Abstract:
Background: In Tanzania, little is known on the species distribution and antifungal susceptibility
profiles of yeast isolates from HIV-infected patients with primary and recurrent oropharyngeal
candidiasis.
Methods: A total of 296 clinical oral yeasts were isolated from 292 HIV-infected patients with
oropharyngeal candidiasis at the Muhimbili National Hospital, Dar es Salaam, Tanzania.
Identification of the yeasts was performed using standard phenotypic methods. Antifungal
susceptibility to fluconazole, itraconazole, miconazole, clotrimazole, amphotericin B and nystatin
was assessed using a broth microdilution format according to the guidelines of the Clinical and
Laboratory Standard Institute (CLSI; M27-A2).
Results: Candida albicans was the most frequently isolated species from 250 (84.5%) patients
followed by C. glabrata from 20 (6.8%) patients, and C. krusei from 10 (3.4%) patients. There was no
observed significant difference in species distribution between patients with primary and recurrent
oropharyngeal candidiasis, but isolates cultured from patients previously treated were significantly
less susceptible to the azole compounds compared to those cultured from antifungal naïve patients.
Conclusion: C. albicans was the most frequently isolated species from patients with oropharyngeal
candidiasis. Oral yeast isolates from Tanzania had high level susceptibility to the antifungal agents
tested. Recurrent oropharyngeal candidiasis and previous antifungal therapy significantly correlated
with reduced susceptibility to azoles antifungal agents.
