Non-albicans oral candidosis in HIV-positive patients

Specimens from HIV-positive patients with oral candidosis were taken for cu lture, species identification and azole susceptibility testing, which was c orrelated with treatment outcome. Of 921 specimens, 95 yielded non-albicans species, mainly from patients with low CD4 lymphocyte counts and extensive previous azole exposure. Most non-albicans isolates were from specimens cc -infected with Candida albicans, complicating the interpretation of in-vitr o susceptibility results, which accurately predicted antifungal failure whe n the non-albicans species was isolated alone. Eighty-five non-albicans iso lates were resistant to fluconazole in vitro. Of 149 courses of azole thera py prescribed, 115 failed to clear non-albicans candidosis clinically. Cult ure media that discoloured in the presence of non-albicans colonies might, therefore, guide therapy.