|
Molecular Identification and Determination of Antifungal Susceptibility Profile of Candida Species Isolated from AIDS Patients in Ahwaz City
|
Maryam Hatami1    , Maryam Erfaninejad2 , Akbar Hoseinnejad3 , Mahnaz Fatahinia4 |
1- Ahvaz Jundishapur University of Medical Sciences, & MSc in Medical Mycology, Department of Medical Mycology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
2- Assistant Professor, Department of Basic Medical Sciences, Shoushtar Faculty of Medical Sciences, Shoushtar, Iran & Assistant Professor, Department of Basic Medical Sciences, Shoushtar Faculty of Medical Sciences, Shoushtar, Iran
3- Ahvaz Jundishapur University of Medical Sciences, & Ph.D. Candidate in Medical Mycology, Department of Medical Mycology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
4- Associate Professor, Department of Medical Mycology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran & Infectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran , Fatahinia@yahoo.com |
|
|
Abstract: (806 Views) |
Background and Aim: Candidiasis is a common opportunistic infection in HIV/AIDS patients caused by different Candida species. The aim of this study was to do molecular identification and determine the antifungal susceptibility profile of Candida species, isolated from the mouths of AIDS patients by the disk diffusion method.
Materials and Methods: This study included 50 samples collected from the oral cavity of 50 AIDS patients with oropharyngeal candidiasis (OPC) in Ahvaz City. After microscopic and macroscopic identification, these samples were finally identified by PCR RFLP method. For these 50 isolates, antifungal susceptibility testing was performed by the disk diffusion method, based on CLSI-M44-A standard protocol.
Results: In this study, among 50 samples collected from the oral cavity of AIDS patients, we found Candida albicans in 36% (18), Candida glabrata in 30% (15), Candida tropicalis in 26% (13), Candida krusei in 6% (3) and Candida parapsilosis in 2 % (1) of the cases. Our results showed that clotrimazole, amphotericin B, ketoconazole, voriconazole and itraconazole had the highest antifungal effect on Candida species, respectively. While fluconazole showed less antifungal activity compared to the other antifungal drugs.
Conclusion: Considering the better antifungal activity of voriconazole and itraconazole compared to fluconazole and the increasing resistance to fluconazole, which is the main antifungal used in the treatment of AIDS patients with OPC, itraconazole and voriconazole can be used as alternative oral antifungal drugs in the treatment of these patients.
|
|
| Keywords: Candida species, HIV patients, Disk diffusion method, Oropharyngeal candidiasis. |
|
|
Full-Text [PDF 633 kb]
(93 Downloads)
|
Type of Study: Original Research |
Subject:
Parasitology and Mycology
Received: 2023/06/17 | Accepted: 2024/04/23 | Published: 2025/03/9
|
|
|
|
|
|
|
| References |
|
1. Armaki MT, Farahbakhsh E, Yadegari MH, Bazl MR, Katiraee F. Evaluating the Sensitivity of Candida Albicans Isolates from Oral Candidiasis of AIDS Patients to Fluconazole by Microdilution Broth and Disk Diffusion Methods. J Isfahan Med Sch. 2011;29(158): 1368-1377. 2. Pathakumari B, Liang G, Liu W. Immune defence to invasive fungal infections: A comprehensive review. Biomed Pharmacother. 2020;130:110550. [ DOI:10.1016/j.biopha.2020.110550] [ PMID] 3. Ali M, Razok A, Gassim M, Elmaki N, Goravey W, Alkhal A, et al. HIV and AIDS-defining opportunistic illnesses in the state of Qatar: A cohort population-based retrospective study covering 17 years (2000-2016). Ann med surg. 2022;78:103842. [ DOI:10.1016/j.amsu.2022.103842] [ PMID] [ ] 4. Farahbakhsh E, Yadegari M, Rajabi Bazl M, Taghizadeh Armaki M. Evaluation of susceptibility of strains of candida albicans isolated from AIDS patients to fluconazole and determination of CDR2 resistance gene in resistant strains by RT-PCR Method. Armaghane danesh. 2011;16(3):201-10. 5. Mirhendi H, Makimura K, Khoramizadeh M, Yamaguchi H. A one-enzyme PCR-RFLP assay for identification of six medically important Candida species. Nippon Ishinkin Gakkai Zasshi. 2006;47(3):225-9. [ DOI:10.3314/jjmm.47.225] [ PMID] 6. Jafarzadeh L, Ranjbar M, Nazari T, Naeimi Eshkaleti M, Aghaei Gharehbolagh S, Sobel JD, et al. Vulvovaginal candidiasis: An overview of mycological, clinical, and immunological aspects. J Obstet Gynaecol Res. 2022;48(7):1546-60. [ DOI:10.1111/jog.15267] [ PMID] 7. Papon N, Courdavault V, Clastre M, Bennett RJ. Emerging and emerged pathogenic Candida species: beyond the Candida albicans paradigm. PLoS pathog. 2013;9(9):e1003550. [ DOI:10.1371/journal.ppat.1003550] [ PMID] [ ] 8. Pfaller MA, Diekema D. Epidemiology of invasive candidiasis: a persistent public health problem. Clin Microbiol Rev. 2007;20(1):133-63. [ DOI:10.1128/CMR.00029-06] [ PMID] [ ] 9. Ranganathan K, Reddy BV, Kumarasamy N, Solomon S, Viswanathan R, Johnson N. Oral lesions and conditions associated with human immunodeficiency virus infection in 300 south Indian patients. Oral Dis. 2000;6(3):152-7. [ DOI:10.1111/j.1601-0825.2000.tb00326.x] [ PMID] 10. Dockrell D, O'Shea D, Cartledge J, Freedman A. British HIV Association guidelines on the management of opportunistic infection in people living with HIV: The clinical management of Candidiasis 2019. HIV med. 2019;20:2-24. [ DOI:10.1111/hiv.12806] [ PMID] 11. Garcia-Cuesta C, Sarrion-Pérez M-G, Bagán JV. Current treatment of oral candidiasis: A literature review. J Clin Exp Dent. 2014;6(5):e576. [ DOI:10.4317/jced.51798] [ PMID] [ ] 12. Zeng B-S, Zeng B-Y, Hung C-M, Chen T-Y, Wu Y-C, Tu Y-K, et al. Efficacy and acceptability of different anti-fungal interventions in oropharyngeal or esophageal candidiasis in HIV co-infected adults: a pilot network meta-analysis. Expert Rev Anti Infect The. 2021;19(11):1469-79. [ DOI:10.1080/14787210.2021.1922078] [ PMID] 13. Lim DH, Jee H, Moon KC, Lim CS, Jang WS. Development of a Simple DNA Extraction Method and Candida Pan Loop-Mediated Isothermal Amplification Assay for Diagnosis of Candidemia. J Pathog. 2022;11(2):111. [ DOI:10.3390/pathogens11020111] [ PMID] [ ] 14. Shokohi T, Soteh MH, Pouri ZS, Hedayati M, Mayahi S. Identification of Candida species using PCR-RFLP in cancer patients in Iran. Indian J Med Microbiol. 2010;28(2):147-51. [ DOI:10.4103/0255-0857.62493] [ PMID] 15. Clinical, Institute LS. Zone diameter interpretive standards and corresponding minimal inhibitory concentration (MIC) interpretive breakpoints. Clinical and Laboratory Standards Institute Wayne^ ePA PA; 2006. 16. Pour AH, Salari S, Almani PGN. Oropharyngeal candidiasis in HIV/AIDS patients and non-HIV subjects in the Southeast of Iran. Curr Med Mycol. 2018;4(4):1. 17. Mousavi S, Salari S, Rezaie S, Nejad N, Hadizadeh S, Kamyabi H, et al. Identification of Candida species isolated from oral colonization in Iranian HIV-positive patients, by PCR-RFLP method. Jundishapur J Microbiol. 2012;5(1):336-40. 18. Spalanzani RN, Mattos K, Marques LI, Barros PFD, Pereira PIP, Paniago AMM, et al. Clinical and laboratorial features of oral candidiasis in HIV-positive patients. Rev Soc Bras Med Trop. 2018;51:352-6. [ DOI:10.1590/0037-8682-0241-2017] [ PMID] 19. Aboualigalehdari E, Tahmasebi BM, 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. doi: 10.4178/epih.e2020033. [ DOI:10.4178/epih.e2020033] [ PMID] [ ] 20. Badiee P, Alborzi A, Davarpanah MA, Shakiba E. Distributions and antifungal susceptibility of Candida species from mucosal sites in HIV positive patients. Arch Iran Med. 2010;13(4):282-287. 21. Mokaddas EM, Al-Sweih NA, Khan ZU. Species distribution and antifungal susceptibility of Candida bloodstream isolates in Kuwait: a 10-year study. J Med Microbiol. 2007;56(2):255-9. [ DOI:10.1099/jmm.0.46817-0] [ PMID] 22. Nweze EI, Ogbonnaya UL. Oral Candida isolates among HIV-infected subjects in Nigeria. J Microbiol Immunol Infect. 2011;44(3):172-7. [ DOI:10.1016/j.jmii.2011.01.028] [ PMID] 23. Lomeli-Martinez SM, González-Hernández LA, Villanueva JFA, Valentín-Goméz E, Ratkovich-González S, Alvarez-Zavala M, et al. In vitro Azole antifungals susceptibility of Candida spp. isolates from HIV-infected patients with periodontitis. J Mycol Med. 2022;32(3):101294. [ DOI:10.1016/j.mycmed.2022.101294] [ PMID] 24. Khedri S, Santos A, Roudbary M, Hadighi R, Falahati M, Farahyar S, et al. Iranian HIV/AIDS patients with oropharyngeal candidiasis: identification, prevalence and antifungal susceptibility of Candida species. Lett Appl Microbiol. 2018;67(4):392-9. [ DOI:10.1111/lam.13052] [ PMID] 25. Ngouana TK, Toghueo R, Kenfack I, Lachaud L, Nana A, Tadjou L, et al. Epidemiology and antifungal susceptibility testing of non-albicans Candida species colonizing mucosae of HIV-infected patients in Yaoundé (Cameroon). J Mycol Med. 2019;29(3):233-8. [ DOI:10.1016/j.mycmed.2019.06.003] [ PMID] 26. Ambe NF, Longdoh NA, Tebid P, Bobga TP, Nkfusai CN, Ngwa SB, et al. 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(1). [ DOI:10.11604/pamj.2020.36.23.18202] [ PMID] [ ] 27. Terças AL, Marques SG, Moffa EB, Alves MB, de Azevedo CM, Siqueira WL, et al. Antifungal drug susceptibility of Candida species isolated from HIV-positive patients recruited at a public hospital in São Luís, Maranhão, Brazil. Front Microbiol. 2017;8:298. [ DOI:10.3389/fmicb.2017.00298] [ PMID] [ ] 28. Goulart LS, Souza WW, Vieira CA, Lima JS, Olinda RA, Araújo C. Oral colonization by Candida species in HIV-positive patients: association and antifungal susceptibility study. einstein (São Paulo). 2018;16(3): eAO4224. [ DOI:10.1590/s1679-45082018ao4224] [ PMID] [ ] 29. Khan N, Malak N, Baradkar V, Shastri JS. Antifungal susceptibility of Candida by disc diffusion method of isolates from clinical cases of vulvovaginitis of a tertiary care hospital in Mumbai. IJHCR. 2021;4(4):71-6. 30. Razzaghi-Abyaneh M, Sadeghi G, Zeinali E, Alirezaee M, Shams-Ghahfarokhi M, Amani A, et al. Species distribution and antifungal susceptibility of Candida spp. isolated from superficial candidiasis in outpatients in Iran. J Mycol Med. 2014;24(2):e43-e50. [ DOI:10.1016/j.mycmed.2014.01.004] [ PMID] 31. Shafi FT, Padmaraj SR, Mullessery NP. Species distribution and antifungal susceptibility pattern of Candida causing oral candidiasis among hospitalized patients. Arch Med Health Sci. 2015;3(2):247. [ DOI:10.4103/2321-4848.171914] 32. Pawar M, Misra RN, Gandham NR, Angadi K, Jadhav S, Vyawahare C, Hatolkar S. Prevalence and antifungal susceptibility profile of Candida species isolated from tertiary care hospital, India. J Pharm Biomed Sci. 2015;05(10):812-6.
|
|
| Send email to the article author |
|
|
|
| Add your comments about this article |
|
|
|
|
Research code: 0G-9945 Ethics code: IR.AJUMS.MEDICINE.REC.1399.034
Hatami M, Erfaninejad M, Hoseinnejad A, Fatahinia M. Molecular Identification and Determination of Antifungal Susceptibility Profile of Candida Species Isolated from AIDS Patients in Ahwaz City. SJKU 2025; 29 (6) :13-23 URL: http://sjku.muk.ac.ir/article-1-7955-en.html
|
