Genotyping and Antifungal Susceptibility Profile of Sequential Candida albicans Isolated from the Oral Cavity of HIV-Infected Individuals

Objective: The study aimed to evaluate the genotypic profiles of C. albicans (Candida albicans) sequentially isolated throughout the course of HIV infections, and to determine its MIC (minimal inhibitory concentrations) to AMB (amphotericin B), FLC (fluconazole), KTC (ketoconazole), and ITC (itraconazole). Design: samples were collected from the oral cavity of HIV-positive individuals during 4 years, with a sterilized swab. MIC was performed by using the microdilution method AFST/EUCAST. The genetic similarities within and between sequential clones of C. albicans were assessed by DNA fingerprinting using the random amplification of polymorphic DNA technique. Results: A total of 142 oral samples were isolated from 59 HIV-infected individuals who attempted up to five visits each, with or without symptoms of oropharyngeal candidiasis. Profile analysis revealed that yeasts isolated over sequential visits from symptomatic or asymptomatic individuals showed 78% or 87% relatedness, respectively. The degree of similarity among C. albicans was higher for isolates from colonization than for those from infection. Genetically identical C. albicans samples also formed connected subclusters in sequential visits. In regard to susceptibility profile, all isolates were susceptible to AMB, FLC, KTC, and ITC and maintained this pattern all along, no differences in MICs of any given antifungal compound were observed for sequential C. albicans isolates. Conclusions: These data suggest that genotype and susceptibility to antifungal drugs were maintained over time in sequentially isolates of C. albicans colonization and a diverse evolutionary genetic trend in C. albicans sequentially isolated from the oral candidiasis of HIV infected individuals.