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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Date
2014-06
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Addis Ababa University
Abstract
Background: Oropharyngeal Candidiasis (OPC) is the most frequent opportunistic fungal
infection of the oral cavity in HIV infected patients. OPC is associated with increased
morbidity and mortality in immunosuppressed patients. However, data on Species distribution
and 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 yeast
isolates from HIV patients and to evaluate antifungal drug susceptibility profile of yeast
isolates 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 Agar
with chloramphenicol. All the isolates were characterized to a species level following standard
microbiological 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 of
colonization is higher in patients that non HAART than HAART initiated (72.3% versus
51.8%). A total of 155 yeasts were isolated of which 153 (98.7%) were accounted by Candida
consisting of five species and 2(1.3%) non-candida yeasts. Out of all isolates C. albicans was
the 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 of
12.3%, 8.4%, 5.8%, 2.6%, 1.3%, and 0.6% respectively. C. albicans were 5.7% resistant to
ketoconazole and 6.6% resistant to Fluconazole. C. glabrata and C. tropicalis were 12.5% and
17.6% 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 that
development of drug resistance by yeast isolates were considerable. Isolation, characterization
and 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