Research article

Species distribution and in vitro antifungal susceptibility of oral yeast isolates from Tanzanian HIV-infected patients with primary and recurrent oropharyngeal candidiasis

Omar JM Hamza¹ , Mecky IN Matee² , Mainen J Moshi³ , Elison NM Simon¹ , Ferdinand Mugusi⁴ , Frans HM Mikx⁵ , Wim H van Palenstein Helderman⁵ , Antonius JMM Rijs^6,7 , André JAM van der Ven^7,8 and Paul E Verweij^6,7

¹  Department of Oral Surgery and Oral Pathology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania

²  Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania

³  Department of Biological and Preclinical studies, Institute of Traditional Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania

⁴  Department of Internal Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania

⁵  WHO Collaborating Center, Dentistry, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands

⁶  Department of Medical Microbiology, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands

⁷  Nijmegen University Center for Infectious Diseases, Nijmegen, The Netherlands

⁸  Department of General Internal Medicine, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands

author email corresponding author email

BMC Microbiology 2008, 8:135doi:10.1186/1471-2180-8-135

Published:	12 August 2008

Abstract

Background

In Tanzania, little is known on the species distribution and antifungal susceptibility profiles of yeast isolates from HIV-infected patients with primary and recurrent oropharyngeal candidiasis.

Methods

A total of 296 clinical oral yeasts were isolated from 292 HIV-infected patients with oropharyngeal candidiasis at the Muhimbili National Hospital, Dar es Salaam, Tanzania. Identification of the yeasts was performed using standard phenotypic methods. Antifungal susceptibility to fluconazole, itraconazole, miconazole, clotrimazole, amphotericin B and nystatin was assessed using a broth microdilution format according to the guidelines of the Clinical and Laboratory Standard Institute (CLSI; M27-A2).

Results

Candida albicans was the most frequently isolated species from 250 (84.5%) patients followed by C. glabrata from 20 (6.8%) patients, and C. krusei from 10 (3.4%) patients. There was no observed significant difference in species distribution between patients with primary and recurrent oropharyngeal candidiasis, but isolates cultured from patients previously treated were significantly less susceptible to the azole compounds compared to those cultured from antifungal naïve patients.

Conclusion

C. albicans was the most frequently isolated species from patients with oropharyngeal candidiasis. Oral yeast isolates from Tanzania had high level susceptibility to the antifungal agents tested. Recurrent oropharyngeal candidiasis and previous antifungal therapy significantly correlated with reduced susceptibility to azoles antifungal agents.