Etiologic Agents and Antifungal Susceptibility of Oral Candidosis from Romanian patients with HIV-infection or type 1 diabetes mellitus


Share / Export Citation / Email / Print / Text size:

Polish Journal of Microbiology

Polish Society of Microbiologists

Subject: Microbiology


ISSN: 1733-1331
eISSN: 2544-4646





Volume / Issue / page

Related articles

VOLUME 65 , ISSUE 1 (March 2016) > List of articles

Etiologic Agents and Antifungal Susceptibility of Oral Candidosis from Romanian patients with HIV-infection or type 1 diabetes mellitus

Bogdan Minea / Valentin Nastasa / Anna Kolecka / Magdalena Mares / Narcisa Marangoci / Irina Rosca / Mariana Pinteala / Monica Hancianu / Mihai Mares *

Keywords : antifungal susceptibility, MXP-4509, oral candidosis, Romanian HIV and diabetes patients

Citation Information : Polish Journal of Microbiology. Volume 65, Issue 1, Pages 123-129, DOI:

License : (CC BY-NC-ND 4.0)

Received Date : 11-March-2015 / Accepted: 21-April-2015 / Published Online: 15-March-2016



This is the first Romanian investigation of oral candidosis in patients suffering of HIV-infection or type 1 diabetes mellitus (T1DM).Candida albicans was the dominant species in both types of isolates: n = 14 (46.7%) in T1DM, n = 60 (69.8%) in HIV. The most frequent non-albicans Candida spp. were Candida kefyr (n = 6; 20%) in T1DM and Candida dubliniensis (n = 8; 9.3%) in HIV. Resistance to fluconazole was detected only in the HIV non-albicans Candida group (n = 8; 9.3%). All isolates were susceptible to VOR. The experimental drug MXP had MIC values equal or close to the ones of VOR. Echinocandin resistance was more frequent than azole resistance.

Content not available PDF Share



Binolfi A., M.S. Biasoli, A.G. Luque, M.E. Tosello and H.M. Magaró. 2005. High prevalence of oral colonization by Candida dubliniensis in HIV-positive patients in Argentina. Med. Mycol. 43(5): 431–437.


Bremenkamp R.M., A.R. Caris, A.O.C. Jorge, G.N. Back-Brito, A.J. Mota, I. Balducci, F.L. Brighenti and C.Y. Koga-Ito. 2011. Prevalence and antifungal resistance profile of Candida spp. oral isolates from patients with type 1 and 2 diabetes mellitus. Arch. Oral Biol. 56(6): 549–555.


Cartledge J.D., J. Midgley and B.G. Gazzard. 1999. Non-albicans oral candidosis in HIV-positive patients. J. Antimicrob. Chemother. 43(3): 419–422.


Costa C.R., J.A. de Lemos, X.S. Passos, C.R. de Araújo, A.J. Cohen,L.K.H.E. Souza and M. do R.R. Silva. 2006. Species distribution and antifungal susceptibility profile of oral Candida isolates from HIV-infected patients in the antiretroviral therapy era. Mycopathologia 162(1): 45–50.


Dannaoui E., O. Lortholary, D. Raoux, M.E. Bougnoux, G. Galeazzi, C. Lawrence, D. Moissenet, I. Poilane, D. Hoinard andF. Dromer. 2008. Comparative in vitro activities of caspofungin and micafungin, determined using the method of the European Committee on antimicrobial susceptibility testing, against yeast isolates obtained in France in 2005–2006. Antimicrob. Agents Chemother. 52 (2): 778–781.


Dorko E., Z. Baranová, A. Jenča, P. Kizek, E. Pilipčinec andL. Tkáčiková. 2005. Diabetes mellitus and candidiases. Folia Microbiol. (Praha) 50(3): 255–261.


Dos Santos Abrantes P.M., C.P. McArthur and C.W.J. Africa. 2014. Multi-drug resistant oral Candida species isolated from HIV-positive patients in South Africa and Cameroon. Diagn. Microbiol. Infect. Dis. 79(2): 222–227.


Drozdowska A. and J. Drzewoski. 2008. Mycoses in diabetes-difficult diagnostic and therapeutic problem. Review of literature. Diabetol. Doświadczalna Klin. 8(1): 1–11.


Erköse G. and Z. Erturan. 2007. Oral Candida colonization of human immunodeficiency virus infected subjects in Turkey and its relation with viral load and CD4+ T-lymphocyte count. Mycoses 50(6): 485–490.


Fong I.W., M. Laurel and A. Burford-Mason. 1997. Asymptomatic oral carriage of Candida albicans in patients with HIV infection. Clin. Investig. Med. Médecine Clin. Exp. 20(2): 85–93.


Giammanco G.M., G. Pizzo, S. Pecorella, S. Distefano, V. Pecoraro and M.E. Milici. 2002. Identification of Candida dubliniensis among oral yeast isolates from an Italian population of human immunodeficiency virus-infected (HIV+) subjects. Oral Microbiol. Immunol. 17(2): 89–94.


Ho M.-W., Y.-L. Yang, C.-C. Lin, C.-Y. Chi, H.-T. Chen, P.-C. Lin, L.-Y. Hsieh, C.-H. Chou, W.-L. Chu, C.-P. Wu and others. 2014. Yeast oropharyngeal colonization in human immunodeficiency virus-infected patients in central Taiwan. Mycopathologia 177(5–6): 309–317.


Kadir T., R. Pisiriciler, S. Akyüz, A. Yarat, N. Emekli and A. Ipbüker. 2002. Mycological and cytological examination of oral candidal carriage in diabetic patients and non-diabetic control subjects: thorough analysis of local aetiologic and systemic factors.J. Oral Rehabil. 29(5): 452–457.


Kolecka A., K. Khayhan, M. Groenewald, B. Theelen, M. Arabatzis, A. Velegraki, M. Kostrzewa, M. Mares, S.J. Taj-Aldeen and T. Boekhout. 2013. Identification of medically relevant species of arthroconidial yeasts by use of matrix-assisted laser desorption ionization-time of flight mass spectrometry. J. Clin. Microbiol. 51(8): 2491–2500.


Leigh J.E., K. Shetty and P.L. Fidel. 2004. Oral opportunistic infections in HIV-positive individuals: review and role of mucosal immu-nity. AIDS Patient Care STDs 18(8): 443–56.


Lin J.-N., C.-C. Lin, C.-H. Lai, Y.-L. Yang, H.-T. Chen, H.-C. Weng,L.-Y. Hsieh, Y.-C. Kuo, T.-L. Lauderdale, F.-C. Tseng and others. 2013. Predisposing factors for oropharyngeal colonization of yeasts in human immunodeficiency virus-infected patients: A prospective cross-sectional study. J. Microbiol. Immunol. Infect. 46(2): 129–135.


Li Y.-Y., W.-Y. Chen, X. Li, H.-B. Li, H.-Q. Li, L. Wang, L. He, X.-P. Yang, X.-C. Wang, Y.-L. Huang and others. 2013. Asymptomatic oral yeast carriage and antifungal susceptibility profile of HIV-infected patients in Kunming, Yunnan Province of China. BMC Infect. Dis. 13(1): 46.


Lortholary O., G. Petrikkos, M. Akova, M.C. Arendrup, S. Arikan--Akdagli, M. Bassetti, J. Bille, T. Calandra, E. Castagnola, O.A. Cornely and others. 2012. ESCMID* guideline for the diagnosis and management of Candida diseases 2012: patients with HIV infection or AIDS. Clin. Microbiol. Infect. 18(Suppl. 7): 68–77.


Mandal S.M., D. Mahata, L. Migliolo, A. Parekh, P.S. Addy, M. Mandal and A. Basak. 2014. Glucose directly promotes antifungal resistance in the fungal pathogen, Candida spp. J. Biol. Chem. 289(37): 25468–25473.


Manfredi M., M.J. McCullough, Z.M. Al-Karaawi, S.J. Hurel and S.R. Porter. 2002. The isolation, identification and molecular analysis of Candida spp. isolated from the oral cavities of patients with diabetes mellitus. Oral Microbiol. Immunol. 17(3): 181–185.


Manfredi M., M.J. McCullough, L. Polonelli, S. Conti, Z.M. Al-Karaawi, P. Vescovi and S.R. Porter. 2006. In vitro antifungal suscep-tibility to six antifungal agents of 229 Candida isolates from patients with diabetes mellitus. Oral Microbiol. Immunol. 21(3): 177–182.


Marangoci N., M. Mares, M. Silion, A. Fifere, C. Varganici,A. Nicolescu, C. Deleanu, A. Coroaba, M. Pinteala and B.C. Simionescu. 2011. Inclusion complex of a new propiconazole derivative with β-cyclodextrin: NMR, ESI-MS and preliminary pharmacological studies. Results Pharma Sci. 1(1): 27–37.


Maurya V., A. Srivastava, J. Mishra, R. Gaind, R.S.K. Marak, A.K. Tripathi, M. Singh and V. Venkatesh. 2013. Oropharyngeal candidiasis and Candida colonization in HIV positive patients in northern India. J. Infect. Dev. Ctries. 7(8): 608–613.


Merenstein D., H. Hu, C. Wang, P. Hamilton, M. Blackmon,H. Chen, R. Calderone and D. Li. 2013. Colonization by Candida species of the oral and vaginal mucosa in HIV-infected and noninfected women. AIDS Res. Hum. Retroviruses 29(1): 30–34.


Mitrovic S., V. Radovic, I. KranjcicZec, V. Arsic, A. Dzamic and D.J. Jevtovic. 1996. Oral candidiasis in HIV infected patients caused by Candida albicans and associated Candida species, Berkarda B. (eds). Monduzzi Editore, Bologna.


Nawrot U., M. Cisło, A. Noczyńska, K. Włodarczyk and E. Baran. 2006. Susceptibility to selected antifungal agents of yeast-like fungi isolated from gastrointestinal tract of diabetes children type 1. Mikol. Lek. 13(1): 35–38.


Ramírez M., M.C. Serrano, C. Castro, E. López, C. Almeida,A. Fernández, A. Romero and E. Martín-Mazuelos. 2006. Comparative study of disc diffusion and microdilution methods in susceptibility testing of micafungin against Candida species. J. Antimicrob. Chemother. 58(4): 861–863.


Romeo O. and G. Criseo. 2011. Candida africana and its closest relatives. Mycoses 54(6):475–86.


Sangeorzan J.A., S.F. Bradley, X. He, L.T. Zarins, G.L. Ridenour, R.N. Tiballi and C.A. Kauffman. 1994. Epidemiology of oral can-didiasis in HIV-infected patients: colonization, infection, treatment, and emergence of fluconazole resistance. Am. J. Med. 97(4): 339–46.


Sanitá P.V., E.G. de Oliveira Mima, A.C. Pavarina, J.H. Jorge,A.L. Machado and C.E. Vergani. 2013. Susceptibility profile of a Brazilian yeast stock collection of Candida species isolated from subjects with Candida-associated denture stomatitis with or without diabetes. Oral Surg. Oral Med. Oral Pathol. Oral Radiol. 116(5): 562–569.


Subcommittee on Antifungal Susceptibility Testing (AFST) of the ESCMID European Committee for Antimicrobial Susceptibility Testing (EUCAST). 2008. EUCAST definitive document EDef 7.1: method for the determination of broth dilution MICs of antifungal agents for fermentative yeasts. Clin. Microbiol. Infect. Off. Publ. Eur. Soc. Clin. Microbiol. Infect. Dis. 14(4): 398–405.


Subcommittee on Antifungal Susceptibility Testing (AFST) of the ESCMID European Committee for Antimicrobial Susceptibility Testing (EUCAST). 2014. Antifungal Agents. Breakpoint tables for interpretation of MICs. Version 7.0, valid from 2014-08-12.


Vargas K.G. and S. Joly. 2002. Carriage frequency, intensity of carriage, and strains of oral yeast species vary in the progression to oral candidiasis in human immunodeficiency virus-positive individuals. J. Clin. Microbiol. 40(2): 341–350.


Vergani C.E., P.V. Sanitá, E.G.O. Mima, A.C. Pavarina andA.L. Machado. 2013. Oral candidiasis: conventional and alternative treatment options. In: Candidiasis Epidemiol. Symptoms Treat. Options, pp. 85–115.