title: High Oral Carriage of Non-albicans Candida spp. among HIV-infected individuals.
abstract: BACKGROUND
  Non-albicans Candida (NAC) spp. in immunocompromised patients are linked to invasive infections with narrow treatment choice. This study aimed at comparing the oral colonization of NAC spp. between HIV and non-HIV infected individuals in Mwanza, Tanzania.
  
  
  METHODS
  Oral rinse of 351 HIV-infected and 639 non-HIV infected individuals were collected between March and July 2015. Phenotypic identifications of Candida spp. was done using Candida Chromogenic agar and confirmed by MALDI-TOF MS.
  
  
  RESULTS
  NAC spp. were detected in 36/351 (10.3%) HIV-infected individuals compared to 28/639 (4.4%) of non-HIV infected individuals; P=0.0003. In HIV infected individuals, commonly isolated NAC spp. were Candida tropicalis, 10(2.8%), C. krusei (Issatschenki orientalis) 9(2.6%) and C. glabrata 8(2.3%). While for non-HIV infected individuals C. dubliniensis 8(1.3%) and C. tropicalis 5(0.9%) were commonly detected. As CD4 count/μl decreases by one unit the risk of being colonized by NAC spp. among HIV infected individuals increases by 1% (OR 1.01, 95% CI; 1.001-1.004, P=0.001).
  
  
  CONCLUSIONS
  The prevalence of NAC spp. is high among HIV-infected individuals with low CD4 count placing them at higher risk of invasive infections. Further studies to investigate the role of NAC spp. in causing invasive infections among immunocompromised patients are recommended.
authors.affiliation: Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Heath and Allied Sciences P.O. Box 1464 Mwanza, Tanzania. Electronic address: marthamushi@yahoo.com.
authors.forename: Martha F
authors.initials: MF
authors.lastname: Mushi
authors.affiliation: Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Heath and Allied Sciences P.O. Box 1464 Mwanza, Tanzania. Electronic address: conjestermtemisika@yahoo.com.
authors.forename: Conjester I
authors.initials: CI
authors.lastname: Mtemisika
authors.affiliation: Institute of Medical Microbiology, University Medical Center Kreuzbergring 57, 37075 Göttingen Germany. Electronic address: obader@med.uni-goettingen.de.
authors.forename: Oliver
authors.initials: O
authors.lastname: Bader
authors.affiliation: Kenya Medical Research Institute, Center for Microbiology Research P.O Box 54840 00200, Nairobi, Kenya. Electronic address: biichristinec@gmail.com.
authors.forename: Christine
authors.initials: C
authors.lastname: Bii
authors.affiliation: Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Heath and Allied Sciences P.O. Box 1464 Mwanza, Tanzania. Electronic address: mmmirambo@gmail.com.
authors.forename: Mariam M
authors.initials: MM
authors.lastname: Mirambo
authors.affiliation: Institute of Medical Microbiology, University Medical Center Kreuzbergring 57, 37075 Göttingen Germany. Electronic address: ugross@gwdg.de.
authors.forename: Uwe
authors.initials: U
authors.lastname: Groß
authors.affiliation: Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Heath and Allied Sciences P.O. Box 1464 Mwanza, Tanzania. Electronic address: mshana72@yahoo.com.
authors.forename: Stephen E
authors.initials: SE
authors.lastname: Mshana
mesh_terms: D000328:Adult; D018791:CD4 Lymphocyte Count; D002175:Candida / Q000302:isolation & purification*; D002353:Carrier State / Q000382:microbiology*; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000276:immunology / Q000382:microbiology*; D006801:Humans; D000072742:Invasive Fungal Infections / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009055:Mouth / Q000382:microbiology*
keywords: HIV; Oral health; non-Candida albicans Candida spp.