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Evaluation of Antifungal Activity Against Candida albicans Isolates From HIV-Positive Patients with Oral Candidiasis in a Major Referral Hospital, West Java, Indonesia

Summary

Researchers in West Java, Indonesia studied fungal infections in the mouths of HIV-positive patients to understand which antifungals work best. They found that a common fungal species called Candida albicans was present in all patients tested, though some resistant strains were discovered. The study showed that certain antifungal medications like voriconazole worked better than others, highlighting the importance of testing which specific medications will be effective for each patient rather than guessing.

Background

Oral candidiasis remains a prevalent opportunistic infection in HIV-positive patients and serves as an early indicator of immunosuppression. While Candida albicans is the primary pathogen, non-Candida albicans species and antifungal resistance patterns are emerging concerns that require local epidemiological data, particularly in resource-limited settings like Indonesia.

Objective

This study aimed to identify Candida species in HIV-positive patients with oral candidiasis and assess the antifungal susceptibility patterns of predominant species to commonly used antifungal agents including nystatin, fluconazole, itraconazole, and voriconazole.

Results

Candida albicans was isolated from all 30 samples (100%), with additional non-Candida albicans species detected including C. glabrata (10%), C. krusei (3.3%), and C. tropicalis (3.3%). Voriconazole showed the largest mean inhibition zone (34.0 ± 10.7 mm), followed by fluconazole (33.0 ± 9.3 mm), with 90% and 86.7% susceptibility respectively. Resistance was detected in 10% to fluconazole and 13.3% to voriconazole.

Conclusion

C. albicans remains the predominant species causing oral candidiasis in HIV-positive patients, with voriconazole demonstrating the broadest antifungal activity. The emergence of antifungal resistance in a subset of isolates underscores the importance of routine species identification and susceptibility testing to guide appropriate therapy and monitor resistance patterns in immunocompromised populations.
  • Published in:HIV/AIDS - Research and Palliative Care,
  • Study Type:Cross-sectional Study,
  • Source: PMID: 41169611, DOI: 10.2147/HIV.S536437
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