Factors associated with the isolation of Candida Spp. from the oral microbiota of people living with HIV

Abstract

This study aimed to analyze the association between the isolation of Candida species in the oral cavity and the clinical and virulence factors of people living with Human immunodeficiency virus (HIV). This cross-sectional study, comprising 106 people living with HIV who were evaluated in an HIV-AIDS outpatient clinic in Fortaleza, Northeast of Brazil, data collection were conducted during August and November 2018. A saliva sample was also collected to isolate Candida. The virulence factors of extracellular and hemolytic phospholipase activities in isolated Candida strains were analyzed. The prevalence of oral Candida was 40.6%, and the presence of oral Candida was associated with smoking habits (p = .005), daily smoking (p = .026), low weight (p = .030), history of hospitalization (p = .014), TCD4 lymphocyte count < 200 cells/mm3 (p = .018), and detectable viral load (p = .005). The multivariate analysis revealed that the variables smoking habits (p = .008), viral load (p = .011), and body mass index (p = .011) were associated with the presence of oral Candida. Strong hemolytic and phospholipase activities were, respectively, identified in 74.4% and 72% of the isolated strains, mainly Candida albicans. As a main conclusion, the isolation of Candida from the oral cavity in people living with HIV/AIDS, has a strong association with the use of tobacco, even under anappropriate treatment.

Antifungal Susceptibility and Candida sp. Biofilm Production in Clinical Isolates of HIV-Positive Brazilian Patients under HAART Therapy

“…Acquired or intrinsic FKS1 point mutations in C. albicans, C. tropicalis, C. glabrata and C. krusei have been linked to these echinocandin resistance cases [38]. Goulart et al [14] have shown that samples from HIV-positive patients that had received HAART presented Candida spp. isolates with 84% sensitivity, 15% DDS and 1% resistance to Flu; 99% sensitivity and 1% resistance to ketoconazole; and 73% sensitivity, 23% DDS and 4% resistance to itraconazole.…”

“…No differences were observed between the study participants regarding the sociodemographic characteristics analyzed and the isolation of oral Candida spp. However, data on lifestyle showed a positive correlation between smoking and Candida isolation [14] (Table 1). In addition, more information about the patients can be accessed in the Supplementary Material, Tables S1 and S2.…”

“…The following supporting information can be downloaded at: https://www. mdpi.com/article/10.3390/biomedicines12020310/s1, Table S1: Characteristics and lifestyle habits of the participants according to Silva et al [14]); Table S2: Clinical characteristics of the participants according to Silva et al [14]); Table S3. Identification and Characterization of Biofilm Formation of Candida sp.…”

Molecular Diagnosis Compared to Conventional Diagnosis for Rapid Detection of Resistant Strains of Candida Spp.

“…In addition, some widely used azolic derivatives, such as fluconazole, are considered fungistatic drugs that inhibit growth but do not kill the fungus, thus providing the opportunity for the development of resistance (Azeredo et al, 2013;Paramythiotou et al, 2014;Morschhäuser, 2016). Especially during repeated or prolonged treatment of recurrent episodes of oropharyngeal candidiasis in patients with AIDS, the evolution of fluconazoleresistant strains of C. albicans has been commonly observed (Paulique, 2017;Da Silva et al, 2020).…”

“…Currently, mycoses are important opportunistic infections in immunosuppressed individuals, and their diagnoses and treatments are decisive, since, in some cases, these can lead to a possible death (Silveira, 2017). Several systems for yeast culture capable of identifying these pathogens have been developed and require a time between 4 to 72 hours for analysis of the results, being widely available and commercialized (Espinel-Ingroff et al, 1998;Silva;Candido, 2005;Oliveira et al, 2006). Although correct identification of clinically important yeast strains can be achieved with these systems, incomplete or incorrect identifications can occur when new and emerging yeast strains are tested (Pfaller et al, 1996;Morschhäuser, 2016).…”