An in vitrostudy of antifungal drug susceptibility of Candida species isolated from human immunodeficiency virus seropositive and human immunodeficiency virus seronegative individuals in Lucknow population Uttar Pradesh

Abstract

Background:Candidiasis is the most common opportunistic infection in human immunodeficiency virus (HIV) seropositive patients, starting from asymptomatic colonization to pathogenic forms and gradual colonization of non-albicans in patients with advanced immunosuppression leads to resistance for azole group of antifungal drugs with high rate of morbidity and mortality.Objectives:To isolate the Candida species and determine of antifungal drug susceptibility against fluconazole, itraconazole, nystatin, amphotericin B, and clotrimazolein HIV seropositive and control individuals, with or without clinical oropharyngeal candidiasis (OPC).Materials and Methods:Includes samples from faucial region of 70 subjects with and without clinical candidiasis in HIV seropositive and controls were aseptically inoculated onto Sabaraud's Dextrose Agar media and yeasts were identified for the specific species by Corn Meal Agar, sugar fermentation and heat tolerance tests. Antifungal drug susceptibility of the isolated species was done against above-mentioned drugs by E-test and disc diffusion method.Results:The commonly isolated species in HIV seropositive and controls were Candida albicans, Candida glabrata and Candida tropicalis Candida guilliermondii and Candida dubliniensis isolated only in HIV seropositive patients. Susceptibility against selected antifungal drugs was observed more in HIV-negative individuals whereas susceptible dose-dependent and resistance were predominant in HIV-positive patients.Conclusion:Resistance is the major problem in the therapy of OPC, especially in HIV seropositive patients due to aggressive and prolonged use of antifungal agents, therefore, our study emphasizes the need for antifungal drug susceptibility testing whenever antifungal treatment is desired, especially in HIV-infected subjects.

In Vitro Antifungal Susceptibility Testing of Tea Tree Oil (TTO) 5% Compared with Nystatin against Candida sp. as Important Agent of Oral Candidiasis in HIV/AIDS Patients

“…14 But, there were also research that showed that some species were resistant to nystatin, like in the study held by Dar et al in India (2015) stated that 61.1% subjects were sensitive, 36.1% intermediate, and 2,8% resistant to nystatin. 15 This could be caused by the changes in sterol composition in the Candida's cell membrane that could decrease the affinity of the this drug to the membrane itself. 7,16 TTO 5% exhibited the antifungal effect against Candida sp.…”

Sensibility Test of Candida species against Nystatin, Ketoconazole, and Fluconazole on Oral Candidiasis with HIV/AIDS using Disc Diffusion Method

“…that are rarely found in immunocompetent patients were also found in HIVseropositive patients, namely Candida dubliniensis, Candida glabrata, and Candida guilermondii. 18 A meta-analysis study conducted in Sub-Saharan Africa in 2005 -2015 showed a prevalence of non-albicans Candida species as much as 33.5% dominated with Candida glabrata, Candida krusei, and Candida tropicalis. The high prevalence of Candida krusei and Candida glabrata in HIV-infected populations in Sub-Saharan Africa has become a public health concern because this species is associated with fluconazole resistance.…”

In vitro susceptibility testing of yeasts to nystatin – low minimum inhibitory concentrations suggest no indication of in vitro resistance of Candida albicans, Candida species or non-Candida yeast species to nystatin

“…In India, an in vitro study of antifungal drug susceptibility of Candida species from human immunodeficiency virus (HIV) positive and HIV negative patients with and without oropharyngeal candidiasis has recently been published [3]. Candida isolates from HIV negative It should be noted, however, that nystatin-resistant isolates of C. albicans have repeatedly been reported.…”

“…A similar situation can be found for nystatin. However, in vitro susceptibility testing studies have shown a low percentage of Candida species isolated from HIV positive patients to be resistant to nystatin [3].…”

“…A similar situation can be found for nystatin. However, in vitro susceptibility testing studies have shown a low percentage of Candida species isolated from HIV positive patients to be resistant to nystatin [3].In this study, a total of 14 currently isolated yeast strains from dermatomycosis patients, and seven reference strains (controls), including isolates from the DSMZ strain collection (German Collection of Microorganisms and Cell Cultures, Braunschweig, Germany) and inter-laboratory ring tests of INSTAND e.V. (the German Society for Promoting Quality Assurance in Medical Laboratories, Düsseldorf, Germany), were tested for their in vitro susceptibility to the polyene antifungal agent nystatin.…”