Candida profile in HIV-Positive children needs a Dynamic clinical appraisal: A microbiological Study

Introduction: Candidiasis is the most prevalent opportunistic infection in Acquired Immuno deficiency Syndrome (AIDS). The prolonged and/or recurrent treatment of Candidiasis that results in alteration of profile of Candida species necessitates customizing the antifungal therapy regimen. This study aimed to identify the profile of candidal species in HIV-positive children and adults. Further the colonization of these species was assessed for their antimicrobial sensitivity. Materials and methods: Ten ml saliva was collected from HIV-positive children (n=30) and adults (n=40) and 100μL was cultured on CHROMagar™ followed by identification, counting of species after 48 hours, and antimicrobial sensitivity using the automated VITEK®2 antimicrobial susceptibility testing system. Results: More numbers of HIV-positive children than adults exhibited Candida colonization. The predominant species identified was C. albicans either alone or in combination with C. glabrata, C. tropicalis or C. krusei. An increased proportion of C. glabrata was seen in children whereas the adults showed increase in colonization by C. tropicalis. Assessment of antibiotic resistance showed C. krusei and C. glabrata to be resistant to fluconazole and partly resistant towards Amphotericin B. Conclusion: Higher colonization observed in children may be attributed to the relatively less developed immunity and higher viral load. Multidrug treatment regimens may have caused the changing profile of species from C. albicans to non-albicans. Resistance to fluconazole is attributed to a difference in affinity of the target enzyme and active efflux of fluconazole by the organisms.