Antifungal susceptibility of Candida albicans isolated from the oral cavities of patients with HIV infection and cancer

This study investigated the antifungal susceptibility of Candida albicans isolated from the oral cavities of 205 HIV positive patients, 49 cancer patients and 20 normal healthy individuals. C. albicans were isolated and the antifungal susceptibility was determined. The results were analysed using the clinical break points and epidemiological cut off values. Prevalence of C. albicans carriage in HIV, in cancer patients, and in healthy individuals was 73%, 45% and 43% respectively. Resistance of the fungus to anidulafungin (0.49%), caspofungin (0.97%), posaconazole (3.4%), voriconazole (0.97%), itraconazole (0.97%), fluconazole (1.94%), amphotericin B (0%) was found to be low. For posaconazole the number of resistant strains and the non wild type (3.4%) were the same. However for the rest of the antifungal drugs, the number of non-wild type was found to be higher than the resistance determined by clinical breakpoints. Multi-azole resistance was also noted in some patients. In conclusion, there is a low rate of antifungal drug resistance among C. albicans isolated from the oral cavities of immuno compromised patients in Johannesburg, South Africa. However, the high number of non-wild type strains suggests that there is a need for an ongoing surveillance.