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Benson M, Turyamuhika L, Mwesigwa A, Nalumaga PP, Kabajulizi I, Njovu IK, Mwebesa E, Luggya T, Ocheng F, Kateete DP, Itabangi H, Mboowa G, Sande OJ, Achan B. Distribution and antifungal susceptibility profile of oropharyngeal Candida species isolated from people living with HIV in the era of universal test and treat policy in Uganda. Ther Adv Infect Dis 2024; 11:20499361241255261. [PMID: 38812710 PMCID: PMC11135083 DOI: 10.1177/20499361241255261] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 04/30/2024] [Indexed: 05/31/2024] Open
Abstract
Background Despite the increased frequency of oropharyngeal candidiasis among people living with human immunodeficiency virus (HIV), its management is no longer effective due to empirical treatment and emergence of antifungal resistance (AFR). This study sought to investigate the prevalence of oropharyngeal candidiasis and assess the antifungal susceptibility profile of oropharyngeal Candida species isolated from people living with human immunodeficiency virus. Additionally, we evaluated the correlation between oropharyngeal candidiasis and CD4 T cell as well as viral load counts. Methods A descriptive cross-sectional study was carried out from April to October 2023 in which 384 people living with HIV underwent clinical examination for oral lesions. Oropharyngeal swabs were collected and cultured on Sabouraud Dextrose agar to isolate Candida species which were identified using the matrix assisted laser desorption ionization time of flight mass spectrometry. Additionally, the antifungal susceptibility profile of Candida isolates to six antifungal drugs was determined using VITEK® (Marcy-l'Étoile, France) compact system. Data on viral load were retrieved from records, and CD4 T cell count test was performed using Becton Dickinson Biosciences fluorescent antibody cell sorter presto. Results The prevalence of oropharyngeal candidiasis was 7.6%. Oropharyngeal candidiasis was significantly associated with low CD4 T cell count and high viral load. A total of 35 isolates were obtained out of which Candida albicans comprised of 20 (57.1%) while C. tropicalis and C. glabrata comprised 4 (11.4%) each. C. parapsilosis, C. dubliniensis and C. krusei accounted for 2 (5.7%) each. Additionally, 7 (20%) isolates were resistant to fluconazole, 1 (2.9%) to flucytocine and 0.2 (5.7%) isolates were intermediate to caspofungin. However, specific specie isolates like C. albicans showed 20% (4/20), C. glabrata 50% (2/4) and C. krusei 50% (1/2) resistance to fluconazole. Additionally, C. krusei showed 50% resistance to flucytosine. Conclusion The prevalence of oropharyngeal candidiasis (OPC) among people living with HIV was low, and there was a significant association between OPC and CD4 T cell count as well as viral load. C. albicans was the most frequently isolated oropharyngeal Candida species. C. glabrata and C. krusei exhibited the highest AFR among the non-albicans Candida species. The highest resistance was demonstrated to fluconazole.
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Affiliation(s)
- Musinguzi Benson
- Department of Immunology and Molecular Biology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda
- Department of Medical Laboratory Sciences, Faculty of Health Sciences, Muni University, Arua, Uganda
| | - Laban Turyamuhika
- Department of Immunology and Molecular Biology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Alex Mwesigwa
- Department of Microbiology and Immunology, School of Medicine, Kabale University Kabale, Uganda
| | - Pauline Petra Nalumaga
- Mycology Unit, Department of Microbiology, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Immaculate Kabajulizi
- Mycology Unit, Department of Microbiology, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Israel Kiiza Njovu
- Mycology Unit, Department of Microbiology, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Edson Mwebesa
- Department of Mathematics, Faculty of Science, Muni University, Arua, Uganda
| | - Tonny Luggya
- Department of Immunology and Molecular Biology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Francis Ocheng
- Department of Dentistry, School of Health Sciences, College of Health Sciences, Makerere University, Kampala, Uganda
| | - David Patrick Kateete
- Department of Immunology and Molecular Biology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Herbert Itabangi
- Department of Microbiology and Immunology, Faculty of Health Sciences, Busitema University, Mbale, Uganda
| | - Gerald Mboowa
- Department of Immunology and Molecular Biology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda
- African Centre of Excellence in Bioinformatics and Data Intensive Sciences, The Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Obondo James Sande
- Department of Immunology and Molecular Biology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Beatrice Achan
- Department of Medical Microbiology, School of Biomedical Sciences, College of Health Sciences, Makerere University, P.O. Box 7072, Kampala, Uganda
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Thanyasrisung P, Satitviboon W, Howattanapanich S, Matangkasombut O. Antifungal drug resistance in oral Candida isolates from HIV-infected and healthy individuals and efficacy of chitosan as an alternative antifungal agent. Arch Oral Biol 2023; 147:105628. [PMID: 36680835 DOI: 10.1016/j.archoralbio.2023.105628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 12/29/2022] [Accepted: 01/16/2023] [Indexed: 01/19/2023]
Abstract
OBJECTIVE This study aimed to investigate antifungal resistance in oral Candida isolates and the efficacy of chitosan, a natural polymer, against drug-resistant Candida. DESIGN Oral Candida isolates were collected from HIV-infected and healthy individuals in our previous study (n = 66 isolates/group). The minimum-inhibitory-concentration (MIC) of amphotericin-B and fluconazole was determined by Epsilometer test. Minimal-fungicidal-concentration (MFC) of 3 chitosan derivatives: high-molecular-weight chitosan (HMWC, 150-200 kDa), oligomer (7-9 kDa) and polymer (900-1000 kDa) chitosan, were investigated by agar dilution method. Statistical analysis was performed using Chi-square or Fisher's exact tests as appropriate. RESULTS Fluconazole-resistant C. albicans were significantly more prevalent in HIV-infected than in healthy individuals (P = 0.02), while amphotericin-B-resistant C. parapsilosis were more common in healthy individuals (P = 0.03). The majority of Candida isolates were killed by HMWC at ≤ 40 mg/ml, as well as by oligomer and polymer chitosan at ≤ 6 mg/ml. Remarkably, chitosan was effective against most antifungal drug-resistant isolates. CONCLUSIONS Antifungal drug resistance was prevalent among oral C. albicans isolates from HIV-infected individuals. Chitosan could serve as a complementary antifungal agent against drug-resistant strains.
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Affiliation(s)
- Panida Thanyasrisung
- Department of Microbiology and Center of Excellence on Oral Microbiology and Immunology, Faculty of Dentistry, Chulalongkorn University, Bangkok 10330 Thailand.
| | - Wuttika Satitviboon
- DDS program, Faculty of Dentistry, Chulalongkorn University, Bangkok 10330 Thailand
| | | | - Oranart Matangkasombut
- Department of Microbiology and Center of Excellence on Oral Microbiology and Immunology, Faculty of Dentistry, Chulalongkorn University, Bangkok 10330 Thailand; Research Laboratory of Biotechnology, Chulabhorn Research Institute, Bangkok 10210 Thailand.
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Leerahakan P, Matangkasombut O, Tarapan S, Lam-Ubol A. Biofilm formation of Candida isolates from xerostomic post-radiotherapy head and neck cancer patients. Arch Oral Biol 2022; 142:105495. [PMID: 35839697 DOI: 10.1016/j.archoralbio.2022.105495] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 06/27/2022] [Accepted: 06/28/2022] [Indexed: 01/08/2023]
Abstract
Oral candidiasis is a common problem in post-radiation head and neck cancer (HNC) patients. While biofilm formation is a crucial virulence factor for Candida colonization, existing information on biofilm formation capability of Candida in cancer patients is scarce. OBJECTIVE To evaluate biofilm formation capability of Candida spp. colonized in xerostomic post-radiotherapy HNC patients. DESIGN Candida albicans and non-albicans Candida species were previously isolated from xerostomic post-radiation cancer patients and healthy individuals. Biofilm mass and biofilm metabolic activity were investigated by crystal violet and MTT assays, respectively. Their relationship with clinical parameters was analyzed using Mann-Whitney U and Chi-square tests. RESULTS A total of 109 and 45 Candida isolates from 64 cancer patients and 34 controls, respectively, were evaluated. Both biofilm mass and metabolic activity of Candida isolates from cancer patients were higher than those from controls. The between-group differences were statistically significant in C. albicans (p < 0.001) for biofilm mass, and in C. tropicalis (p = 0.01) for biofilm metabolic activity. Overall, C. tropicalis was the best biofilm producers in both groups. Additionally, we found that higher biofilm formation among C. albicans was associated with low saliva buffering capacity. CONCLUSIONS C. albicans and C. tropicalis isolated from xerostomic post-radiation cancer patients had higher biofilm formation capability than those from healthy individuals. Our findings suggest that, in addition to compromised host factors, higher biofilm formation capability may also contribute to the pathogenesis of oral candidiasis in HNC patients. This novel information potentially adds to proper management for these patients.
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Affiliation(s)
| | - Oranart Matangkasombut
- Department of Microbiology and Center of Excellence on Oral Microbiology and Immunology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand; Research Laboratory of Biotechnology, Chulabhorn Research Institute, Bangkok, Thailand
| | - Supanat Tarapan
- Faculty of Dentistry, Srinakharinwirot University, Bangkok, Thailand; Langsuan Hospital, Chumphon, Thailand
| | - Aroonwan Lam-Ubol
- Faculty of Dentistry, Srinakharinwirot University, Bangkok, Thailand.
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Oral Cavity and Candida albicans: Colonisation to the Development of Infection. Pathogens 2022; 11:pathogens11030335. [PMID: 35335659 PMCID: PMC8953496 DOI: 10.3390/pathogens11030335] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 03/07/2022] [Accepted: 03/08/2022] [Indexed: 02/01/2023] Open
Abstract
Candida colonisation of the oral cavity increases in immunocompromised individuals which leads to the development of oral candidiasis. In addition, host factors such as xerostomia, smoking, oral prostheses, dental caries, diabetes and cancer treatment accelerate the disease process. Candida albicans is the primary causative agent of this infection, owing to its ability to form biofilm and hyphae and to produce hydrolytic enzymes and candialysin. Although mucosal immunity is activated, from the time hyphae-associated toxin is formed by the colonising C. albicans cells, an increased number and virulence of this pathogenic organism collectively leads to infection. Prevention of the development of infection can be achieved by addressing the host physiological factors and habits. For maintenance of oral health, conventional oral hygiene products containing antimicrobial compounds, essential oils and phytochemicals can be considered, these products can maintain the low number of Candida in the oral cavity and reduce their virulence. Vulnerable patients should be educated in order to increase compliance.
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Pesee S, Samaranayake L, Roytrakul S, Paaopanchon C, Phantumvanit P. Prevalence And Susceptibility Profiles of Oral Yeast Species Isolated From A Healthy Adult Thai Cohort. Arch Oral Biol 2022; 138:105415. [DOI: 10.1016/j.archoralbio.2022.105415] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 03/19/2022] [Accepted: 03/21/2022] [Indexed: 12/13/2022]
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Orlandini RK, Rocha ACSD, Silva GA, Watanabe E, Motta ACF, Silva-Lovato CH, Oliveira VDC, Bollela VR, Lourenço AG. Increased diversity, fungal burden, and virulence of oral Candida spp. in patients undergoing anti-tuberculosis treatment. Microb Pathog 2021; 161:105280. [PMID: 34742893 DOI: 10.1016/j.micpath.2021.105280] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 10/30/2021] [Accepted: 11/02/2021] [Indexed: 11/26/2022]
Abstract
Some studies have demonstrated a high prevalence of Candida species in patients with tuberculosis (TB). This is most likely due to long-term antimicrobial therapy. To date, no longitudinal studies addressed the effects of anti-TB treatment on the fungal burden and virulence of Candida spp. This study investigated the prevalence and virulence of Candida spp. in the oral cavity of 30 TB patients at different stages of treatment through a cohort study. These results were compared with those of 60 systemically healthy individuals in a cross-sectional study. Oral rinse samples from TB patients were collected before 45 and after 120 days of treatment. In the control group, the biological samples were collected only once. Candida spp. were identified by restriction fragment length polymorphism (RFLP) assays, and the following virulence factors were studied: phospholipase C and proteinase production, as well as Candida spp. biofilm and hyphae formation. The clinical diagnosis of TB and its treatment time were associated with the greater fungal burden (p < 0.0001), presence of non-albicans Candida (NAC) species (p = 0.0003), and increased virulence factors when compared with the Candida spp. isolated from systemically healthy individuals. The results showed that anti-TB treatment time was responsible for the increased fungal burden and isolation of NAC in TB patients (p = 0.0233). The increased prevalence, quantification, and virulence of Candida spp. isolated from the oral cavity of TB patients highlight the greater risk of oral lesions and cases of systemic dissemination in these patients.
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Affiliation(s)
- Renata Klemp Orlandini
- Department of Basic and Oral Biology, Ribeirão Preto School of Dentistry, University of São Paulo, Brazil
| | | | - Gilberto André Silva
- Department of Basic and Oral Biology, Ribeirão Preto School of Dentistry, University of São Paulo, Brazil
| | - Evandro Watanabe
- Department of Restorative Dentistry, Ribeirão Preto School of Dentistry, University of São Paulo, Brazil
| | - Ana Carolina Fragoso Motta
- Department of Stomatology, Public Oral Health, and Forensic Dentistry, Ribeirão Preto School of Dentistry, University of São Paulo, Brazil
| | - Claúdia Helena Silva-Lovato
- Department of Dental Materials and Prosthesis, Ribeirão Preto School of Dentistry, University of São Paulo, Brazil
| | - Viviane de Cássia Oliveira
- Department of Dental Materials and Prosthesis, Ribeirão Preto School of Dentistry, University of São Paulo, Brazil
| | - Valdes Roberto Bollela
- Department of Internal Medicine, Ribeirão Preto School of Medicine, University of São Paulo, Brazil
| | - Alan Grupioni Lourenço
- Department of Basic and Oral Biology, Ribeirão Preto School of Dentistry, University of São Paulo, Brazil.
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Pfavayi LT, Denning DW, Baker S, Sibanda EN, Mutapi F. Determining the burden of fungal infections in Zimbabwe. Sci Rep 2021; 11:13240. [PMID: 34168204 PMCID: PMC8225815 DOI: 10.1038/s41598-021-92605-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 06/08/2021] [Indexed: 02/05/2023] Open
Abstract
Zimbabwe currently faces several healthcare challenges, most notably HIV and associated infections including tuberculosis (TB), malaria and recently outbreaks of cholera, typhoid fever and COVID-19. Fungal infections, which are also a major public health threat, receive considerably less attention. Consequently, there is dearth of data regarding the burden of fungal diseases in the country. We estimated the burden of fungal diseases in Zimbabwe based on published literature and 'at-risk' populations (HIV/AIDS patients, survivors of pulmonary TB, cancer, chronic obstructive pulmonary disease, asthma and patients receiving critical care) using previously described methods. Where there was no data for Zimbabwe, regional, or international data was used. Our study revealed that approximately 14.9% of Zimbabweans suffer from fungal infections annually, with 80% having tinea capitis. The annual incidence of cryptococcal meningitis and Pneumocystis jirovecii pneumonia in HIV/AIDS were estimated at 41/100,000 and 63/100,000, respectively. The estimated prevalence of recurrent vulvovaginal candidiasis (RVVC) was 2,739/100,000. The estimated burden of fungal diseases in Zimbabwe is high in comparison to other African countries, highlighting the urgent need for increased awareness and surveillance to improve diagnosis and management.
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Affiliation(s)
- Lorraine T. Pfavayi
- grid.4991.50000 0004 1936 8948Nuffield Department of Medicine, Centre for Tropical Medicine and Global Health, University of Oxford, Old Road Campus, Roosevelt Drive, Oxford, OX3 7LG UK ,grid.4305.20000 0004 1936 7988Institute of Immunology and Infection Research, University of Edinburgh, Ashworth Laboratories, King’s Buildings, Charlotte Auerbach Road, Edinburgh, EH9 3FL UK ,grid.4305.20000 0004 1936 7988NIHR Global Health Research Unit Tackling Infections To Benefit Africa (TIBA), University of Edinburgh, Ashworth Laboratories, King’s Buildings, Edinburgh, UK
| | - David W. Denning
- grid.5379.80000000121662407Manchester Fungal Infection Group, The University of Manchester and Manchester Academic Health Science Centre, Manchester, UK
| | - Stephen Baker
- grid.5335.00000000121885934University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, CB2 0AW UK ,grid.5335.00000000121885934Department of Medicine, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, CB2 2QQ UK
| | - Elopy N. Sibanda
- Asthma Allergy and Immunology Clinic, Twin Palms Medical Centre, Harare, Zimbabwe ,grid.4305.20000 0004 1936 7988TIBA Zimbabwe, NIHR Global Health Research Unit Tackling Infections To Benefit Africa (TIBA), University of Edinburgh, Edinburgh, UK ,grid.440812.bDepartment of Pathology, National University of Science and Technology (NUST) Medical School, Bulawayo, Zimbabwe
| | - Francisca Mutapi
- grid.4305.20000 0004 1936 7988Institute of Immunology and Infection Research, University of Edinburgh, Ashworth Laboratories, King’s Buildings, Charlotte Auerbach Road, Edinburgh, EH9 3FL UK ,grid.4305.20000 0004 1936 7988NIHR Global Health Research Unit Tackling Infections To Benefit Africa (TIBA), University of Edinburgh, Ashworth Laboratories, King’s Buildings, Edinburgh, UK
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Mushi MF, Loi N, Mshana SE. Oral candidiasis in HIV-uninfected pediatric population in areas with limited fungal diagnosis: A case study from a tertiary hospital, Tanzania. Ther Adv Infect Dis 2021; 8:20499361211016964. [PMID: 34094534 PMCID: PMC8141982 DOI: 10.1177/20499361211016964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 04/21/2021] [Indexed: 10/25/2022] Open
Abstract
Background Oral candidiasis (OC) is an indirect indicator of cell-mediated immunodeficiency with a high predictive value of disseminated candidiasis. Here, we report the prevalence and factors associated with laboratory-confirmed OC in human immunodeficiency virus (HIV)-uninfected children with clinical OC attending the outpatient clinic or admitted in pediatric wards of the Bugando Medical Center (BMC). Methods A cross-sectional study was conducted between January and June 2017. Social demographic and clinical data were collected using a pre-tested data collection tool. Oral swabs were collected using a sterile cotton swab and mycological culture was done to detect Candida spp. followed by susceptibility testing as per European Committee on Antimicrobial Testing (EUCAST) guidelines. Data were analyzed using STATA version 13 following study objectives. Results A total of 325 non-repetitive oral swabs from HIV-uninfected children aged between 2 and 156 months were collected. Candida spp. were detected in 123 (37.8%) children. One (1.8%) C. albicans isolate was resistant to fluconazole, voriconazole, and posaconazole with minimum inhibitory concentrations (MIC) of 256 μg/ml, 32 μg/ml, and 0.31 μg/ml, respectively. Upon multivariate logistic regression analysis, being a male child (OR 2, 95% CI 1.2-3.2, p = 0.008) and having a history of antibiotic use (OR 1.8, 95% CI 1.1-2.8, p = 0.017) independently predicted laboratory-confirmed OC among HIV-uninfected children. Conclusion Only a third of children with clinical OC were laboratory confirmed, and this was more likely in male children with a history of antibiotic use. Most of the isolates were highly susceptible to commonly used antifungal agents like fluconazole. Treatment of children at risk should be prioritized to reduce associated morbidity.
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Affiliation(s)
- Martha F Mushi
- Department of Microbiology/Immunology, Weill Bugando School of Medicine, The Catholic University of Health and Allied Sciences (CUHAS), PO BOX 1464, Mwanza, Tanzania
| | - Neema Loi
- Instutite of Allied Sciences, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Stephen E Mshana
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
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Černáková L, Rodrigues CF. Microbial interactions and immunity response in oral Candida species. Future Microbiol 2020; 15:1653-1677. [PMID: 33251818 DOI: 10.2217/fmb-2020-0113] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Oral candidiasis are among the most common noncommunicable diseases, related with serious local and systemic illnesses. Although these infections can occur in all kinds of patients, they are more recurrent in immunosuppressed ones such as patients with HIV, hepatitis, cancer or under long antimicrobial treatments. Candida albicans continues to be the most frequently identified Candida spp. in these disorders, but other non-C. albicans Candida are rising. Understanding the immune responses involved in oral Candida spp. infections is a key feature to a successful treatment and to the design of novel therapies. In this review, we performed a literature search in PubMed and WoS, in order to examine and analyze common oral Candida spp.-bacteria/Candida-Candida interactions and the host immunity response in oral candidiasis.
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Affiliation(s)
- Lucia Černáková
- Department of Microbiology & Virology, Faculty of Natural Sciences, Comenius University in Bratislava, Ilkovičova 6, 842 15 Bratislava, Slovakia
| | - Célia F Rodrigues
- Department of Chemical Engineering, LEPABE - Laboratory for Process Engineering, Environment, Biotechnology & Energy, Faculty of Engineering, University of Porto, Portugal
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Hyposalivation, oral health, and Candida colonization in independent dentate elders. PLoS One 2020; 15:e0242832. [PMID: 33237956 PMCID: PMC7688165 DOI: 10.1371/journal.pone.0242832] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 11/09/2020] [Indexed: 12/12/2022] Open
Abstract
Hyposalivation is an important problem in elders and could interfere with several oral functions and microbial ecology. While the number of independent elders who retain more natural teeth increases worldwide, few studies examined hyposalivation in this population. Thus, this study aims to examine relationships between hyposalivation, oral health conditions and oral Candida colonization in independent dentate elders and evaluate factors associated with salivary flow and Candida carriage. We conducted a cross-sectional study in fifty-three dentate elders (≥65 years old with at least 4 pairs of posterior occlusal contacts) with no, or well-controlled, systemic conditions. Participants were interviewed for medical history, subjective dry mouth symptoms, oral hygiene practices and denture information. Unstimulated and stimulated salivary flow rates, objective dry mouth signs, gingival, tongue-coating, and root-caries indices were recorded. Stimulated saliva was cultured on Sabouraud-dextrose agar for Candida counts. Candida species were identified using chromogenic Candida agar and polymerase chain reaction. Statistical significance level was set at p<0.05. The results showed that hyposalivation was associated with higher gingival and tongue-coating indices (p = 0.003 and 0.015, respectively), but not root-caries index. Hyposalivation was also associated with higher prevalence of oral Candida colonization (p = 0.010; adjusted OR = 4.36, 95% confidence interval = 1.29–14.72). These two indices and Candida load were negatively correlated with unstimulated and stimulated salivary flow rates. Interestingly, non-albicans Candida species were more prevalent in denture wearers (p = 0.017). Hence, hyposalivation is a risk factor for poorer oral health and oral Candida colonization in independent dentate elders. Because of its potential adverse effects on oral and systemic health, hyposalivation should be carefully monitored in elders.
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Sodré CS, Rodrigues PMG, Vieira MS, Marques Paes da Silva A, Gonçalves LS, Ribeiro MG, de Carvalho Ferreira D. Oral mycobiome identification in atopic dermatitis, leukemia, and HIV patients - a systematic review. J Oral Microbiol 2020; 12:1807179. [PMID: 32944157 PMCID: PMC7482892 DOI: 10.1080/20002297.2020.1807179] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 07/27/2020] [Accepted: 08/03/2020] [Indexed: 01/04/2023] Open
Abstract
INTRODUCTION Oral mycobiome profiling is important to understand host-pathogen interactions that occur in various diseases. Invasive fungal infections are particularly relevant for patients who have received chemotherapy and for those who have HIV infection. In addition, changes in fungal microbiota are associated with the worsening of chronic conditions like atopic dermatitis (AD). This work aims, through a systematic review, to analyze the methods used in previous studies to identify oral fungi and their most frequent species in patients with the following conditions: HIV infection, leukemia, and atopic dermatitis. METHODS A literature search was performed on several different databases. Inclusion criteria were: written in English or Portuguese; published between September 2009 and September 2019; analyzed oral fungi of HIV-infected, leukemia, or AD patients. RESULTS 21 studies were included and the most identified species was Candida. The predominant methods of identification were morphological (13/21) and sugar fermentation and assimilation tests (11/21). Polymerase chain reaction (PCR) was the most used molecular method (8/21) followed by sequencing techniques (3/21). CONCLUSIONS Although morphological and biochemical tests are still used, they are associated with high-throughput sequencing techniques, due to their accuracy and time saving for profiling the predominant species in oral mycobiome.
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Affiliation(s)
- Camila Stofella Sodré
- Faculty of Medicine, Department of Clinical Medicine, Universidade Federal do Rio de Janeiro - UFRJ, Rio de Janeiro, Brazil
| | - Paulo Matheus Guerra Rodrigues
- Laboratory of Oral and Systemic Infections, Faculty of Dentistry, Estácio de Sá University- UNESA, Rio de Janeiro, Brazil
| | | | | | - Lucio Souza Gonçalves
- Laboratory of Oral and Systemic Infections, Faculty of Dentistry, Estácio de Sá University- UNESA, Rio de Janeiro, Brazil
| | - Marcia Gonçalves Ribeiro
- Medical Genetics Service, Martagão Gesteira Pediatric Institute (IPPMG- UFRJ), Universidade Federal do Rio de Janeiro-UFRJ, Rio de Janeiro, Brazil
| | - Dennis de Carvalho Ferreira
- Laboratory of Oral and Systemic Infections, Faculty of Dentistry, Estácio de Sá University- UNESA, Rio de Janeiro, Brazil
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Lam-Ubol A, Matangkasombut O, Trachootham D, Tarapan S, Sattabanasuk V, Talungchit S, Paemuang W, Phonyiam T, Chokchaitam O, Mungkung OO. Efficacy of gel-based artificial saliva on Candida colonization and saliva properties in xerostomic post-radiotherapy head and neck cancer patients: a randomized controlled trial. Clin Oral Investig 2020; 25:1815-1827. [PMID: 32779011 PMCID: PMC7966128 DOI: 10.1007/s00784-020-03484-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 07/29/2020] [Indexed: 11/28/2022]
Abstract
Objective To evaluate the efficacy of an edible artificial saliva gel, oral moisturizing jelly (OMJ), and a topical commercial gel (GC dry mouth gel) on Candida colonization and saliva properties. Materials and methods This study was a secondary analysis of a single-blinded randomized controlled trial conducted in xerostomic post-radiotherapy head and neck cancer patients. Candida colonization, stimulated salivary flow rate (SSFR), saliva pH, and buffering capacity (BC) were measured at 0, 1, and 2 months after each intervention. Candida colonization was quantified by colony counts and species identified by Candida Chromagar, polymerase chain reaction, and API 20C AUX system. Statistical significance level was 0.05. Results A total of 56 participants in OMJ (N = 30) and GC (N = 26) groups completed the study. OMJ significantly increased saliva pH (p = 0.042) and BC (p = 0.013) after 1-month use, while GC only improved saliva pH (p = 0.027). Both interventions tended to increase SSFR but only GC had a significant increase at 2 months (p = 0.015). GC and OMJ significantly decreased the number of Candida species at 1 and 2 months, respectively. Both groups tended to reduce Candida counts but not significant. Conclusions Both OMJ and GC saliva gels could improve saliva pH and decrease the number of Candida species. OMJ is superior to GC in its buffering capacity, while GC may better improve salivary flow rate. Long-term and large-scale study is warranted to test the efficacy of artificial saliva in oral health improvement. Clinical relevance OMJ and GC gel could decrease the number of Candida species and improve saliva properties in post-radiation xerostomic patients. Trial registration number Clinicaltrials.gov NCT03035825. Date of registration: 25th January 2017.
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Affiliation(s)
- Aroonwan Lam-Ubol
- Department of Oral Surgery and Oral Medicine, Faculty of Dentistry, Srinakharinwirot University, 114 Sukhumvit 23, Wattana, Bangkok, 10110, Thailand.
| | - Oranart Matangkasombut
- Department of Microbiology and Research Unit on Oral Microbiology and Immunology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand.,Laboratory of Biotechnology, Chulabhorn Research Institute, Bangkok, Thailand
| | | | - Supanat Tarapan
- Department of Oral Surgery and Oral Medicine, Faculty of Dentistry, Srinakharinwirot University, 114 Sukhumvit 23, Wattana, Bangkok, 10110, Thailand.,Langsuan Hospital, Chumphon, Thailand
| | | | - Sineepat Talungchit
- Department of Oral Surgery and Oral Medicine, Faculty of Dentistry, Srinakharinwirot University, 114 Sukhumvit 23, Wattana, Bangkok, 10110, Thailand
| | - Wannaporn Paemuang
- Department of Vascular Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Tawaree Phonyiam
- Institute of Nutrition, Mahidol University, Nakhon Pathom, Thailand
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13
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Eghtedar Nejad E, Ghasemi Nejad Almani P, Mohammadi MA, Salari S. Molecular identification of Candida isolates by Real-time PCR-high-resolution melting analysis and investigation of the genetic diversity of Candida species. J Clin Lab Anal 2020; 34:e23444. [PMID: 32656934 PMCID: PMC7595915 DOI: 10.1002/jcla.23444] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 06/01/2020] [Accepted: 06/03/2020] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Candida species are considered as the cause of one of the most important opportunistic fungal diseases. Accurate identification of Candida species is important because of antifungal susceptibility patterns are different among these species, so proper identification helps in the selection of antifungal drugs for the prevention and treatment. Phenotypic methods for identification of Candida species, which are widely used in clinical microbiology laboratories, have some limitations. Real-time PCR followed by the high-resolution melting analysis (HRMA) is a novel approach for the rapid recognition of pathogenic fungi. Molecular phylogeny is essential for obtaining a better understanding of the evolution of the genus Candida and the identification of the relative degree of the Candida species. The purpose of this study was molecular identification of Candida isolates by Real-time PCR-high-resolution melting analysis and investigation of the genetic diversity of Candida species. METHODS Two hundred and thirty-two Candida isolates including 111 Candida isolates obtained from 96 HIV/AIDS patients and 121 Candida isolates obtained from 98 non-HIV persons were identified by real-time PCR and high-resolution melting curve analysis. To evaluate genetic diversity and relationships among Candida species, PCR products of nine clinical Candida isolates, as a representative of each kind of species, were randomly selected for DNA sequence analysis. RESULTS In HIV/AIDS patients, six species of Candida spp. were identified as follows: C albicans (n = 64; 57.7%), C glabrata (n = 31; 27.92%), C parapsilosis (n = 9; 8.1%), C tropicalis (n = 4; 3.6%), C krusei (n = 2; 1.8%), and C kefyr (n = 1; 0.90%). In non-HIV persons, we identified eight species of Candida including C albicans (n = 46; 38.33%) followed by C glabrata and C krusei (each one, n = 18; 15%), C tropicalis (n = 13; 10.83%), C lusitaniae (n = 12; 5.17%), C parapsilosis (n = 10; 4.31%), and C kefyr and C guillermondii (each one, n = 2; 1.66%). Also, the phylogenetic analysis showed the presence of two main clades and six separate subclades. Accordingly, about 88.9% of the isolates were located in clade I and 11.10% of the studied isolates were in clade II. CONCLUSIONS Real-time PCR followed by high-resolution melting analysis (HRMA) is known as a reliable, fast, and simple approach for detection and accurate identification of Candida species, especially in clinical samples.
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Affiliation(s)
- Esmaeel Eghtedar Nejad
- Pathobiology and Medical Diagnosis Laboratory, Mehregan Hospital, Kerman, Iran.,Department of Medical Parasitology and Mycology, Kerman University of Medical Sciences, Kerman, Iran
| | - Pooya Ghasemi Nejad Almani
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.,Students Research Committee, Kerman University of Medical Sciences, Kerman, Iran.,Leishmaniasis Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohammad Ali Mohammadi
- Research Center for Hydatid Disease in Iran, Kerman University of Medical Sciences, Kerman, Iran
| | - Samira Salari
- Department of Medical Parasitology and Mycology, Kerman University of Medical Sciences, Kerman, Iran.,HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.,Medical Mycology and Bacteriology Research Center, Kerman University of Medical Sciences, Kerman, Iran
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14
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Aboualigalehdari E, Tahmasebi Birgani M, Fatahinia M, Hosseinzadeh M. Oral colonization by Candida species and associated factors in HIV-infected patients in Ahvaz, southwest Iran. Epidemiol Health 2020; 42:e2020033. [PMID: 32512666 PMCID: PMC7644944 DOI: 10.4178/epih.e2020033] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 05/24/2020] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES Oropharyngeal candidiasis is one of the most common opportunistic fungal infections among human immunodeficiency virus (HIV)-infected individuals. The most common cause is Candida albicans, followed by non-albicans Candida. This study aimed to identify colonized Candida species in HIV-infected patients from Ahvaz, Iran. Additionally, the relationships between immunity-related factors, lifestyle, and colonization of Candida spp. were studied. METHODS Oral swabs were taken from 201 HIV-positive patients referred for consultations at the Behavioral Modification Center. Oral Candida colonization was detected using culture-based and molecular assays. Data were assessed by descriptive statistics and analyzed to investigate the correlation between Candida colonization and various factors, including the CD4+ cell count and viral load. RESULTS It was found that 43.8% of patients were positive for Candida. The most common species was C. albicans (48.0%), followed by non-albicans Candida isolates, including C. dubliniensis, C. glabrata, C. tropicalis, C. parapsilosis, C. guilliermondii, C. kefyr, and C. krusei. Colonization of Candida spp. in patients was associated with a CD4 count ≤200 cells/mm3 (odds ratio [OR], 4.62; p<0.05), history of shared injections (OR, 6.96; p<0.001), and sex (OR, 3.59; p<0.05). CONCLUSIONS The results of this study showed that C. albicans was the dominant pathogen. The risk factors for colonization of Candida spp. were a CD4 count ≤ 200/mm3 , a history of shared injections, and sex. Other factors with potential relationships include viral load, age, and opportunistic infections, but further investigations are needed.
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Affiliation(s)
- Elham Aboualigalehdari
- Department of Medical Mycology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Maryam Tahmasebi Birgani
- Department of Medical Genetics, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mahnaz Fatahinia
- Department of Medical Mycology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.,Infectious and Tropical Diseases Research Center, Health Research Institute, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mehran Hosseinzadeh
- Thalassemia and Hemoglobinopathy Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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15
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Ambe NF, Longdoh NA, Tebid P, Bobga TP, Nkfusai CN, Ngwa SB, Nsai FS, Cumber SN. The prevalence, risk factors and antifungal sensitivity pattern of oral candidiasis in HIV/AIDS patients in Kumba District Hospital, South West Region, Cameroon. Pan Afr Med J 2020; 36:23. [PMID: 32774600 PMCID: PMC7392032 DOI: 10.11604/pamj.2020.36.23.18202] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 03/02/2020] [Indexed: 11/16/2022] Open
Abstract
Introduction Oral candidiasis is one of the most common opportunistic infection in HIV/AIDS patient and it is caused by Candida 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 Candida 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. Candida species were isolated and identified. Antifungal sensitivity testing was performed using modified kirby-bauer susceptibility testing technique. Results Candida species were present in 42.86% of the samples and Candida albicans was the most prevalent (60.2%) amongst the six Candida isolates identified, followed by Candida glabrata (16.9%), Candida krusei (12.3%), Candida tropicalis (6.4%), Candida parapsilosis (2.3%) and Candida pseudotropicalis (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 Candida isolates. Conclusion Oral Candida 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.
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Affiliation(s)
- Ngwa Fabrice Ambe
- Department of Medical Laboratory Sciences, Faculty Health Sciences, University of Buea, Buea, Cameroon
| | - Njunda Anna Longdoh
- Department of Medical Laboratory Sciences, Faculty Health Sciences, University of Buea, Buea, Cameroon
| | - Patience Tebid
- Department of Medical Laboratory Sciences, Faculty Health Sciences, University of Buea, Buea, Cameroon
| | - Tanyi Pride Bobga
- Department of Medical Laboratory Sciences, Faculty Health Sciences, University of Buea, Buea, Cameroon
| | - Claude Ngwayu Nkfusai
- Department of Microbiology and Parasitology, Faculty of Science, University of Buea, Buea, Cameroon.,Cameroon Baptist Convention Health Service(CBCHS), Yaoundé, Cameroon
| | - Sangwe Bertrand Ngwa
- Department of Medical Laboratory Sciences, Faculty Health Sciences, University of Buea, Buea, Cameroon
| | - Frankline Sanyuy Nsai
- Department of Microbiology and Parasitology, Faculty of Science, University of Buea, Buea, Cameroon.,Cameroon Baptist Convention Health Service(CBCHS), Yaoundé, Cameroon
| | - Samuel Nambile Cumber
- Office of the Dean, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa.,Centre for Health Systems Research & Development, University of the Free State, Bloemfontein, South Africa.,School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
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16
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Dockrell DH, O’Shea D, Cartledge JD, Freedman AR. British HIV Association guidelines on the management of opportunistic infection in people living with HIV: The clinical management of Candidiasis 2019. HIV Med 2020; 20 Suppl 8:2-24. [PMID: 31670458 DOI: 10.1111/hiv.12806] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- D H Dockrell
- University of Edinburgh, Edinburgh, UK and Regional Infectious Diseases Unit, NHS Lothian Infection Service, Edinburgh, UK
| | - D O’Shea
- University of Edinburgh, Edinburgh, UK and Regional Infectious Diseases Unit, NHS Lothian Infection Service, Edinburgh, UK
| | | | - A R Freedman
- Cardiff University School of Medicine, Cardiff, UK
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17
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Namangkalakul W, Benjavongkulchai S, Pochana T, Promchai A, Satitviboon W, Howattanapanich S, Phuprasong R, Ungvijanpunya N, Supakanjanakanti D, Chaitrakoonthong T, Muangsawat S, Thanyasrisung P, Matangkasombut O. Activity of chitosan antifungal denture adhesive against common Candida species and Candida albicans adherence on denture base acrylic resin. J Prosthet Dent 2019; 123:181.e1-181.e7. [PMID: 31813582 DOI: 10.1016/j.prosdent.2019.09.026] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 09/27/2019] [Accepted: 09/30/2019] [Indexed: 12/14/2022]
Abstract
STATEMENT OF PROBLEM Candida adherence to the denture base is an important cause of denture stomatitis. In addition, infections with drug-resistant Candida have become more prevalent, especially among elderly and immunocompromised patients. Thus, alternative safe antifungal agents for oral applications are needed. PURPOSE The purpose of this in vitro study was to investigate the activity of chitosan, a natural biopolymer, against common oral Candida species and its efficacy in inhibiting C albicans adherence to denture-base acrylic resin. MATERIAL AND METHODS The minimum fungicidal concentrations (MFCs) of 5 types of chitosan against 6 species of Candida and 10 C albicans clinical isolates were determined by broth and agar dilution, respectively. N-succinyl chitosan (NSC), low- and high-molecular-weight water-soluble chitosan (LMWC and HMWC), and oligomer and polymer shrimp-chitosan were examined. NSC and HMWC, as pure gel and as a mixture with carboxymethylcellulose (CMC), were applied to acrylic resin disks, incubated with C albicans for 24 hours, and washed, and adherent cells were collected for colony count. The effects of HMWC on human gingival fibroblasts after 1 and 24 hours of treatment were measured by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. The retention force of HMWC gel was measured by using a universal testing machine. The Kruskal-Wallis and Mann-Whitney U tests were used to compare the antiadherence activity (α=.05). RESULTS HMWC had the highest antifungal activity against most Candida species tested and C albicans clinical isolates. HMWC gel completely inhibited C albicans adherence to denture base acrylic resin (P<.001). CMC denture adhesive significantly increased C albicans adherence (P<.001), but adding 2×MFC HMWC into CMC reduced the adherence, although this was not statistically significant (P=.06). HMWC at 1×MFC and 2×MFC showed no toxic effect on gingival fibroblast viability and proliferation. Moreover, the retention force provided by HMWC gel was sufficient for use as a denture adhesive (>5000 Pa). CONCLUSIONS High-molecular-weight, water-soluble chitosan is a biocompatible biopolymer that could inhibit C albicans adherence and that showed properties suitable for development into an antifungal denture adhesive.
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Affiliation(s)
- Worachat Namangkalakul
- Instructor, Department of Anatomy, Faculty of Dentistry, Chulalongkorn University, Pathumwan, Bangkok, Thailand
| | - Sunpatch Benjavongkulchai
- Instructor, Department of Radiology, Faculty of Dentistry, Chulalongkorn University, Pathumwan, Bangkok, Thailand
| | - Teeraphat Pochana
- Student, Faculty of Dentistry, Chulalongkorn University, Pathumwan, Bangkok, Thailand
| | - Alitta Promchai
- Student, Faculty of Dentistry, Chulalongkorn University, Pathumwan, Bangkok, Thailand
| | - Wuttika Satitviboon
- Student, Faculty of Dentistry, Chulalongkorn University, Pathumwan, Bangkok, Thailand
| | | | - Rawi Phuprasong
- Student, Faculty of Dentistry, Chulalongkorn University, Pathumwan, Bangkok, Thailand
| | - Nicha Ungvijanpunya
- Instructor, Department of Orthodontics, Faculty of Dentistry, Chulalongkorn University, Pathumwan, Bangkok, Thailand
| | - Danaiya Supakanjanakanti
- Student, Faculty of Dentistry, Chulalongkorn University, Pathumwan, Bangkok, Thailand; Instructor, Faculty of Dentistry, Prince of Songkhla University, Hat Yai, Songkhla, Thailand
| | | | - Sureeporn Muangsawat
- Scientist, Department of Microbiology and Research Unit on Oral Microbiology and Immunology, Faculty of Dentistry, Chulalongkorn University, Pathumwan, Bangkok, Thailand
| | - Panida Thanyasrisung
- Associate Professor, Department of Microbiology and Research Unit on Oral Microbiology and Immunology, Faculty of Dentistry, Chulalongkorn University, Pathumwan, Bangkok, Thailand
| | - Oranart Matangkasombut
- Associate Professor, Department of Microbiology and Research Unit on Oral Microbiology and Immunology, Faculty of Dentistry, Chulalongkorn University, Pathumwan, Bangkok, Thailand; Researcher, Laboratory of Biotechnology, Chulabhorn Research Institute, Lak Si, Bangkok, Thailand.
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18
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Tarapan S, Matangkasombut O, Trachootham D, Sattabanasuk V, Talungchit S, Paemuang W, Phonyiam T, Chokchaitam O, Mungkung OO, Lam-Ubol A. Oral Candida colonization in xerostomic postradiotherapy head and neck cancer patients. Oral Dis 2019; 25:1798-1808. [PMID: 31257663 DOI: 10.1111/odi.13151] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2019] [Revised: 06/16/2019] [Accepted: 06/25/2019] [Indexed: 12/24/2022]
Abstract
OBJECTIVES To evaluate (a) oral colonization of Candida species, especially for non-albicans Candida species (NACS), in xerostomic postradiotherapy head and neck cancer patients and (b) risk factors affecting their colonization. MATERIALS AND METHODS Subjective and objective dry mouth scores, stimulated salivary flow rates, pH and buffering capacity were measured in 72 xerostomic postradiotherapy head and neck cancer patients. Candida counts and species identification were performed using oral rinse samples cultured in Candida Chromagar, followed by polymerase chain reaction and API 20C AUX system. RESULTS Candida colonization was observed in 87.5% of subjects, with 80.6% and 48.6% of study population colonized by C. albicans and NACS, respectively. NACS was associated with high objective dry mouth scores, denture use, and females (p = .006, .009, and .036, respectively). In addition, Candida glabrata was detected more in females (p = .018) and denture wearers (p = .026), while Candida tropicalis was associated with high objective dry mouth scores (p = .022) and females (p = .027). Quantity of Candida colonization correlated positively with objective dry mouth scores (r = 0.599, p < .001) and negatively with salivary flow rates (r = -0.258, p = .041) and pH (r = -0.290, p = .022). CONCLUSION NACS colonization was common in xerostomic head and neck cancer patients. Increased signs of dry mouth, female and dental prostheses may promote NACS colonization.
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Affiliation(s)
- Supanat Tarapan
- Faculty of Dentistry, Srinakharinwirot University, Bangkok, Thailand
| | - Oranart Matangkasombut
- Department of Microbiology and Research Unit on Oral Microbiology and Immunology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand.,Laboratory of Biotechnology, Chulabhorn Research Institute, Bangkok, Thailand
| | | | | | | | | | - Tawaree Phonyiam
- Institute of Nutrition, Mahidol University, Nakhon Pathom, Thailand
| | | | | | - Aroonwan Lam-Ubol
- Faculty of Dentistry, Srinakharinwirot University, Bangkok, Thailand
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19
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Mushi MF, Bader O, Bii C, Groß U, Mshana SE. Virulence and susceptibility patterns of clinical Candida spp. isolates from a tertiary hospital, Tanzania. Med Mycol 2019; 57:566-572. [PMID: 30380077 DOI: 10.1093/mmy/myy107] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Revised: 09/12/2018] [Accepted: 10/05/2018] [Indexed: 12/17/2022] Open
Abstract
Despite the increased burden of human immunodeficiency virus (HIV) and other comobidities in developing countries, information regarding antifungal susceptibility patterns of Candida spp. and their virulence potential are still limited. Here, we report the virulence and antifungal susceptibility patterns of Candida spp. from varieties spectrum of candidiasis in a tertiary hospital, Tanzania. The study was conducted from March to December 2017. Candida spp. from clinical samples were characterized. Antifungal susceptibility patterns based on EUCAST guidelines and virulence activities (phospholipase, protease, hemolysin, and coagulase activity) were determined. A total of 399 Candida spp. isolates were obtained, of these, 278, 51 and 47 were C. albicans, C. tropicalis, and C. glabrata, respectively. Phospholipase 193/268, protease 32/51 and coagulase 25/47 were the most frequently detected virulence activities in C. albicans, C. tropicalis, and C. glabrata, respectively. Protease and phospholipase were frequently detected virulence activities from C. albicans from blood and esophageal brushes. The median zone diameter of protease activities was significantly larger among C. tropicalis than C. albicans. C. albicans, and C. tropicalis isolates were 100% sensitive to caspofungin. The proportions of C. albicans isolate resistant to fluconazole, voriconazole and posaconazole were 3.1, 3.6%, and 1.8%, respectively. In conclusion, the majority of Candida spp. isolates were sensitive to fluconazole. There are different phenotypes of C. albicans, C. glabrata and C. tropicalis based on susceptibility and virulence activities patterns, necessitating further molecular characterizations to place them in global perspective. Routine antifungal susceptibility testing to guide clinical therapy should be encouraged in developing countries.
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Affiliation(s)
- Martha F Mushi
- Department of Microbiology and immunology, Weill Bugando School of Medicine, Catholic University of Heath and Allied Sciences Mwanza, Tanzania
| | - Oliver Bader
- Institute of Medical Microbiology, University Medical Center Gottingen, Germany
| | - Christine Bii
- Kenya Medical Research Institute, Center for Microbiology Research
| | - Uwe Groß
- Institute of Medical Microbiology, University Medical Center Gottingen, Germany
| | - Stephen E Mshana
- Department of Microbiology and immunology, Weill Bugando School of Medicine, Catholic University of Heath and Allied Sciences Mwanza, Tanzania
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20
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Siljander H, Honkanen J, Knip M. Microbiome and type 1 diabetes. EBioMedicine 2019; 46:512-521. [PMID: 31257149 PMCID: PMC6710855 DOI: 10.1016/j.ebiom.2019.06.031] [Citation(s) in RCA: 92] [Impact Index Per Article: 18.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 06/11/2019] [Accepted: 06/17/2019] [Indexed: 12/15/2022] Open
Abstract
The steep increase in the incidence of type 1 diabetes (T1D), in the Western world after World War II, cannot be explained solely by genetic factors but implies that this rise must be due to crucial interactions between predisposing genes and environmental changes. Three parallel phenomena in early childhood – the dynamic development of the immune system, maturation of the gut microbiome, and the appearance of the first T1D-associated autoantibodies – raise the question whether these phenomena might reflect causative relationships. Plenty of novel data on the role of the microbiome in the development of T1D has been published over recent years and this review summarizes recent findings regarding the associations between islet autoimmunity, T1D, and the intestinal microbiota.
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Affiliation(s)
- Heli Siljander
- Children's Hospital, University of Helsinki and Helsinki University Hospital, 00014 Helsinki, Finland; Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, 00014 Helsinki, Finland
| | - Jarno Honkanen
- Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, 00014 Helsinki, Finland
| | - Mikael Knip
- Children's Hospital, University of Helsinki and Helsinki University Hospital, 00014 Helsinki, Finland; Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, 00014 Helsinki, Finland; Tampere Center for Child Health Research, Tampere University Hospital, 33520 Tampere, Finland; Folkhälsan Research Center, 00290 Helsinki, Finland.
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21
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Filina YS, Shatokhin AI, Volchkova EV, Nesvizhskiy YV, Pak SG. [Antimycotic therapy impact on oral mucosa Candida species composition in HIV-infected patients]. STOMATOLOGII︠A︡ 2019; 97:28-33. [PMID: 30589421 DOI: 10.17116/stomat20189706128] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
RESEARCH OBJECTIVES the analysis of a specific and strains drift of Candida in HIV/AIDS patients with oropharyngeal candidiasis and the analysis of Candida sensitivity dynamics to reference antimycotic drugs. The study comprised 49 HIV-infected patients aged 20-69 years. The study revealed candidiasis treatment provides specific and strains drift of Candida. Eradication of fluconazole sensitive C. albicans leads to growth of more resistant strains (C. glabratae, krusei, tropicalis) thus lowering antimycotic therapy efficacy. The efficacy improvement requires selective approach to candidiasis treatment with azol agents.
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Affiliation(s)
- Yu S Filina
- Infectious Diseases Clinical Hospital #2, Moscow, Russia; I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - A I Shatokhin
- Infectious Diseases Clinical Hospital #2, Moscow, Russia
| | - E V Volchkova
- I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Yu V Nesvizhskiy
- I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - S G Pak
- I.M. Sechenov First Moscow State Medical University, Moscow, Russia
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22
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Khadija B, Abbasi A, Khan S, Nadeem M, Badshah L, Faryal R. Isolation of pathogenic Candida species from oral cavity of postpartum females, and its association with obstetric and dental problems. Microb Pathog 2019; 131:40-46. [PMID: 30905714 DOI: 10.1016/j.micpath.2019.03.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2018] [Revised: 01/31/2019] [Accepted: 03/18/2019] [Indexed: 12/22/2022]
Abstract
OBJECTIVE The aim of the current study was to investigate pathogenic Candida spp. Colonization in oral cavity of postpartum females and its association with adverse pregnancy outcomes (APOs) and dental issues. METHODS Saliva samples and clinico-demographic data were collected from 267 postpartum females along with 54 non-pregnant females (Jan 2016-March 2018). Isolation of Candida was carried out by using standard microbiological methods and different virulence factors (Esterase activity, phospholipase activity and biofilm formation) were evaluated. RESULTS Candidacolonization was high in postpartum females (p<0.001, OR = 4.28). This colonization was not significant among females with APOs, however, one to three folds risk was seen with different obstetric and dental factors. High esterase activity was seen among Candida isolates from postpartum females in comparison to control group (p = 0.01). Phospholipase activity of C.albicans isolates from this group was also high (p = 0.001). Majority of the Candida isolates (66.87%) from postpartum females were biofilm formers. Increase in antifungal activity was seen among isolates from postpartum females, with 85% isolates resistant to Fluconazole and Voriconazole (p<0.001) and Amphotericin B resistance was present in 64.38% isolates (p<0.001). CONCLUSION Postpartum females are more susceptible to oral Candida colonization, which exhibit enhanced virulence characteristics and its carriage are associated with increased risk for development of APOs and dental problems.
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Affiliation(s)
- Bibi Khadija
- Department of Microbiology, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad, Pakistan
| | - Aqsa Abbasi
- Department of Microbiology, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad, Pakistan
| | - Sadia Khan
- Holy Family Hospital, Rawalpindi Medical College, Rawalpindi, Pakistan
| | - Meera Nadeem
- Department of Microbiology, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad, Pakistan
| | - Lal Badshah
- Department of Microbiology, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad, Pakistan
| | - Rani Faryal
- Department of Microbiology, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad, Pakistan.
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Nishimaki F, Yamada SI, Kawamoto M, Sakurai A, Hayashi K, Kurita H. Relationship Between the Quantity of Oral Candida and Systemic Condition/Diseases of the Host: Oral Candida Increases with Advancing Age and Anemia. Mycopathologia 2019; 184:251-260. [PMID: 30825055 DOI: 10.1007/s11046-019-00326-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Accepted: 02/18/2019] [Indexed: 01/10/2023]
Abstract
BACKGROUND The impact of host systemic conditions/diseases on the prosperity of oral Candida colonies remains unclear. The aim of the present study was to investigate whether a relationship exists between the quantity of oral Candida and the systemic condition/diseases of the host. PATIENTS AND METHODS The cross-sectional relationship between Candida mannan concentrations and health check-up results was analyzed in consideration of local conditions that influence the prevalence of oral Candida. RESULTS Candida mannan concentrations correlated with age, the number of untreated decayed teeth, number of prosthetic teeth, salivary pH, HbA1c, and the red blood cell count in a univariate analysis. In a multivariate analysis, Candida mannan concentrations correlated with age, the number of untreated decayed teeth, number of prosthetic teeth, salivary pH, and the red blood cell count. Candida mannan concentrations were higher in subjects older than 80 years, with a higher number of either untreated or prosthetic teeth, with a lower salivary pH, and with a decreased red blood cell count. Mannan concentrations were slightly higher in subjects with elevated HbA1c. CONCLUSIONS The present results suggest a close relationship between the quantity of oral Candida and the systemic condition/diseases of the host. Oral Candida may increase in immunocompromised hosts.
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Affiliation(s)
- Fumihiro Nishimaki
- Department of Dentistry and Oral Surgery, Shinshu University School of Medicine, 3-1-1, Asahi, Matsumoto, 390-8621, Japan
| | - Shin-Ichi Yamada
- Department of Dentistry and Oral Surgery, Shinshu University School of Medicine, 3-1-1, Asahi, Matsumoto, 390-8621, Japan.
| | - Makiko Kawamoto
- Department of Dentistry and Oral Surgery, Shinshu University School of Medicine, 3-1-1, Asahi, Matsumoto, 390-8621, Japan
| | - Akinari Sakurai
- Department of Dentistry and Oral Surgery, Shinshu University School of Medicine, 3-1-1, Asahi, Matsumoto, 390-8621, Japan
| | - Kiyonori Hayashi
- Department of Dentistry and Oral Surgery, Shinshu University School of Medicine, 3-1-1, Asahi, Matsumoto, 390-8621, Japan
| | - Hiroshi Kurita
- Department of Dentistry and Oral Surgery, Shinshu University School of Medicine, 3-1-1, Asahi, Matsumoto, 390-8621, Japan
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24
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Lam-Ubol A, Rungsiyanont S, Vacharotayangul P, Sappayatosok K, Chankanka O. Oral manifestations, salivary flow rates and Candida species in Thai HIV-infected patients. J Clin Exp Dent 2019; 11:e138-e145. [PMID: 30805118 PMCID: PMC6383906 DOI: 10.4317/jced.55384] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2018] [Accepted: 01/21/2019] [Indexed: 12/13/2022] Open
Abstract
Background Effects of various Highly Active Antiretroviral Therapy (HAART) regimens on oral heath are unclear. Objectives: We aimed to evaluate effects of HAART on oral manifestations, salivary flow rates (SFR) and Candida species in HIV-infected patients who took mostly non-protease inhibitor-based HAART regimens. Material and Methods A cross-sectional study was performed on HIV-infected patients taking and never taken HAART who attended Thai Red Cross AIDS Research Centre (n = 48). Non-HIV subjects were recruited as control (n = 20). Oral conditions and salivary flow rates were evaluated using oral examination and measurement of unstimulated and stimulated saliva. In addition, Candida colonization counts (colony forming units; CFUs) and Candida species from the collected saliva were evaluated using CHROMagar. Results The most common oral manifestation in HIV-infected subjects taking HAART was hyperpigmentation. Unstimulated and stimulated SFR among the three groups were not statistically significant. Candida colonization was detected in 64%, 65% and 35% of HIV-infected subjects taking HAART, HAART-naïve, and non-HIV subjects, respectively. While 20% and 35% of HIV-infected subjects with and without HAART, respectively, had Candida CFUs higher than 500/ml, all non-HIV carriers had Candida CFUs lower than 500/ml. The most common Candida colonization species was C. albicans in HAART and non-HIV groups. Interestingly, HAART-naïve group was colonized more by non-albicans species. Conclusions HAART has minimal effects on oral health. While HAART may not prevent Candida colonization, it might lead to reduction of non-albicans species. Because maintaining low Candida counts is important, HAART administration and antifungal sensitivity test should be considered in HIV-infected patients. Key words:HIV, Candida, HAART, Oral manifestation, Salivary flow rates.
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Affiliation(s)
- Aroonwan Lam-Ubol
- Faculty of Dentistry, Srinakharinwirot University, 114 Sukhumvit 23, Wattana, Klongtoey Nua, Bangkok 10110, Thailand
| | - Sorasun Rungsiyanont
- Faculty of Dentistry, Srinakharinwirot University, 114 Sukhumvit 23, Wattana, Klongtoey Nua, Bangkok 10110, Thailand
| | - Piamkamon Vacharotayangul
- Faculty of Dentistry, Srinakharinwirot University, 114 Sukhumvit 23, Wattana, Klongtoey Nua, Bangkok 10110, Thailand
| | - Kraisorn Sappayatosok
- Faculty of Dentistry, Rangsit University, 52/347 Phaholyothin Road, Mueang Pathum Thani District, Pathum Thani 12000, Thailand
| | - Oitip Chankanka
- Faculty of Dentistry, Prince of Songkla University, 15 Karnjanavanich Raod, Hat Yai, Songkhla 90110, Thailand
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25
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Liu Z, Yong X, Jiang L, Zhang L, Lin X, Liu W, Peng Y, Tao R. Salivary human beta-defensins affected by oral Candida status in Chinese HIV/AIDS patients undergoing ART. Oral Dis 2018; 24:964-971. [PMID: 29498794 DOI: 10.1111/odi.12847] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Revised: 02/08/2018] [Accepted: 02/18/2018] [Indexed: 12/14/2022]
Abstract
OBJECTIVES To observe relationships between oral Candida status and salivary human beta-defensin 2 and 3 (hBD-2 and hBD-3) levels in HIV/AIDS patients of Guangxi, China during the first year of antiretroviral therapy (ART) dynamically, and to understand the influence of ART on oral Candida status and salivary hBDs expressions. METHODS A prospective self-controlled study was carried to observe the dynamic changes of CD4+ T cell counts, oral Candida carriages and salivary hBD-2,3 expressions in HIV/AIDS patients during the first year of ART. A total of 90 HIV/AIDS patients were enrolled and were examined at the baseline, 3rd, 6th, 12th month of ART. Thirty healthy individuals were enrolled as control. Peripheral blood, oral rinse sample, and unstimulated whole saliva were collected to test CD4+ T cell counts, oral Candida carriages, and hBD-2,3 expressions. RESULTS In the first year of ART, CD4+ T cell counts increased significantly. However, oral Candida carriages and oral candidiasis decreased significantly, and salivary hBD-2 expressions in HIV/AIDS patients decreased gradually, salivary hBD-3 levels were highly variable. Salivary hBD-2 concentrations were positively related to oral Candida carriages. CONCLUSIONS The incidence of oral candidiasis among HIV/AIDS patients gradually decreased due to the immune reconstruction of ART. Salivary defensins might play an important role in Candida-host interaction in HIV/AIDS patients.
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Affiliation(s)
- Z Liu
- Department of Periodontics and Oral Medicine, College of Stomatology, Guangxi Medical University, Nanning, Guangxi, China.,Guangxi Key Laboratory of AIDS Prevention and Treatment, Guangxi Medical University, Guangxi, China
| | - X Yong
- Department of Periodontics and Oral Medicine, College of Stomatology, Guangxi Medical University, Nanning, Guangxi, China
| | - L Jiang
- Department of Periodontics and Oral Medicine, College of Stomatology, Guangxi Medical University, Nanning, Guangxi, China
| | - L Zhang
- Department of Periodontics and Oral Medicine, College of Stomatology, Guangxi Medical University, Nanning, Guangxi, China
| | - X Lin
- Department of Periodontics and Oral Medicine, College of Stomatology, Guangxi Medical University, Nanning, Guangxi, China
| | - W Liu
- Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention (CDC), Guangxi, China
| | - Y Peng
- Department of Periodontics and Oral Medicine, College of Stomatology, Guangxi Medical University, Nanning, Guangxi, China
| | - R Tao
- Department of Periodontics and Oral Medicine, College of Stomatology, Guangxi Medical University, Nanning, Guangxi, China.,Guangxi Key Laboratory of AIDS Prevention and Treatment, Guangxi Medical University, Guangxi, China
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26
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Nguyen TNY, Matangkasombut O, Ritprajak P. Differential dendritic cell responses to cell wall mannan of Candida albicans, Candida parapsilosis, and Candida dubliniensis . J Oral Sci 2018; 60:557-566. [DOI: 10.2334/josnusd.17-0426] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Affiliation(s)
- Thu N. Y. Nguyen
- Graduate program in Oral Biology, Faculty of Dentistry, Chulalongkorn University
- Research Unit on Oral Microbiology and Immunology and Department of Microbiology, Faculty of Dentistry, Chulalongkorn University
| | - Oranart Matangkasombut
- Research Unit on Oral Microbiology and Immunology and Department of Microbiology, Faculty of Dentistry, Chulalongkorn University
- Laboratory of Biotechnology, Chulabhorn Research Institute
| | - Patcharee Ritprajak
- Research Unit on Oral Microbiology and Immunology and Department of Microbiology, Faculty of Dentistry, Chulalongkorn University
- Oral Biology Research Center, Faculty of Dentistry, Chulalongkorn University
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27
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Vidya KM, Rao UK, Nittayananta W, Liu H, Owotade FJ. Oral mycoses and other opportunistic infections in HIV: therapy and emerging problems - a workshop report. Oral Dis 2017; 22 Suppl 1:158-65. [PMID: 27109283 DOI: 10.1111/odi.12437] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Oral mycoses and other opportunistic infections are recognized features of HIV infection even after four decades of the epidemic. The therapeutic options, challenges of therapy, and evolving patterns of opportunistic infections were evaluated by the workshop. It was observed that high Candida counts and infection are still more prevalent in HIV-positive individuals even in the era of antiretroviral therapy. Furthermore, one or more non-Candida albicans are present in some HIV-positive individuals. While Candida species are more virulent in HIV infection, similar virulence may be present in other states of immunosuppression. Consequently, the interplay between host factors and virulence ultimately determines the clinical outcomes. Adverse clinical outcomes such as candidemia and other deep fungal infections are on the increase in HIV infection. Disseminated histoplasmosis and penicilliosis have been reported, especially with low CD4 counts. Even with advances in antifungal therapy, mortality and morbidity from deep fungal infections have not changed significantly. In addition, long-term exposure to common antifungal drugs such as fluconazole has led to the development of antifungal resistance in 6% to 36%. Development of new antifungal therapeutic agents and the use of alternative therapies may offer breakthrough. In addition, effective strategies to enhance the host immune status are being explored.
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Affiliation(s)
- K M Vidya
- Department of Oral and Maxillofacial Pathology and Microbiology, Sathyabama University Dental College, Sathyabama University, Chennai, India
| | - U K Rao
- Ragas Dental College and Hospital, Chennai, India
| | - W Nittayananta
- Excellent Research Laboratory, Phytomedicine and Pharmaceutical Biotechnology Excellence Center, Hat Yai, Songkhla, Thailand.,Natural Products Research Center of Excellence, Faculty of Science, Prince of Songkla University, Hat Yai, Songkhla, Thailand.,Graduate School, Prince of Songkla University, Hat Yai, Songkhla, Thailand
| | - H Liu
- Department of Oral Medicine and Traditional Chinese Medicine, Peking University School of Stomatology, Haidian District, Beijing, China
| | - F J Owotade
- Department of Oral and Maxillofacial Surgery and Oral Pathology, Faculty of Dentistry, Obafemi Awolowo University, Ile-Ife, Nigeria
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28
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Mushi MF, Bader O, Taverne-Ghadwal L, Bii C, Groß U, Mshana SE. 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; 9:1317579. [PMID: 28748027 PMCID: PMC5508360 DOI: 10.1080/20002297.2017.1317579] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Accepted: 04/04/2017] [Indexed: 11/18/2022] Open
Abstract
Oral candidiasis (OC) is the most common opportunistic fungal infection among immunocompromised individuals. This systematic review and meta-analysis reports on the contribution of non-albicans Candida species in causing OC among human immunodeficiency virus (HIV)-infected individuals in sub-Saharan Africa between 2005 and 2015. Thirteen original research articles on oral Candida infection/colonization among HIV-infected African populations were reviewed. The prevalence of OC ranged from 7.6% to 75.3%. Pseudomembranous candidiasis was found to range from 12.1% to 66.7%. The prevalence of non-albicans Candida species causing OC was 33.5% [95% confidence interval (CI) 30.9–36.39%]. Of 458 non-albicans Candida species detected, C. glabrata (23.8%; 109/458) was the most common, followed by C. tropicalis (22%; 101/458) and C. krusei (10.7%; 49/458). The overall fluconazole resistance was 39.3% (95% CI 34.4–44.1%). Candida albicans was significantly more resistant than non-albicans Candida species to fluconazole (44.7% vs 21.9%; p < 0.001). One-quarter of the cases of OC among HIV-infected individuals in sub-Saharan Africa were due to non-albicans Candida species. Candida albicans isolates were more resistant than the non-albicans Candida species to fluconazole and voriconazole. Strengthening the capacity for fungal diagnosis and antifungal susceptibility testing in sub-Saharan Africa is mandatory in order to track the azole resistance trend.
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Affiliation(s)
- Martha F Mushi
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Heath and Allied Sciences, Mwanza, Tanzania
| | - Oliver Bader
- Institute of Medical Microbiology, University Medical Center, Göttingen, Germany
| | | | - Christine Bii
- Kenya Medical Research Institute, Center for Microbiology Research, Nairobi, Kenya
| | - Uwe Groß
- Institute of Medical Microbiology, University Medical Center, Göttingen, Germany
| | - Stephen E Mshana
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Heath and Allied Sciences, Mwanza, Tanzania
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29
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Wu CJ, Ko WC, Ho MW, Lin HH, Yang YL, Lin JN, Huang IW, Wang HY, Lai JF, Shiau YR, Hsieh LY, Chen HT, Lin CC, Chu WL, Lo HJ, Lauderdale TL. Prevalence of and risk factors for methicillin-resistant Staphylococcus aureus colonization among human immunodeficient virus-infected outpatients in Taiwan: oral Candida colonization as a comparator. J Oral Microbiol 2017; 9:1322446. [PMID: 28748029 PMCID: PMC5508359 DOI: 10.1080/20002297.2017.1322446] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Accepted: 04/17/2017] [Indexed: 12/30/2022] Open
Abstract
Human immuodeficency virus (HIV)-infected patients receiving highly active antiretroviral therapy (HAART) and community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) have increased in recent years in Taiwan. This study was undertaken to determine the prevalence of and risk factors for nasal and oral S. aureus and MRSA colonization among contemporary HIV-infected populations. Clinical variables for S. aureus and MRSA colonization among HIV-infected outpatients from three hospitals were analyzed and compared with those for oral Candida colonization. Genetic characteristics of MRSA isolates were analyzed. A total of 714 patients were screened for nasal S. aureus colonization, and a subset of 457 patients were also screened for oral S. aureus colonization. Of all patients, 79.4% were receiving HAART, and their mean CD4 count was 472 cells/mm3. The colonization rates in the oral cavity, nasal cavity, and at either site were 18.8%, 31.7%, and 36.8%, respectively, for S. aureus, and 3.1%, 4.4%, and 5.5%, respectively, for MRSA. These rates were all much lower than the previously reported rate of oral Candida colonization (52.4%). By multivariate analysis, a suppressed viral load (<200 copies/mL) protected against oral S. aureus, MRSA, and Candida colonization, and recent use of antibacterial agents protected against oral and nasal S. aureus colonization. Recent incarceration increased the risk of nasal MRSA colonization, while recent hospitalization, tuberculosis, older age, and intravenous drug use increased the risk of oral Candida colonization. Candida spp. did not augment S. aureus or MRSA colonization in the oral cavity. Most of the 41 MRSA isolates recovered belonged to the SCCmec IV/pvl-negative (51.2%) and VT/pvl-positive (26.8%) ST59 local prevalent CA-MRSA clones. Distinct carriage rates demonstrated here suggested that mucosal immunity against colonization might differ in terms of microbes and sites. A decreased risk in oral carriage of MRSA and Candida might be a benefit of HAART.
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Affiliation(s)
- Chi-Jung Wu
- National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Zhunan, Taiwan.,Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Wen-Chien Ko
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Mao-Wang Ho
- Section of Infectious Diseases, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Hsi-Hsun Lin
- Division of Infectious Diseases, Department of Internal Medicine, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan
| | - Yun-Liang Yang
- Institute of Molecular Medicine and Bioengineering, National Chiao Tung University, Hsinchu, Taiwan.,Department of Biological Science and Technology, National Chiao Tung University, Hsinchu, Taiwan
| | - Jiun-Nong Lin
- Division of Infectious Diseases, Department of Internal Medicine, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan
| | - I-Wen Huang
- National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Zhunan, Taiwan
| | - Hui-Ying Wang
- National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Zhunan, Taiwan
| | - Jui-Fen Lai
- National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Zhunan, Taiwan
| | - Yih-Ru Shiau
- National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Zhunan, Taiwan
| | - Li-Yun Hsieh
- National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Zhunan, Taiwan
| | - Hui-Ting Chen
- National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Zhunan, Taiwan.,Department of Biological Science and Technology, National Chiao Tung University, Hsinchu, Taiwan
| | - Chih-Chao Lin
- National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Zhunan, Taiwan
| | - Wen-Li Chu
- National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Zhunan, Taiwan
| | - Hsiu-Jung Lo
- National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Zhunan, Taiwan.,School of Dentistry, China Medical University, Taichung, Taiwan
| | - Tsai-Ling Lauderdale
- National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Zhunan, Taiwan
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30
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Relationship between the quantity of oral Candida and immunological vigor. JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY, MEDICINE, AND PATHOLOGY 2017. [DOI: 10.1016/j.ajoms.2016.09.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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31
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Mushi MF, Mtemisika CI, Bader O, Bii C, Mirambo MM, Groß U, Mshana SE. High Oral Carriage of Non-albicans Candida spp. among HIV-infected individuals. Int J Infect Dis 2016; 49:185-8. [PMID: 27401585 DOI: 10.1016/j.ijid.2016.07.001] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Accepted: 07/03/2016] [Indexed: 10/21/2022] Open
Abstract
BACKGROUND Non-albicans Candida (NAC) spp. in immunocompromised patients are linked to invasive infections with narrow treatment choice. This study aimed at comparing the oral colonization of NAC spp. between HIV and non-HIV infected individuals in Mwanza, Tanzania. METHOD Oral rinse of 351 HIV-infected and 639 non-HIV infected individuals were collected between March and July 2015. Phenotypic identifications of Candida spp. was done using Candida Chromogenic agar and confirmed by MALDI-TOF MS. RESULTS NAC spp. were detected in 36/351 (10.3%) HIV-infected individuals compared to 28/639 (4.4%) of non-HIV infected individuals; P=0.0003. In HIV infected individuals, commonly isolated NAC spp. were Candida tropicalis, 10(2.8%), C. krusei (Issatschenki orientalis) 9(2.6%) and C. glabrata 8(2.3%). While for non-HIV infected individuals C. dubliniensis 8(1.3%) and C. tropicalis 5(0.9%) were commonly detected. As CD4 count/μl decreases by one unit the risk of being colonized by NAC spp. among HIV infected individuals increases by 1% (OR 1.01, 95% CI; 1.001-1.004, P=0.001). CONCLUSION The prevalence of NAC spp. is high among HIV-infected individuals with low CD4 count placing them at higher risk of invasive infections. Further studies to investigate the role of NAC spp. in causing invasive infections among immunocompromised patients are recommended.
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Affiliation(s)
- Martha F Mushi
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Heath and Allied Sciences P.O. Box 1464 Mwanza, Tanzania.
| | - Conjester I Mtemisika
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Heath and Allied Sciences P.O. Box 1464 Mwanza, Tanzania.
| | - Oliver Bader
- Institute of Medical Microbiology, University Medical Center Kreuzbergring 57, 37075 Göttingen Germany.
| | - Christine Bii
- Kenya Medical Research Institute, Center for Microbiology Research P.O Box 54840 00200, Nairobi, Kenya.
| | - Mariam M Mirambo
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Heath and Allied Sciences P.O. Box 1464 Mwanza, Tanzania.
| | - Uwe Groß
- Institute of Medical Microbiology, University Medical Center Kreuzbergring 57, 37075 Göttingen Germany.
| | - Stephen E Mshana
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Heath and Allied Sciences P.O. Box 1464 Mwanza, Tanzania.
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32
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Agarwal J, Agarwal RS, Shrivastava A, Shrivastava S. Analysis of Information, Impact and Control of HIV amongst Dental Professionals of Central India. J Clin Diagn Res 2015; 9:ZC80-4. [PMID: 26393211 PMCID: PMC4573044 DOI: 10.7860/jcdr/2015/14300.6236] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2015] [Accepted: 06/08/2015] [Indexed: 11/24/2022]
Abstract
BACKGROUND Dental health care providers may be exposed to a variety of microorganisms via blood, oral or respiratory secretions. Though the risk of transmission of Human Immunodeficiency Virus (HIV) in dental settings is low, the consequences of being infected are life threatening. Therefore, high standards in infection control and waste management are required in controlling occupational contagion and cross infection. AIM To obtain comprehensive information about the HIV related information, its impact on the health care provider's attitude towards treating patients living with HIV/AIDS (PLWHA), infection control & waste disposal practices among dental professionals of Malwa region of Madhya Pradesh; situated in Central India. MATERIALS AND METHODS A cross-sectional survey was conducted among 320 private dental practitioners. Data was collected using a pretested, self administered 40 item questionnaire and statistically analysed. RESULTS The response rate was 81.25%. Over all 50.76% dentists were graded as having good knowledge of HIV. Unfortunately, their willingness to treat these patients remained low. In all 39.23% dentist were willing to render care to PLWHA. Junior dentists expressed less hesitation with regard to acceptance of risk patients than other dentists. Over 65% of the respondents reported adherence to universal precautions. The most alarming observation was that dentists were not following safe waste management practices. CONCLUSION Dental professionals continue to indicate a reluctance to treat patients with HIV/AIDS or those in high- risk groups. The results suggest need to have a comprehensive motivational program and implementing ways to ensure access and availability of safe dental care for PLWHA. The desire to get training on how to handle PLWHA illustrates that receptiveness to change exists.
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Affiliation(s)
- Jatin Agarwal
- Professor, Department of Prosthodontics, Sri Aurobindo college of Dentistry, Indore, India
| | - Rolly Shrivastava Agarwal
- Professor, Department of Conservative Dentistry and Endodontics, Sri Aurobindo college of Dentistry, Indore, India
| | - Asha Shrivastava
- Professor, Department of Physiology, GMC Medical College, Bhopal, India
| | - Sudha Shrivastava
- Professor, Department of Anatomy, MGMC Medical College, Indore, India
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33
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Oever JT, Netea MG. The bacteriome-mycobiome interaction and antifungal host defense. Eur J Immunol 2014; 44:3182-91. [DOI: 10.1002/eji.201344405] [Citation(s) in RCA: 76] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2014] [Revised: 06/14/2014] [Accepted: 09/23/2014] [Indexed: 01/21/2023]
Affiliation(s)
- Jaap ten Oever
- Department of Internal Medicine; Radboud University Medical Center; Nijmegen The Netherlands
| | - Mihai G. Netea
- Department of Internal Medicine; Radboud University Medical Center; Nijmegen The Netherlands
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