Abstract:
Oral Candidiasis is the most common HIV related oral lesion. Most patients
are infected with a strain originally present as a commensal of the oral cavity. The chronic
use of antifungal agents, in the treatment of candidiasis mainly in HIV/AIDS patients
leads to the selection of strain resistant to this therapy. The objective of this study was to
evaluate the in vitro susceptibility of Candida albicans to commonly used antifungal
agents in Ethiopia.
Methods: In vitro susceptibility tests were performed using the broth microdilution
method following the National Committee for Clinical Laboratory Standards (NCCLS)
M27-A guidelines. Data were then analyzed using SPSS for windows version 16.0. Tests
of proportions were done with Chi-Square, and a p value of <0.05 was considered as
statistically significant.
Results: A total of 42 oral C.albicans isolates from HIV-infected patients were
included in this study. Forty one (97.7%) of all isolates were determined fully susceptible
to amphotericin B, 40 (95.3%) to nystatin, and 39 (92.9%) to ketoconazole and
miconazole. On the other hand, the isolates showed highest rates of resistance against
fluconazole (11.9%) relatively. There was little difference in the antifungal susceptibilities
of C.albicans isolated from patients who had a history of previous antifungal therapy
compared with those who had not received antifungal treatment.
Conclusion: The in vitro antifungal susceptibility testing of C.albicans in this study
showed relatively high resistance to commonly used azoles. As with the prescribing of
any antimicrobial agent, the use of a systemic antifungal drug must be justified. Efforts
must be maintained to avoid inappropriate or unnecessary prescribing of these antifungal.
