CROSS-SECTIONAL STUDY OF ORAL CANDIDA CARRIAGE IN A HUMAN-IMMUNODEFICIENCY-VIRUS (HIV)-SEROPOSITIVE POPULATION - PREDISPOSING FACTORS, EPIDEMIOLOGY AND ANTIFUNGAL SUSCEPTIBILITY

The Candida species isolated from oral rinses of 130 human immunodefic iency virus (HIV) infected patients were compared with those of 130 he althy non-matched volunteers. The oral rinses were plated on CHROMagar Candida medium (CAC) and on CAC supplemented with 10 mu g (CF10) and 100 mu g (CF100) of fluconazole per mi. The prevalence of non-albicans Candida spp. in oral rinses of HIV-infected patients and their correl ation with the clinical and epidemiological characteristics of the pat ients were studied. Susceptibility of the Candida spp. isolated was de termined by a microbroth dilution method based on the NCCLS reference procedure. Results of susceptibility tests of the yeast isolates were compared with their growth at the time of isolation on CAC supplemente d with fluconatole. Thirty five (30.7%) strains of non-albicans Candid a spp. were isolated from the HIV-positive population, vs. seven (15.9 %) from the immunocompetent population. Growth on CF10 correlated in 9 6% of the cases with fluconatole minimum inhibitory concentration (MIC )>8 mu g ml(-1). Smoking and use of azoles were significantly associat ed with oral carriage of non-albicans Candida spp. (P<0.05). The preva lence of non-albicans Candida spp. in HIV-positive persons in oral rin se samples is twice as high as in the HIV-negative population. Smoking and treatment with azoles are risk factors for the oral carriage of n on-albicans Candida spp. The isolation of yeasts on CAC plates supplem ented with fluconazole allows combination of presumptive yeast identif ication and fluconazole susceptibility testing.