title: Antifungal Drug Susceptibility ofCandidaSpecies Isolated from HIV-Positive Patients Recruited at a Public Hospital in São Luís, Maranhão, Brazil.
abstract: Oropharyngeal candidiasis is the most common fungal infection in hospitalized patients with acquired immune deficiency syndrome (AIDS). Its progression results in invasive infections, which are a significant cause of morbidity and mortality. This study aimed to quickly and accurately identifyCandidaspp. from oral mucosa of AIDS patients recruited at Presidente Vargas Hospital, in São Luís city, Brazil and to evaluate the sensitivity profile of these fungi to antifungals by using an automated system. Isolates were collected from oropharyngeal mucosa of 52 hospitalized AIDS patients, under anti-viral and antifungal therapies. Patients were included in research if they were HIV-positive, above 18 years of age and after obtaining their written consent. CHROMagar®Candidaand the automated ViteK-2®system were used to isolate and identifyCandidaspp., respectively. Antifungal susceptibility testing was performed using the ViteK-2®system, complemented with the Etest®, using the drugs amphotericin B, fluconazole, flucytosine, and voriconazole. Oropharyngeal candidiasis had a high prevalence in these hospitalized AIDS patients (83%), and the most prevalent species wasCandida albicans(56%). Antifungal susceptibility test showed that 64.7% of theCandidaspp. were susceptible, 11.8% were dose-dependent sensitive, and 23.5% were resistant. All theCandida kruseiandCandida famataisolates and two ofCandida glabratawere resistant to fluconazole. Most of AIDS patients presented oropharyngeal candidiasis andC. albicanswas the most frequently isolated species. The results showed high variability in resistance among isolated species and indicates the need to identify theCandidaspp. involved in the infection and the need to test antifungal susceptibility as a guide in drug therapy in patients hospitalized with AIDS. This is the first relate about AIDS patients monitoring in a public hospital in São Luís concerning the precise identification and establishing of antifungal profile ofCandidaspp..
authors.affiliation: Department Federal Technological Teaching Center of Maranhão São Luis, Brazil.
authors.forename: Ana L G
authors.initials: AL
authors.lastname: Terças
authors.affiliation: Nucleus of Tropical Pathology and Social Medicine, Department of Pathology, Federal University of Maranhão São Luis, Brazil.
authors.forename: Sirlei G
authors.initials: SG
authors.lastname: Marques
authors.affiliation: Department of Post-Graduate Program in Dentistry, CEUMA UniversitySão Luis, Brazil; Department of Post-Graduate Program in Parasite Biology, CEUMA UniversitySão Luis, Brazil.
authors.forename: Eduardo B
authors.initials: EB
authors.lastname: Moffa
authors.affiliation: Department of Post-Graduate Program in Parasite Biology, CEUMA University São Luis, Brazil.
authors.forename: Márcia B
authors.initials: MB
authors.lastname: Alves
authors.affiliation: Department of Medicine, Federal University of Maranhão São Luis, Brazil.
authors.forename: Conceição M P S
authors.initials: CM
authors.lastname: de Azevedo
authors.affiliation: Schulich Dentistry and Department of Biochemistry, Schulich School of Medicine and Dentistry, The University of Western Ontario, London ON, Canada.
authors.forename: Walter L
authors.initials: WL
authors.lastname: Siqueira
authors.affiliation: Department of Post-Graduate Program in Parasite Biology, CEUMA University São Luis, Brazil.
authors.forename: Cristina A
authors.initials: CA
authors.lastname: Monteiro
keywords: AIDS; Candida; HIV; antifungals; oropharyngeal candidiasis