Determination of Antifungal Susceptibility of Isolated Candidal Strains for Fluconazole and Voriconazole: An in vitro Study

Abstract

This chapter highlights to detect the prevalence of asymptomatic Candidal colonization among HIV-positive and Healthy individuals and assess antifungal drug susceptibility for Candida species by Fluconazole and Voriconazole.

Human immunodeficiency virus (HIV) infection is a worldwide health problem, which affects in both developing and developed countries. The oral lesions caused due to this disease can drastically change the life of the patient, in terms of quality. The present Case-control study was conducted during 2008-2010, among 50 HIV-positive patients as cases who were admitted to the community care center of Acharya Vinoba  Bhave Rural Hospital, Wardha, India. Oral swabs were collected from the tongue and palate, Candidal species were isolated and antifungal susceptibility testing had conducted based on disk diffusion procedures.

Prevalence of Candidal colonization was 52% among the cases which was significantly higher than the healthy control (8%) (p=0.00001). There is no association between asymptomatic Candidal colonization on the tongue and palate with decreasing CD4 T lymphocyte count statistically (P=0.3454, P=0.7279). Fungal infections are caused due to eukaryotic organisms which results in more difficult therapeutic problems than bacterial infections. During the initial episodes of oral Candidiasis topical antifungal treatment is useful, but most patients suffer multiple episodes,d fluconazole or itraconazole can help in the management. Antifungal susceptibility, among cases, Candidal colonization, 78.8% and 71.1% were sensitive and 17.3% and 26.9% were resistant respectively. To Fluconazole and Voriconazole.

The frequency of Candidal colonisation was particularly high in HIV-positive people. The CD4 T- lymphocyte count is unrelated to oral Candidal colonisation in asymptomatic individuals. Antifungal medication sensitivity testing is necessary.  Due to the rising emergence of resistance to azoles, these agents should be used cautiously and should be preserved for severe candidiasis or clinically symptomatic patients.