Especies y sensibilidad a antifúngicos de cepas de Candida spp. aisladas de la cavidad bucal de pacientes con VIH de Paraguay
DOI:
https://doi.org/10.18004/mem.iics/1812-9528/2021.019.03.12Keywords:
Candida, cavidad oral, VIH, antifúngicosAbstract
Candida albicans es la levadura más aislada de la cavidad oral de personas con VIH. Sin embargo, el uso de antifúngicos ha incrementado el aislamiento de especies no C. albicans resistentes o con sensibilidad reducida. El objetivo del estudio fue determinar las especies de Candida y la sensibilidad a los antifúngicos de aislamientos de la cavidad bucal de pacientes con VIH, que acudieron al Instituto de Medicina Tropical entre julio a diciembre de 2019. Las levaduras se sembraron en Agar Cromogénico Candida (CONDA®, España) para la identificación presuntiva. Las colonias verdes se identificaron por PCR dúplex y las de coloración distinta o PCR negativa mediante el sistema comercial VITEK®2. La susceptibilidad antifúngica de C. albicans se determinó por VITEK®2, y las no albicans por el método de difusión de discos. De 278 levaduras, C. albicans se aisló en 70,9 %, seguido de C. tropicalis (8,3 %) y C. krusei (5 %). C. albicans presentó 93 % de sensibilidad y 2 % de sensibilidad dosis dependiente al fluconazol; 87 % sensibles y 3 % con sensibilidad intermedia frente a voriconazol; 97, 98 y 100 % sensibilidad a flucitosina, anfotericina B y equinocandinas, respectivamente. C. parapsilosis y C. tropicalis no registraron resistencias a fluconazol y voriconazol. Todos los aislamientos de C. glabrata fueron sensibles dosis dependientes a fluconazol y todos los aislamientos de C. krusei resultaron sensibles a voriconazol. La portación oral de Candida spp. resistentes a azoles podría llevar a fracasos terapéuticos en pacientes con VIH que desarrollen candidiasis orofaríngea.
Downloads
References
Oliva Ferrando MM, Bargagna B, Maldonado M, López MA. Evaluation of the prevalence of oral lesions in patients with HIV/AIDS and their identification: a systematic review. FASO. 2019; 26(1):72-7. Disponible en: http://faso.org.ar/revista/2019_26_1.htm
Daniel HM, Lachance MA, Kurtzman CP. On the reclassification of species assigned to Candida and other anamorphic ascomycetous yeast genera based on phylogenetic circumscription. Antonie Van Leeuwenhoek. julio de 2014; 106(1):67-84. Doi: https://doi.org/10.1007/s10482-014-0170-z
Das PP, Saikia L, Nath R, Phukan SK. Species distribution and antifungal susceptibility pattern of oropharyngeal Candida isolates from human immunodeficiency virus infected individuals. Indian J Med Res. 2016; 143(4):495-501. DOI: https://doi.org/10.4103/0971-5916.184288
Nweze EI, Ogbonnaya UL. Oral Candida isolates among HIV-infected subjects in Nigeria. J Microbiol Immunol Infect. 2011; 44(3): 172-7. DOI: https://doi.org/10.1016/j.jmii.2011.01.028
Sullivan DJ, Westerneng TJ, Haynes KA, Bennett DE, Coleman DC. Candida dubliniensis sp. nov.: phenotypic and molecular characterization of a novel species associated with oral candidosis in HIV-infected individuals. Microbiology. 1995; 141(7): 1507-21. DOI: https://doi.org/10.1099/13500872-141-7-1507
Ahmad S, Khan Z, Asadzadeh M, Theyyathel A, Chandy R. Performance comparison of phenotypic and molecular methods for detection and differentiation of Candida albicans and Candida dubliniensis. BMC Infect Dis. 2012; 12: 230. DOI: https://doi.org/10.1186/1471-2334-12-230
Arendrup MC, Patterson TF. Multidrug-Resistant Candida: Epidemiology, Molecular Mechanisms, and Treatment. J Infect Dis. 2017; 216(suppl_3): S445-51. DOI: https://doi.org/10.1093/infdis/jix131
Sanabria R, Samudio M, Fariña N, Laspina F, Canese JO de, Ledesma GA, et al. Identification of candida species isolated from ambulatory, hospitalized and immune-depressed patients in Paraguay. Mem Inst Investig en Cienc Salud. 2006; 4(2):45-8. Disponible en: http://scielo.iics.una.py/scielo.php?script=sci_arttext&pid=S1812-95282006000200008&lng=en .
Clinical and Laboratory Standards Institute (CLSI). Performance standards for antifungal susceptibility testing of yeasts. M 60. Wayne, PA: CLSI, 2017.
Clinical and Laboratory Standards Institute (CLSI). Method for antifungal disk diffusion susceptibility testing of yeast, 2nd ed. CLSI Document M44-A2. Wayne, PA: CLSI, 2009
Li X, Lei L, Tan D. Oropharyngeal Candida colonization in human immunodeficiency virus infected patients. 121. 2012; 5: 375-402. DOI: https://doi.org/10.1111/apm.12006
Araiza J, Magallón-Zazueta L, Contreras-García S, Tirado-Sánchez A, Bonifaz A. Oral candidiasis in patients with HIV / AIDS; clinical and etiological spectrum. Rev Médica MD. 2018; 9. 10(4): 322-7. Disponible en: https://www.medigraphic.com/cgi-bin/new/resumen.cgi?IDARTICULO=82626
Castrillo S, Castrillo M, Alvarez M, Castrillo N. Candida species in HIV / AIDS patients with Oropharyngeal Candidiasis. Acta Odontológica Venez. 2012; 50(3). Disponible en: https://www.actaodontologica.com/ediciones/2012/3/art-5/
Goulart LS, Souza WWR de, Vieira CA, Lima JS de, Olinda RA de, Araújo C de, et al. Oral colonization by Candida species in HIV-positive patients: association and antifungal susceptibility study. Einstein São Paulo. 2018;16(3). DOI: https://doi.org/10.1590/S1679-45082018AO4224
Castro-Alegría LÁ, Álvarez-Valle MI, Martínez-Buitrago E. Candida in the oral cavity of HIV patients in Cali, Colombia: determination of species and sensitivity to fluconazole. Iatreia. 2015; 28(4): 368-77. Doi: https://doi.org/10.17533/udea.iatreia.v28n4a02
Clark-Ordóñez I, Callejas-Negrete OA, Aréchiga-Carvajal ET, Mouriño-Pérez RR. Candida species diversity and antifungal susceptibility patterns in oral samples of HIV/AIDS patients in Baja California, Mexico. Med Mycol. 2017; 55 (3): 285-94. Doi: https://doi.org/10.1093/mmy/myw069
Yorio VP. Candida dubliniensis and Candida albicans: phenotypically and phylogenetically related opportunistic oral pathogens. Actas Odontológicas Publ Discontinuada. 2006; 3(1):36-41. DOI: https://doi.org/10.22235/ao.v3i1.988
Abharian PH, Dehghan P, Abharian PH, Tolouei S. Molecular characterization of Candida dubliniensis and Candida albicans in the oral cavity of drug abusers using duplex polymerase chain reaction. Curr Med Mycol. 2018; 4(1):12. Doi: https://doi.org/10.18502/cmm.4.1.29
Luque AG, Biasoli MS, Tosello ME, Binolfi A, Lupo S, Magaró HM. Oral yeast carriage in HIV-infected and non-infected populations in Rosario, Argentina. Mycoses. 2009; 52 (1): 53-9. Doi: https://doi.org/10.1111/j.1439-0507.2008.01542.x
Satana D, Gonca E, Genc Z, Erturan Z. The antifungal susceptibilities of oral Candida spp. isolates from HIV-infected patients. Afr J Microbiol Res. 2010; 4(6):466-70. Disponible en: https://academicjournals.org/journal/AJMR/article-abstract/C203B6612087
Chavasco JK, Paula CR, Hirata MH, Aleva NA, Melo CE de, Gambale W, et al. Molecular identification of Candida dubliniensis isolated from oral lesions of HIV-positive and HIV-negative patients in São Paulo, Brazil. Rev Inst Med Trop São Paulo. 2006; 48(1):21-6. DOI: https://doi.org/10.1590/S0036-46652006000100005
Mariel-Carballo G. Phenotypic identification of Candida dubliniensis isolated from oral mucosa candidiasis in immunosuppressed patients. Dermatol Rev Mex. 2019; 63(1):14-25. Disponible en: https://www.medigraphic.com/cgi-bin/new/resumenI.cgi?IDARTICULO=85014
Llanos González I, Montoya Ojeda R, Puello Hoyos M, Young Castro G, Correa Jiménez O, Suárez Álvarez P. Carriage of Candida spp. in the oral cavity in diabetics and non-diabetics. Rev Cuba Endocrinol. 2017; 28(3): 1-11. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_abstract&pid=S1561-29532017000300007&lng=es&nrm=iso&tlng=es
Kirkpatrick WR, Revankar SG, Mcatee RK, Lopez-Ribot JL, Fothergill AW, McCarthy DI, et al. Detection of Candida dubliniensis in oropharyngeal samples from human immunodeficiency virus-infected patients in North America by primary CHROMagar candida screening and susceptibility testing of isolates. J Clin Microbiol. 1998; 36(10): 3007-12. Doi: https://doi.org/10.1128/JCM.36.10.3007-3012.1998
Terças ALG, Marques SG, Moffa EB, Alves MB, de Azevedo CMPS, Siqueira WL, et al. Antifungal Drug Susceptibility of Candida Species Isolated from HIV-Positive Patients Recruited at a Public Hospital in São Luís, Maranhão, Brazil. Front Microbiol. 2017; 8: 298. DOI: https://doi.org/10.3389/fmicb.2017.00298
Zuluaga A, Arango-Bustamante K, Caceres DH, Sánchez-Quitian ZA, Velásquez V, Gómez BL, et al. Concordance analysis between different methodologies used for identification of oral isolates of Candida species. Colomb Médica. 2018; 49 (3): 193-200. DOI: https://doi.org/10.25100/cm.v49i3.3774
Ochiuzzi ME, Cataldi S, Guelfand L, Maldonado I, Arechavala A. Evaluation of the Vitek 2 system for the identification of the main yeast species of the Candida genus. Rev Argent Microbiol. 2014; 46(2): 107-10. DOI: 10.1016/S0325-7541(14)70058-6
Garzón C, Gutiérrez L, Salazar C, Barrientos S, Romero C. Candida's species in relation with CD4 counts in HIV-AIDS patients. Dialnet. 27. 2008; 59: 29-33. Disponible en: https://dialnet.unirioja.es/servlet/articulo?codigo=3986456
Rao RP. Isolation, identification and speciation of Candida species from various clinical samples in a tertiary care teaching Hospital in Karnataka, India. J Evid Based Med Healthc. 2019; 6(11):866-8. DOI: 10.18410/jebmh/2019/182
Gutiérrez C, de Bedout C, Tobón A, Cano L, Arango M, Tabares A, et al. Sensitivity to Fluconazol and Voriconazol in Candida spp. isolates from the oral mucosa of HIV positive patients. Infectio. 2007; 11(4):183-9. Disponible en: http://www.scielo.org.co/scielo.php?script=sci_abstract&pid=S0123-93922007000400005&lng=en&nrm=iso&tlng=es
Ortega Riveros M. Estudio de la patogenicidad de Candida y de la actividad de los fármacos antifúngicos en un modelo animal en Caenorhabditis elegans [Internet] [Tesis Doctoral]. Universidad del País Vasco - Euskal Herriko Unibertsitatea; 2015 [citado 27 de marzo de 2020]. Disponible en: https://dialnet.unirioja.es/servlet/tesis?codigo=100132
Brito D, Fernández J, Castillo M, Azuero S, Hernández R, Saúl Y, et al. Fluconazole and voriconazole susceptibility in oral colonization isolates of Candida spp. in HIV patients. Invest Clin. 2019; 60 (4): 275-82. Disponible en: https://produccioncientificaluz.org/index.php/investigacion/article/view/31668
Khedri S, Santos ALS, Roudbary M, Hadighi R, Falahati M, Farahyar S, Khoshmirsafa M, Kalantari S. Iranian HIV/AIDS patients with oropharyngeal candidiasis: identification, prevalence and antifungal susceptibility of Candida species. Lett Appl Microbiol. 2018; 67(4): 392-9. doi: 10.1111/lam.13052. Epub 2018 Aug 16. PMID: 30019443.
Aguilar G, Araujo P, Lird G, Insaurralde S, Kawabata A, Ayala E, et al. Identificación y perfil de sensibilidad de Candida spp. aisladas de hemocultivos en hospitales de Paraguay. Rev Panam Salud Publica. 2020; 44: e34. https://doi.org/10.26633/RPSP.2020.34
Ochiuzzi ME, Arechavala A, Guelfand L, Maldonado I, Soloaga R. Evaluation of the VITEK 2 system (AST-YSO1 cards) for antifungal susceptibility testing against different Candida species. Rev Argent Microbiol. 2014; 46(2):111-8.
Estrella MC. Antifungals in the treatment of systemic infections: importance of the mechanism of action, spectrum of activity and resistance. Rev Esp Quimioter. 2010; 23(4):169-76. Disponible en: https://dialnet.unirioja.es/servlet/articulo?codigo=3705373
Valencia Torres B. Antifungal resistance mechanisms and new develping antifungals [Internet] [Trabajo de Grado]. Universidad Complutense; 2018. Disponible en: http://147.96.70.122/Web/TFG/TFG/Memoria/BEATRIZ%20VALENCIA%20TORRES.pdf
Pfaller M, Boyken L, Hollis R, Kroeger J, Messer S, Tendolkar S, et al. In vitro susceptibility of invasive isolates of Candida spp. to anidulafungin, caspofungin, and micafungin: six years of global surveillance. J Clin Microbiol. 2008; 46: 150-6. DOI: https://doi.org/10.1128/JCM.01901-07
Kaur R, Dhakad MS, Goyal R, Haque A, Mukhopadhyay G. Identification and Antifungal Susceptibility Testing of Candida Species: A Comparison of Vitek-2 System with Conventional and Molecular Methods. J Glob Infect Dis. 2016;8(4):139-46. DOI: https://doi.org/10.4103/0974-777X.192969
Catalán M, Montejo JC. Systemic antifungals. Pharmacodynamics and pharmacokinetics. Rev Iberoam Micol. 2006; 23(1): 39-49. DOI: https://doi.org/10.1016/S1130-1406(06)70012-2
Grazziotin NA, Danielli LJ, Maroso CT, Madalozzo VA, Jaskulski M da R. Susceptibility of Candida isolates from HIV-positive patients to azoles and amphotericin B. Saúde St Maria. 2015; 41(2):169-74. DOI: https://doi.org/10.5902/2236583417006
Blignaut E, Messer S, Hollis RJ, Pfaller MA. Antifungal susceptibility of South African oral yeast isolates from HIV/AIDS patients and healthy individuals. Diagn Microbiol Infect Dis. 2002; 44(2):169-74. DOI: https://doi.org/10.1016/S0732-8893(02)00440-6.
