures. Vigilant surveillance by hospital infection control teams and prompt investigation to identify the source of nosocomial infections are crucial to stop an outbreak.

The Impact of Coronavirus Disease 2019 (COVID-19) among Immune Compromised Patients in Augusta Victoria Hospital AVH-2021

Background: Coronavirus disease 2019 which is officially known as COVID-19 belongs to family viruses. COVID-19 manifestations vary among affected people. These symptoms may become more serious among patients suffering from chronic disease and those who are on treatment which may af-fect their defense mechanism or immune-compromised patients who become more vulnerable to complications of COVID-19, and at high risk for morbidity and mortality with any bacterial or viral illness. Method: A retrospective, non-experimental research design was applied with a quantitative approach among patients with COVID-19 who were admitted to COVID-19 department at AVH with a total of 72 patients. Data were extracted from a patients’ elec-tronic medical record. Results: During COVID-19 outbreak 72 patients were admitted to COVID department at AVH, 54.2% were female and 33% of study participants were from Gaza governorate followed by Jerusalem 27%. Most participants 34.7% had first clinic visit after two days from the onset of COVID-19 symptoms. 45.8% were discharged to home while 13.9% died. All inflammatory markers that include ferritin, C-RP, IL-6 and D-dimer are in-creasing in all patients that were admitted to hospital; IL-6 and D-dimer were significant inflammatory markers in relation to the mortality rate. The study found the risk of mortality with IL-6 mean (218.5), and D-dimer mean (12). Furthermore there was a relation between increased risk of mortality and im-mune comprised. Conclusion: Mortality rate increased among COVID-19 pa-tients when IL-6 was higher than 218.5 and D-dimer higher than 12, and there was a relationship between increased risk of mortality and immune comprised.

Non-traumatic, non-clostridial gas gangrene of the lower limb requiring hip disarticulation: A case report

Introduction: Non-traumatic (spontaneous) gas gangrene is very rare and usually caused by clostridial organism in immune compromised patients. This case report presents a rare occurrence of this condition by non-clostridial organism in a patient with no known immune compromising status. Case Report: A 45-year-old male plumber presented with a three months history progressively worsening atraumatic right leg gas gangrene. Within 48 hours of admission, the infection ascended from the knee to the hip joint necessitating a hip disarticulation. Tissue culture yielded Klebsiella pneumoniae as the offending organism. Conclusion: Non-traumatic, non-clostridial gas gangrene may occur in previously healthy individuals. Systemic manifestation of sepsis is delayed hence improving the chances of survival if identified early and prompt and appropriate antibiotic and surgical intervention is instituted.

Histoplasmosis: An Important Mycosis of Public Health Significance

Histoplasmosis, a highly infectious fungal disease of public health concern, is caused by Histoplasma capsulatum var. capsulatum, a dimorphic fungus that occurs in mycelial and yeast form. The respiratory tract is recognized as the primary site of H. capsulatum var.capsulatum and the infection is acquired by inhalation of fungal spores from the saprobic environment. Disease can occur in sporadic as well as in epidemic form causing morbidity and mortality in susceptible individuals. Sporadic cases of histoplasmosis are reported from over 60 countries of the world including India. In USA, 25,000 cases of histoplasmosis are diagnosed every year. Certain groups of people who are associated with the soil related activities are at greater risk for developing the severe forms of disease. The fungus has the potential to infect every organ of the body including the skin, lung, brain, eye, adrenal gland, heart, liver, spleen, nose, gastrointestinal tract etc. The infection remains asymptomatic in over 90% of cases. The clinical presentation is varied and the affected person shows fever, headache, dry cough, dyspnea, chest pain, profuse sweating, lymphadenopathy, lesions in the mouth and skin etc. histoplasmosis in immune compromised patients, especially suffering from AIDS has poor prognosis. Mycological, immunological, and molecular techniques are employed to confirm an unequivocal diagnosis of disease. However, the isolation of H. capsulatum var. capsulatum from the clinical specimens still considered the gold standard of diagnosis. Antifungal drugs like liposomal amphotericin B and itraconazole are recommended for the management of disease. The disseminated histoplasmosis can be fatal if left untreated. It is imperative that immune compromised persons must avoid visiting the heavily contaminated sites that are inhabited by bats excreta and avian droppings

Isolation and Antibiotic-Resistant Pattern of Opportunistic Infectious Microbes from the Infected Sites of Oral Cancer Patients Compared to That of Healthy People Oral Microbiota

Introduction: Oral cancer is the third most prominent type of cancer in Bangladesh. During or after oral cancer treatment, immune-compromised cancer patients may be susceptible to an infection by multi-drug-resistant opportunistic microbes. This study aims to identify the prevalent microorganisms from the infected site of oral cancer patients and observe their antibiotic susceptibility pattern. Materials and Methods: Clinical samples were collected from the infected sites of oral cancer patients and healthy people. The swabs collected were placed on nutrient agar slant, then incubated for 24 hours at 37ºC. Bacteria from the slant were inoculated in several selective media (Mannitol Salt Agar Media, KF Streptococcus Agar media, Cetrimide Agar, Eosin Methylene Blue Agar). Several biochemical tests identified opportunistic microorganisms. Finally, the antibiotic susceptibility test was performed by the Kirby Bauer disc diffusion method. Results: The study found that 65.4% of microbes isolated from the patients’ oral cavities were Gram-negative bacteria, and 34.6% were Gram-positive bacteria. Among the patient group isolates (n = 55), the most prevalent organism was Pseudomonas spp. (30; 54.54%). Others were Klebsiella spp. (27; 49.09%), Staphylococcus spp. (24; 43.63%), E. coli (14; 25.45%), Streptococcus spp. (14; 25.45%), Proteus spp. (12; 21.8%) and Enterococcus spp. (6; 10.90%). Both Gram-positive and Gram-negative microbes from the patient group have shown high resistance to the commonly used antibiotics. In the control group (n = 50), the most prevalent organism was Staphylococcus spp. (15; 30%). Other organisms were Streptococcus spp. (6; 12%), Klebsiella spp. (11; 22%), E. coli (3; 6%), Streptococcus spp. (14; 25.45%), Pseudomonas spp. (8; 16%). The microbes of the control group showed less resistance to the antibiotics and rather showed sensitivity to them. Conclusion: The study revealed a high prevalence of multi-drug-resistant opportunistic microbes on immune-compromised oral cancer patients compared to microbes isolated from healthy people’s oral cavity.

Simple Interrupted and Continuous Interlocking Suturing Techniques Comparison in Maxillofacial Trauma – A Randomized Controlled Trial

Aim: To compare the efficacy of simple interrupted and continuous interlocking suturing techniques using 3-0 vicryl (polyglactin) sutures. Method: The study sample included 20 patients (16 males and four females) with maxillofacial trauma requiring ORIF (Open Reduction and Internal Fixation) of maxilla or mandible fractures. They were randomly allocated to two groups (Group A and Group B). Patients in the age group of 20-50 years, requiring ORIF under local anesthesia or general anesthesia through an intraoral approach and incision measuring 4-6 cm were included in the study. Exclusion criteria included patients requiring extra-oral incisions, comminuted fractures with acute illness, infection, pregnancy, immune compromised conditions and patients not willing to participate in the study. Surgical site was closed in single layer using 3-0 vicryl sutures. Intraoperatively, time taken for suturing, wound dehiscence and wound healing were monitored on third, seventh and 30th day post-operatively. Results: In terms of time taken for suturing, dehiscence of wound and wound healing, continuous interlocking sutures showed superior results than that of simple interrupted sutures. Conclusion: Even though simple interrupted suturing is an easy technique, continuous interlocking suturing technique showed superior results. However, surgeons operating maxillofacial trauma may have their own point of view and selection of technique depends on individual preferences.

Moving ahead in HCV diagnostics: Need for the introduction of HCV core antigen assay in low and middle-income countries

Hepatitis C virus (HCV) infections are associated with significant morbidity and mortality globally. The diagnosis of HCV is primarily based on indirect serological assays such as enzyme-linked immunosorbent assay (ELISA), chemiluminescence immunoassay (CIA), and rapid diagnostic tests to detect HCV antibodies. Direct tests detect/quantify components of HCV virions, such as HCV ribonucleic acid (RNA) (nucleic acid test or nucleic acid amplification test [NAT]) and HCV core antigen (HCVcAg). The HCVcAg assay (CIA, Abbott ARCHITECT) is an immune assay used for the quantitative determination of the HCVcAg. This test is simple and fast with the potential to be incorporated into diagnostic guidelines and be used in combination with anti-HCV (CIA) as an effective screening test. HCVcAg can also be used as a potential biomarker for treatment initiation and monitoring patients to assess the treatment response. Apart from this, the scope for implementation of the HCVcAg assay in resource limited setting lies in screening of immune compromised patients where anti-HCV serology is not dependable. However, concerns related to lower sensitivity compared to HCV RNA do exist. Nevertheless, the HCVcAg assay can make a significant difference in the measures taken for the control and eradication of hepatitis C and its complications in India.

A Review on the Microbial Contamination in the Non-sterile Pharmaceutical Products

This article aims to review available scientific data dealing with the Microbial contamination that may occur by some environmental factors (temperature, pH, and water activity), these factors are a major problem for the spoilage of pharmaceutical dosage form, and raw material, personnel, and other factor contributing to the transfer of the microbe into the pharmaceutical product. Non-sterile oral pharmaceuticals, including syrups, do not need to be sterile. At the same time, certain quality-control tests and some measures were followed, according to current good manufacture practice (cGMP), which are essential to keep the microbial content of these preparations safe and acceptable. Similarly, may manufacturer failures to comply with the Good Manufacturing Practice (GMP) at any stage of pharmaceutical production may consequently affect the microbiological quality of the product, and ultimately they caused economical loss for industrialists on the spoilage of pharmaceuticals. Microbial contamination in the pharmaceutical products increases from prescribed limits may change their Physico-chemical properties of the dosage form may be chances to hazardous for the immune-compromised patient due to overload microbial contamination. All the components of the non-sterile pharmaceuticals such as API and all kinds of excipients are at risk due to microbe overloaded and spoilage. Strictly the following (cGMP), continuous pharmaceutical surveillance is required to control microbial contamination within the pharmaceutical preparations.

Vanishing primary lung aspergilloma in young female with diabetes mellitus

Aspergilloma is a saprophytic infection caused by Aspergillus fumigatus. It is common but frequently misdiagnosed clinical condition. It is usually diagnosed in patients with a long standing history of tuberculosis and other diseases leading to cavity formation. Although, primary Aspergilloma also seen in immune compromised patient without previous history of cavitary lung disease. Aspergilloma have unique radiological manifestation. Very rarely, they have been resolved without surgical intervention. We hereby report a case of primary Aspergilloma in cavitatory lung mass presenting with hemoptysis in young diabetic female. The establishment of Aspergilloma as the underlying diagnosis led to conservative medical treatment which was followed by complete resolution of the cavitary mass like opacity. The present case highlights that Aspergilloma can be conservatively managed with antifungal therapy leads to disappearance of lesion. Keywords: CECT thorax; Hemoptysis; Primary aspergilloma.

Whole-genome sequence, functional annotation, and comparative genomics of the high biofilm-producing multidrug-resistant Pseudomonas aeruginosa MZ4A isolated from clinical waste

Being an opportunistic pathogen, Pseudomonas aeruginosa causes a wide-array of nosocomial infections, especially in immune-compromised patients. Therefore, the genomic study of this bacteria is of utmost importance to understand their pathogenic behaviour. In this study, we aimed to report and analyse the genome sequence of P. aeruginosa strain MZ4A, a heavy biofilm-producing multidrug-resistant strain isolated from clinical waste. The estimated genome size was 6.42 Mb with 66.3% of G + C content. The genome encoded 5856 protein-coding genes, 51 pseudogenes, and 71 RNA genes. The virulome and resistome of MZ4A comprise 234 and 52 genes, respectively. Of the 234 virulent genes, 204 were functionally annotated in which 80 genes are involved in type-IV pili and flagella-mediated surface adherence. Furthermore, most of the antimicrobial resistance genes were associated with efflux pump functionality. Based on the orthologues clustering, MZ4A shared gene families linked to pathogenicity and adaption with other nosocomial pathogens. Phylogenetic analysis revealed that the strain MZ4A is closely related to P. aeruginosa PAO1. Finally, the annotated draft genome has been deposited at the NCBI database under the accession number WOVI00000000.

Mechanistic insights into Candida biofilm eradication potential of eucalyptol.

Candida-associated fungal infections are prevalent in hospitalized and immune-compromised patients. Their biofilm architecture and high rate of antifungal resistance make treatment challenging. Eucalyptol (EPTL), a monoterpene majorly present in the essential oil of eucalyptus is well known for curing respiratory infections. Hence, the present study investigated the anti-biofilm efficacy of EPTL against the laboratory strains and clinical isolates of Candida to delineate its mode of action. The effect of EPTL on the viability, biofilm formation, and mature biofilm of Candida strains was studied. Furthermore, its effect on cell cycle arrest, mitochondrial membrane potential (MMP), ROS generation, germ tube formation, ergosterol content and transcriptional expression of selected genes was also investigated. EPTL exhibited anti-biofilm activity against mature and developing biofilm of Candida albicans and Candida glabrata along with their clinical isolates. The biochemical components and enzyme activity were differentially modulated in EPTL-treated biofilm extracellular matrix. EPTL generated ROS and arrested cell cycle at the G1 /S phase in both the species, while altered MMP was recorded in C. glabrata. Transcriptional analysis evidenced for differential gene expression of selected ABC transporters, secreted hydrolytic enzymes, and cell wall biogenesis in C. albicans/C. glabrata upon treating with EPTL. The current data on anti-biofilm activity of EPTL establish its candidacy for drug development or as an adjuvant with existing antifungal formulations. Present investigation elucidates the mode of action of Eucalyptol as antifungal agent and would stand as a candidate for management of topical fungal infection.

STREPTOCOCCUS SALIVARIUS: AN UNUSUAL ETIOLOGY OF NEONATAL SEPSIS

Streptococcus salivarius is a rare cause of infection in neonate .It is a commensal organism in the oral cavity. Though commensal it can cause invasive infection in immune compromised patients. We report blood stream infection with streptococcus salivarius in a neonate with pneumonia. The blood stream infection was considered significant and treated.

Determinants of periodontitis according to the immunological and virological profiles of HIV-infected patients in Yaound\xe9, Cameroon

BackgroundHIV infection is associated to different oral manifestations (including periodontal diseases), which have decreased with the advent of antiretroviral therapy (ART). Yet, the occurrence of periodontitis is still consistent among patients with HIV living in sub Saharan-Africa, with limited evidence on the driven factors and mitigating measures in these settings. We aimed at evaluating the occurrence of periodontitis and its associated immunological and virological factors in patients with HIV living in Yaoundé, Cameroon.MethodsWe included 165 (44 ART-naïve and 121 ART-experienced) patients > 18 years old attending the Yaoundé Central Hospital and the Chantal BIYA International Reference Centre, from January-April 2018. The periodontal status was assessed by measuring the clinical attachment loss, periodontal pocket depth, plaques index and gingival bleeding index. CD4+/CD8+ cells and viremia were measured using the fluorescence-activated cell sorting method (FACS Calibur) and the Abbott m2000 RT HIV-1 RNA kit respectively. A standard-questionnaire concerning participants’ medical records and oral hygiene methods was filled. Data was analyzed and p < 0.05 considered statistically significant.ResultsThere was a significantly high prevalence of periodontitis in the ART-naïve (53.2%) compared to the ART-experienced group (37.3%), with a twofold increased risk of the ART-naïve population presenting with periodontitis than the ART-experienced population (OR 2.06, p = 0.03). More importantly, ART-naïve, patients with CD4 < 200 cells presented with higher risk of having periodontitis compared to those with higher CD4-values, with a threefold difference (OR 3.21). Worth noting, males presented with a higher risk of having clinical attachment loss (OR 6.07). There was no significant association between the occurrence of periodontitis and the CD8 (p = 0.45) or viremia (p = 0.10).ConclusionIn the Cameroonian context, a considerable number of adults infected with HIV suffer from periodontitis regardless of their treatment profile. Nonetheless, ART-naïve patients have a higher risk, indicating the protective role of ART. Interestingly, severely immune-compromised patients and men are vulnerable to periodontitis, thereby highlighting the need for clinicians to refer patients for regular periodontal screening especially male patients and those with low CD4. Such measures could greatly improve the quality of life of the population living with HIV in Cameroon.

Effect of phenotypic switching on the susceptibility of Candida krusei towards amphotericin B, nystatin and Piper betle aqueous extract

Candida krusei (C. krusei) is associated with oral candidiasis, particularly in immunecompromised patients. The objective of the study was to determine the effect of phenotypic switching to the susceptibility of C. krusei towards amphotericin B, nystatin and aqueous extract of Piper betle (P. betle). To induce phenotypic switching, C. krusei was inoculated in yeast extract peptone dextrose (YEPD) broth supplemented with 5 mg mL-1 phloxine B andincubated for five hours at 25 °C. Later, 100 µL of the suspension was inoculated on YEPD agar supplemented with 5 mg mL-1 phloxine B and incubated for five days at 25 °C. Disc diffusion and minimum inhibitory concentration (MIC) assays were conducted to determine the susceptibility of C. krusei. The results showed that all C. krusei switched generations were susceptible towards amphotericin B and nystatin with the 3rd and 4th generations significantly more susceptible than the un-switched, respectively (P&lt;0.05). All C. krusei switched generations were also observed to be susceptible towards the aqueous extract of P. betle. The MIC of amphotericin B, nystatin and P. betle were determined at 10 µg mL-1, 10 µg mL-1 and 12.5 mg mL-1, respectively for all generations of C. krusei. In conclusion, the susceptibility of C. krusei was phenotypically switched generation dependent towards amphotericin B, nystatin, and Piper betle aqueous extract.