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Background and Purpose: Oropharyngeal candidiasis is the most prevalent opportunistic fungal infection in patients with human immunodeficiency virus (HIV) as well as other immunodeficiency disorders, which is caused by various Candida species, mostly Candida albicans. Studies have shown that Candida isolates differ in their pathogenicity. These variations are attributed to virulence factors, host characteristics, and the target tissue. This study aimed to determine and compare the secretion of hydrolytic enzymes in C. albicans and non-albicans Candida species isolated from HIV+ /AIDS patients and healthy individuals. Materials and Methods: Samples were taken from 201 patients with HIV and 118 healthy individuals. The samples were identified by macroscopic, phenotypic, and molecular methods, and virulence factors were subsequently measured. Statistical differences in enzymatic activity of various Candida isolates were calculated (P<0.0001). Results: In total, 95 samples (47.20%) from patients and 46 samples (38.90%) from healthy individuals were positive for the growth of different Candida species. There were 39 (41.10%) and 36 (78.30%) C. albicans in patients and healthy individuals, respectively, as well as 56 (58.90%) and 10 (21.70%) non-albicans species in patients and healthy subjects, respectively. All the enzymes produced by Candida species enzymes were at low, medium, and high levels. Hemolysin activity in Candida species isolated from patients was significantly higher, compared to healthy individuals. Moreover, the activity of all C. albicans enzymes in patients was significantly higher than other Candida species. Conclusion: The C. albicans isolated from HIV-positive individuals secreted higher amounts of exoenzymes, and can cause oropharyngeal candidiasis and become a source of candidiasis for the host.

Background: Since there are various factors with different importance that determine environmental health status of hospitals, judging and prioritizing the required corrective actions using the current qualitative checklists is problematic and, in some cases, deceptive. This study explored a decision support model for hospital environmental health status to establish a quantitative method based on the analytic hierarchy process (AHP) using the Iranian National Hospital Evaluation checklist. Methods: The research was done in two separate phases; first, score weighting of the criteria and sub-criteria (questions) in the existing checklist using the AHP, and second, a field study of the environmental health status of the hospitals using a weighted checklist. In the field study, the environmental health status of the studied hospitals was sored using checklist questions, and finally, the final scores of each criterion were calculated and aggregated to determine the environmental health status of the studied hospitals. Results: Among the main criteria, the infection control criteria with a final weight coefficient of 0.5371, was the most important factor, and the building criteria with a final weight coefficient of 0.0341 had the lowest weight in determining the environmental health status of the hospitals. On average, the environmental health status of the studied hospitals was about 76%, which are in a moderate status. Conclusion: The environmental health status of Iran’s hospitals has typically been evaluated only qualitatively and without considering their weight importance. The present study provides a flexible method for quantitative assessment of the environmental health status of hospitals.

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