The Prevalence, Risk Factors and Antifungal Sensitivity Pattern of Oral Candidiasis in HIV/AIDS Patients in Kumba District Hospital, South West Region, Cameroon

Overview

Journal Pan Afr Med J

Date 2020 Aug 11

PMID 32774600

Citations 20

Authors

Ngwa Fabrice Ambe

Njunda Anna Longdoh

Patience Tebid

Tanyi Pride Bobga

Claude Ngwayu Nkfusai

Sangwe Bertrand Ngwa

Frankline Sanyuy Nsai

Samuel Nambile Cumber

Affiliations

Soon will be listed here.

Abstract

Introduction: Oral candidiasis is one of the most common opportunistic infection in HIV/AIDS patient and it is caused by species. The low absolute CD4+T-lymphocyte count has traditionally been cited as the greatest risk factor for the development of Oral Candidiasis. The aim of this study was to identify species isolated from the oral cavity of HIV/AIDS patients, to determine their in vitro antifungal susceptibility and to investigate the possible risk factors associated with oral candidiasis.

Methods: This was a hospital based cross sectional study that was carried out for a period of 3 months amongst HIV/AIDS patients in Kumba District Hospital, whether on HAART or not. Mouth swabs were collected from 378 participants using sterile cotton wool swabs and 5ml venous blood were collected for determination of CD4 cell. species were isolated and identified. Antifungal sensitivity testing was performed using modified kirby-bauer susceptibility testing technique.

Results: species were present in 42.86% of the samples and was the most prevalent (60.2%) amongst the six isolates identified, followed by (16.9%), (12.3%), (6.4%), (2.3%) and (1.8%). Pregnancy, oral hygiene and antibiotic usage were significantly associated with oral candidiasis in HIV/AIDS patients (P<0.05). Oral candidiasis was mostly frequent in HIV/AIDS patients between 21-40 years. A CD4 cell count less than 200 cells/μl was a significant risk factor for acquiring oral candidiasis in HIV/AIDS patients (P<0.001). Nystatin was the most sensitive drug (83.6%) meanwhile ketonazole was the most resistant drug (29.2%), followed by fluconazole (24.6%) to all oral isolates.

Conclusion: Oral colonization occurs more frequently in HIV/AIDS patients and the is a need for the government to implement regular checks for opportunistic infections in HIV/AIDS patients, including oral candidiasis in HIV/AIDS patients to monitor disease progression and prevent subsequent complications such as candidemia and diarrhea.

Citing Articles

Extracellular hydrolytic enzyme activities and biofilm formation in Candida species isolated from people living with human immunodeficiency virus with oropharyngeal candidiasis at HIV/AIDS clinics in Uganda.

Musinguzi B, Akampurira A, Derick H, Turyamuhika L, Mwesigwa A, Mwebesa E Microb Pathog. 2024; 199():107232.

PMID: 39675440 PMC: 11745906. DOI: 10.1016/j.micpath.2024.107232.

Distribution of Candida species isolated from people living with human immunodeficiency virus with oropharyngeal and oral candidiasis in Africa in the era of universal test and treat policy: a systematic review and meta-analysis.

Musinguzi B, Obuku E, Mwesigwa A, Migisha R, Kinengyere A, Ndagire R Trop Med Health. 2024; 52(1):88.

PMID: 39593167 PMC: 11600869. DOI: 10.1186/s41182-024-00649-6.

Oral Manifestations of HIV Infection and Dental Health Needs of Children with HIV Attending HIV Treatment Clinics in Western Cameroon.

Agbor A, Sohal K, Nguimfack N, Tarkang E, George E, Naidoo S Int J MCH AIDS. 2024; 13:e022.

PMID: 39526170 PMC: 11544498. DOI: 10.25259/IJMA_7_2024.

Prevalence of Oropharyngeal Candidiasis and distribution of species among People Living with Human Immunodeficiency Virus in Africa: a systematic review and meta-analysis.

Musinguzi B, Obuku E, Kinengyere A, Ndagire R, Baguma A, Mwesigwa A Res Sq. 2024; .

PMID: 38883750 PMC: 11177986. DOI: 10.21203/rs.3.rs-4534730/v1.

Drug-resistant oral candidiasis in patients with HIV infection: a systematic review and meta-analysis.

Keyvanfar A, Najafiarab H, Talebian N, Falah Tafti M, Adeli G, Ghasemi Z BMC Infect Dis. 2024; 24(1):546.

PMID: 38822256 PMC: 11143751. DOI: 10.1186/s12879-024-09442-6.

References

Sardi J, Scorzoni L, Bernardi T, Fusco-Almeida A, Mendes Giannini M . Candida species: current epidemiology, pathogenicity, biofilm formation, natural antifungal products and new therapeutic options. J Med Microbiol. 2012; 62(Pt 1):10-24. DOI: 10.1099/jmm.0.045054-0. View

Clark-Ordonez I, Callejas-Negrete O, Arechiga-Carvajal E, Mourino-Perez R . Candida species diversity and antifungal susceptibility patterns in oral samples of HIV/AIDS patients in Baja California, Mexico. Med Mycol. 2016; 55(3):285-294. DOI: 10.1093/mmy/myw069. View

Berberi A, Noujeim Z, Aoun G . Epidemiology of Oropharyngeal Candidiasis in Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome Patients and CD4+ Counts. J Int Oral Health. 2015; 7(3):20-3. PMC: 4385720. View

Nweze E, Ogbonnaya U . Oral Candida isolates among HIV-infected subjects in Nigeria. J Microbiol Immunol Infect. 2011; 44(3):172-7. DOI: 10.1016/j.jmii.2011.01.028. View

Mokaddas E, Al-Sweih N, Khan Z . Species distribution and antifungal susceptibility of Candida bloodstream isolates in Kuwait: a 10-year study. J Med Microbiol. 2007; 56(Pt 2):255-259. DOI: 10.1099/jmm.0.46817-0. View

Osaigbovo I, Lofor P, Oladele R . Fluconazole Resistance among Oral Candida Isolates from People Living with HIV/AIDS in a Nigerian Tertiary Hospital. J Fungi (Basel). 2018; 3(4). PMC: 5753171. DOI: 10.3390/jof3040069. View

Thanyasrisung P, Kesakomol P, Pipattanagovit P, Youngnak-Piboonratanakit P, Pitiphat W, Matangkasombut O . Oral Candida carriage and immune status in Thai human immunodeficiency virus-infected individuals. J Med Microbiol. 2014; 63(Pt 5):753-759. DOI: 10.1099/jmm.0.069773-0. View

Owotade F, Patel M, Ralephenya T, Vergotine G . Oral Candida colonization in HIV-positive women: associated factors and changes following antiretroviral therapy. J Med Microbiol. 2012; 62(Pt 1):126-132. DOI: 10.1099/jmm.0.047522-0. View

Liu X, Liu H, Guo Z, Luan W . Association of asymptomatic oral candidal carriage, oral candidiasis and CD4 lymphocyte count in HIV-positive patients in China. Oral Dis. 2006; 12(1):41-4. DOI: 10.1111/j.1601-0825.2005.01155.x. View

10.

Vazquez-Gonzalez D, Perusquia-Ortiz A, Hundeiker M, Bonifaz A . Opportunistic yeast infections: candidiasis, cryptococcosis, trichosporonosis and geotrichosis. J Dtsch Dermatol Ges. 2013; 11(5):381-93. DOI: 10.1111/ddg.12097. View

11.

Shetti A, Gupta I, Charantimath S . Oral Candidiasis: Aiding in the Diagnosis of HIV-A Case Report. Case Rep Dent. 2012; 2011:929616. PMC: 3335721. DOI: 10.1155/2011/929616. View

12.

Gottfredsson M, Cox G, Indridason O, de Almeida G, Heald A, Perfect J . Association of plasma levels of human immunodeficiency virus type 1 RNA and oropharyngeal Candida colonization. J Infect Dis. 1999; 180(2):534-7. DOI: 10.1086/314887. View

13.

Mushi M, Mtemisika C, Bader O, Bii C, Mirambo M, Gross U . High Oral Carriage of Non-albicans Candida spp. among HIV-infected individuals. Int J Infect Dis. 2016; 49:185-8. DOI: 10.1016/j.ijid.2016.07.001. View

14.

Maheshwari M, Kaur R, Chadha S . Candida Species Prevalence Profile in HIV Seropositive Patients from a Major Tertiary Care Hospital in New Delhi, India. J Pathog. 2016; 2016:6204804. PMC: 4820622. DOI: 10.1155/2016/6204804. View

15.

Beighton D, Ludford R, Clark D, Brailsford S, Pankhurst C, Tinsley G . Use of CHROMagar Candida medium for isolation of yeasts from dental samples. J Clin Microbiol. 1995; 33(11):3025-7. PMC: 228627. DOI: 10.1128/jcm.33.11.3025-3027.1995. View

16.

Shahapur P, Bidri R . Recent trends in the spectrum of opportunistic infections in human immunodeficiency virus infected individuals on antiretroviral therapy in South India. J Nat Sci Biol Med. 2014; 5(2):392-6. PMC: 4121922. DOI: 10.4103/0976-9668.136200. View

17.

Mushi M, Bader O, Taverne-Ghadwal L, Bii C, Gross U, Mshana S . Oral candidiasis among African human immunodeficiency virus-infected individuals: 10 years of systematic review and meta-analysis from sub-Saharan Africa. J Oral Microbiol. 2017; 9(1):1317579. PMC: 5508360. DOI: 10.1080/20002297.2017.1317579. View

18.

De Bernardis F, Tacconelli E, Mondello F, Cataldo A, Arancia S, Cauda R . Anti-retroviral therapy with protease inhibitors decreases virulence enzyme expression in vivo by Candida albicans without selection of avirulent fungus strains or decreasing their anti-mycotic susceptibility. FEMS Immunol Med Microbiol. 2004; 41(1):27-34. DOI: 10.1016/j.femsim.2003.12.006. View

19.

Rex J, Walsh T, Sobel J, Filler S, Pappas P, Dismukes W . Practice guidelines for the treatment of candidiasis. Infectious Diseases Society of America. Clin Infect Dis. 2000; 30(4):662-78. DOI: 10.1086/313749. View

20.

Ribeiro A, Menezes T, de Melo Alves-Junior S, de Menezes S, Marques-da-Silva S, Vallinoto A . Oral carriage of Candida species in HIV-infected patients during highly active antiretroviral therapy (HAART) in Belém, Brazil. Oral Surg Oral Med Oral Pathol Oral Radiol. 2015; 120(1):29-33. DOI: 10.1016/j.oooo.2015.03.008. View