Characterisation of candida species from oral thrush in hiv seropositive cases

Introduction: Globally 36.7 million people are infected with AIDS. India alone has 2.1 million patients with HIV infection. Oral Candidiasis is the most common opportunistic fungal infection. In HIV infection, the isolation of non-albicans from oral Candidiasis is on a rise. Hence it is necessary to identify Candida albicans as well as non-albicans species too. Method: The present study was undertaken on 100 patients to identify the isolates and correlate them to CD4+ lymphocyte count for the period of one year. KOH mount and Gram’s stain done for demonstration of yeast like cells. Isolation was done on SDA media. Isolation was further processed by germ tube test and confirmed by fermentation and sugar assimilation test. Culture was grown on Chrom agar and CD4+ T cell count done. Result: Specificity of Gram’s stain and KOH mount was 76% and 64% respectively. SDA yielded 100% growth. Germ tube was positive in all C. albicans and C.dubilinensis cases. C.albicans was the most common species isolated (28.3%), followed by C.tropicalis (26.66%), C.guillermondii (17.69%), C.dubilinensis (10.61%), C.krusi (7.07%), C.parapsilosis (6.19%), C.kefyr (3.53%), least isolated species C.glabrata (0.88%). Mean CD4+ T lymphocyte count was 125.28± 78.45 cells/µl of blood. Discussion: In 2007 work in Maulana Azad Medical College, New Delhi found that C. albicans was most predominant 59.3%, followed by C.glabrata(14.8%), C.parapsilosis (11.8%), C.guillermondii and C.tropicalis 1% each. In 2009 Kumar G.Menon CP, Thangam et al showed that out of 54 cases of HIV positive patients, 44% were infected with C.albicans and 56% were non-candida albicans. Conclusion: There is an increase in occurrence of non-candida albicans species in Oral Candidiasis. Oral Candidiasis affects patient’s compliance of ART and nutritional intake.