52例HIV/AIDS患者口腔念珠菌病的临床表型及病原学鉴定

中国真菌学杂志　 2015, Vol. 10 　Issue (3): 154-157.

52例HIV/AIDS患者口腔念珠菌病的临床表型及病原学鉴定

李泽慧, 李刚, 薛瑞

新疆医科大学第一附属医院牙周黏膜科, 乌鲁木齐 830054

收稿日期:2015-04-22 出版日期:2015-06-28 发布日期:2015-06-28
通讯作者: 薛瑞, E-mail:xuerui322@126.com E-mail:xuerui322@126.com
作者简介:李泽慧, 女 (汉族), 硕士, 主治医师.E-mail:lizehui1123@126.com
基金资助:
新疆维吾尔自治区自然科学基金(2009211B21)

Clinical and etiologic features in 52 oral candidiasis patients with HIV/AIDS

LI Ze-hui, LI Gang, XUE Rui

Department of Periodontology, The First Affiliated Hospital of Xingjiang Medical University, Urumqi 830054, xingjiang, China

Received:2015-04-22 Online:2015-06-28 Published:2015-06-28

摘要/Abstract

摘要：

目的口腔念珠菌病(oral candidiasis,OC)是HIV/AIDS患者中最常见的口腔疾病,研究其临床表型及病原学特点对AIDS相关性口腔念珠菌病的诊断和临床用药有重要的指导意义。方法将70例确诊为HIV/AIDS且初步诊断为AIDS相关性口腔念珠菌病患者使用棉拭子在其病损区取材,接种至科玛嘉念珠菌显色培养基检验。结果 HIV/AIDS患者念珠菌感染的病例为52例,临床表型以假膜型和红斑型为主,其中假膜型最为常见 (56%)。HIV/AIDS患者口腔念珠菌病各致病病原菌以白念珠菌的检出率最高 (60.32%),热带念珠菌次之 (19.05%),光滑念珠菌为 (12.70%),克柔念珠菌 (7.94%)。有9例HIV/AIDS伴口腔念珠菌病患者,检测出病原菌的混合感染,其中2例为3种病原菌感染。结论 HIV/AIDS患者口腔念珠菌病临床表型复杂且可以伴发,单纯通过临床表现鉴别诊断常不准确,且病原菌的准确分型可以指导临床用药,降低耐药菌的产生。

关键词: 口腔念珠菌病, HIV/AIDS患者, 白念珠菌, 临床表型

Abstract:

Objective Oral candidiasis is considered one of the most common oral diseases of Human Immunodeficiency Virus /Acquired Immune Deficiency Syndrome patients.Understanding the clinical and etiologic features of the disease plays a vital role in its diagnosis and use of medication.Methods Mucosal swab samples were collected from 70 HIV/AIDS patients with oral candidiasis.And yeast colonies were developed and identified by CHROMagar Candida.Results There were 52 cases of oral candidiasis with 70 HIV/AIDS patients,mainly manifested in Pseudomembranous and erythema types,of which Pseudomembranous is the most common.The detection rate of Candida albicans was the highest (60.32%) in patients with oral candidiasis HIV/AIDS.Other identified Candida species were C.tropicalis (19.05%),C.glabrata (12.70%) and C.crusei (7.94%).There were 9 cases of oral candidiasisin of HIV/AIDS patients with mixed infection and 2 cases with three kinds of pathogenic bacterias.Conclusion The Clinical manifestation of HIV/AIDS patients with oral candidiasis is complex and concurrent.However,diagnosing based merely on its clinical appearance of the disease is insufficient.Therefore,accurate classification of pathogenic bacterias can guide the usage of clinical medication and reduce the production of drug resistant bacterias.

Key words: oral candidiasis, HIV/AIDS patient, Candida albicans, Clinical phenotype

中图分类号:

R756.5

李泽慧, 李刚, 薛瑞. 52例HIV/AIDS患者口腔念珠菌病的临床表型及病原学鉴定[J]. 中国真菌学杂志, 2015, 10(3): 154-157.

LI Ze-hui, LI Gang, XUE Rui. Clinical and etiologic features in 52 oral candidiasis patients with HIV/AIDS[J]. Chinese Journal of Mycology, 2015, 10(3): 154-157.

参考文献

[1] Badiee P,Alborzi A,Davarpanah MA,et al.Distributions and antifungal susceptibility of Candida species from mucosal sites in HIV positive patients
[J].Arch Iran Med,2010,13 (4):282-287.

[2] Chidzonga MM,Mwale M,Malvin,et al.Oral candidiasis as a marker of HIV disease progression among zimbabwean women
[J].Acquir Immune Defic Syndr,2008,47(5):579-584.

[3] Ribeiro Ribeiro AL,de Alencar Menezes TO,de Melo Alves-Junior S,et al.Oral carriage of Candida species in HIV-infected patients during highly active antiretroviral therapy (HAART) in Belém,Brazil
[J].Oral Surg Oral Med Oral Pathol Oral Radiol,2015,120(1):29-33.

[4] 中华医学会感染病学分会艾滋病学组.艾滋病诊疗指南
[J].中华传染病杂志,2011,29(10):631-632.

[5] 陈谦明.口腔粘膜病学
[M].北京:人民卫生出版社,2012:179.

[6] Owotade FJ,Patel M.Virulence of oral Candida isolated from HIV-positive women with oral candidiasis and asymptomatic carriers
[J].Oral Surg Oral Med Oral Pathol Oral Radiol Endod,2014,118(4):455-460.

[7] Dodd CL,Winkler JR,Heinic GS,et al.Cytomegalovirus infection presenting as acute periodontal infection in a patient infected with the human immunodeficiency virus
[J].J Clin Periodontol,1993,20(4):282-285.

[8] Adedigbal MA,Ogunbodedel EO,Jeboda SO,et al.Patterns of oralmanifestation of HIV/AIDS among 225 Nigerian patients
[J].Oral Dis,2008,14(4):341-346.

[9] Gaitan Cepeda LA,Ceballos Salobrea A,López Ortega K,et al.Oral lesions and immune reconstitution syndrome in HIV+/AIDS patients receiving highly active antiretroviral therapy.Epidemiological evidence
[J].Med Oral Patol Oral Cir Bucal,2008,13(2):E85-93.

[10] Jain PA,Veerabhadrudu K,Kulkarni RD et al.Comparative study of adherence of oral Candida albicans isolates from HIV sero-positive individuals and HIV sero-negative individuals to human huccal epi-thelial cells
[J].Indian J Pathol Microbiol,2010,53(3):513-517.

[11] Alfonso C,Lapez M,Arechavala A,et al.Presumptive identification of Candida spp.And other clinically importantyeasts:Usefulness of Brilliance Candida Agar
[J].Rev Iberoam Micol,2010,27(2):90-93.

[12] Lisboa C,Santos A,Azeve doF,et al.Direct impression on agar surface as a diagnostics ampling procedure for cand idabal anitis
[J].Sex Transm Infect,2010,86(1):32-35.

[13] 许宏涛,张秀珍.科玛嘉念珠菌显色培养基的应用
[J].中华检验医学杂志,2000,23(5):298.

[14] Chakraborty N,Mukherjee A,Santra S,et al.Current trends of opportunistic infections among HIV-seropositive patients from Eastern India
[J].J Infect Dis,2008,61(1):49-53.

[15] Vazquez JA.Therapeutic options for the management of oropharyngeal and esophageal candidiasis in HIV /AIDS patients
[J].HIV Clin Trials,2000,1(1):47-59.

[16] Junqueira JC,Vilela SF,Rossoni RD,et al.Oral colonization by yeasts in HIV-positive patients in Brazil
[J].Rev Inst Med Trop Sao Paulo,2012,54(1):17-24.

[17] Dalazen D,Zanrosso D,Wanderley L,et al.Comparação do perfil de suscetibilidade entre isolados clínicos de Candida spp.orais e vulvovaginais no Sul do Brasil
[J].J Bras Patol Med Lab,2011,47(1):33-38.