Species Distribution and in vitro Antifungal Susceptibility of Oropharyngeal Yeast Isolates from HIV Patients in Zewditu Memorial Hospital, Addis Ababa, Ethiopia
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2014-06
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Addis Ababa University
Abstract
Background: Oropharyngeal Candidiasis (OPC) is the most frequent opportunistic fungalinfection of the oral cavity in HIV infected patients. OPC is associated with increasedmorbidity and mortality in immunosuppressed patients. However, data on Species distributionand antifungal susceptibility profiles of yeast isolated from HIV-infected patients in Ethiopia is limited.
Objective: The aim of the study was to determine the spectrum of Oropharyngeal yeastisolates from HIV patients and to evaluate antifungal drug susceptibility profile of yeastisolates to commonly used antifungal drugs.
Method: A cross sectional study was conducted in Zewditu Memorial Hospital, Addis Ababa.Oral swabs were collected from 224 HIV patients and cultured on Sabouraud Dextrose Agarwith chloramphenicol. All the isolates were characterized to a species level following standardmicrobiological techniques. The antifungal susceptibility profiles of all yeast were determined using disk diffusion method.
Result: Of 224 HIV patients screened, 139 (62.1%) were colonized by yeasts. The rate ofcolonization is higher in patients that non HAART than HAART initiated (72.3% versus51.8%). A total of 155 yeasts were isolated of which 153 (98.7%) were accounted by Candidaconsisting of five species and 2(1.3%) non-candida yeasts. Out of all isolates C. albicans wasthe most frequently isolated species accounting 68.4% followed by C. glabrata (15.5%) and C.tropicalis (11%). The Antifungal susceptibility pattern of the yeast isolates for Fluconazole,ketoconazole, Amphotericin B, Clotrimazole, Nystatin and Miconazole showed a resistance of12.3%, 8.4%, 5.8%, 2.6%, 1.3%, and 0.6% respectively. C. albicans were 5.7% resistant toketoconazole and 6.6% resistant to Fluconazole. C. glabrata and C. tropicalis were 12.5% and17.6% resistant to ketoconazole and 16.6% and 35.3% resistant to fluconazole respectively
Conclusion: The spectrum of yeast isolated in the present study was relatively high even if C.albicans was the predominantly isolated yeast. The results of this study also revealed thatdevelopment of drug resistance by yeast isolates were considerable. Isolation, characterizationand evaluating drug susceptibility pattern of the isolates in this hospital in particular and in health institutions through out of the country in general is recommended.
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HIV Patients