title: Diversity and antifungal resistance patterns of prevalent opportunistic pathogenic yeasts colonizing the oral cavities of asymptomatic human immunodeficiency virus-infected individuals, and their relation to CD4(+) counts.
abstract: BACKGROUND
  Yeasts are important opportunistic pathogens, in individuals infected with human immunodeficiency virus (HIV). Yeast species inhabiting the oral mucosa of HIV-infected persons can act as source of oral lesions, especially as the individual progresses towards immunocompromised state. Present study was conducted to evaluate the diversity of yeasts in oral cavities of asymptomatic HIV-infected persons and their association with CD4(+) cell counts.
  
  
  METHODS
  100 HIV seropositive subjects and 100 healthy controls were screened for oral yeast carriage using standard procedures.
  
  
  RESULTS
  Of the 100 HIV-seropositive persons screened, 48 were colonized by different yeasts, either alone or in association with another species. Candida albicans was the most common species (56.90%) while non C. albicans Candida (NCAC) accounted for 39.65%. Among NCAC, Candida tropicalis and Candida krusei were most common. One isolate each of rare opportunistic pathogenic yeasts, Geotrichum candidum and Saccharomyces cereviseae, was recovered. The control group had an oral candidal carriage rate of 23%; C. albicans was the predominant species, followed by Candida glabrata, C. tropicalis and Candida parapsilosis. Antifungal susceptibility testing revealed no resistance in C. albicans, to the commonly used antifungal agents, whereas resistance or dose dependent susceptibility to fluconazole was observed in some of the NCAC species.
  
  
  CONCLUSIONS
  Oral carriage of opportunistic pathogenic yeasts was greater in HIV-seropositive persons heading towards immunocompromised state, as evidenced by their CD4(+) cell count. The predominant yeast isolated in this study (C. albicans), was found to be susceptible to commonly used antifungals.
authors.affiliation: Department of Biosciences, Jamia Millia Islamia, New Delhi, India.
authors.forename: Deepa Anil
authors.initials: DA
authors.lastname: Kumar
authors.affiliation: Department of Regional STD Teaching Training and Research Centre, VMMC and Safdarjung Hospital, New Delhi, India.
authors.forename: Sumathi
authors.initials: S
authors.lastname: Muralidhar
authors.affiliation: Department of Microbiology, AIIMS, New Delhi, India.
authors.forename: Uma
authors.initials: U
authors.lastname: Banerjee
authors.affiliation: Department of Biosciences, Jamia Millia Islamia, New Delhi, India.
authors.forename: Seemi Farhat
authors.initials: SF
authors.lastname: Basir
authors.affiliation: Department of Laboratory Medicine, JPNA Trauma Centre - AIIMS, New Delhi, India.
authors.forename: Purva
authors.initials: P
authors.lastname: Mathur
authors.affiliation: Department of Biosciences, Jamia Millia Islamia, New Delhi, India.
authors.forename: Luqman Ahmad
authors.initials: LA
authors.lastname: Khan
keywords: Antifungal susceptibility test; CD4+ count; human immunodeficiency virus; opportunistic infections; oral candidiasis; oral yeast carriage; seropositive