HIV感染者口腔念珠菌负荷及生物型研究

目的调查人类免疫缺陷病毒（human immunodeficiency virus，HIV）感染者口腔中念珠菌负荷状况、生物分型及与口腔念珠菌病临床表现的关系。方法采取漱口法对64例HIV感染者和42名健康对照者进行口腔念珠菌的定量分离培养，并综合利用革兰染色、厚壁孢子生成实验、CHROMagar显色培养和API 20C AUX酵母菌鉴定系统对分离株进行生物型鉴定。结果64例HIV感染者中，52例中可分离出念珠菌74株，阳性分离率为81．3％，而42名健康对照者口腔念珠菌阳性分离率仅为16．7％（P〈0．001）。通过对74株念珠菌的生物型进行鉴定，发现有39株白色念珠菌，15株热带念珠菌及其他6个生物型20株。健康对照组中，分离出5株白色念珠菌和其他裂2株。结论HIV感染者口腔念珠菌感染率明显增加，其口腔念珠菌的检出率和负荷量亦明显增加，白色念珠菌和热带念珠菌为其主要分离菌；与健康对照组相比，HIV感染者的口腔念珠菌分离株生物类型旱现多样化。

Oral candidal carriage and biotyping of Candida species in HIV positive patients

OBJECTIVE: To investigate the candidal carriage and the Candida species in HIV positive patients and to explore the relationship between oral candidal carriage and oral candidiasis. METHODS: Sixty-four HIV positive patients and 42 healthy controls were included in this study. Oral rinse technique was used to detect the candidal carriage. The isolates were identified using multiple measures, including Gram staining reaction, chlamydospore, pseudohyphal and hyphal production test, CHROMagar Candida test and API 20 C AUX yeast identification system. RESULTS: Thirty-nine of 64 HIV positive cases were diagnosed as oral candidiasis. Seventy-four Candida strains were isolated from 52 of 64 HIV positive cases, only 7 strains were isolated from 42 healthy controls (P < 0.001). Of the 74 Candida strains isolated from HIV positive cases, 39 were Candida albicans, 15 Candida tropicalis, and 20 other 6 species. CONCLUSIONS: A high prevalence of oral candidiosis and high candidal carriage were found in HIV positive patients compared with those in controls. Candida albicans and Candida tropicalis were the major species. The biotyping of the species isolated from HIV positive patients showed more diversified compared to healthy people, which may suggest the decreased immune ability of the HIV positive patients.