The resistance to fluconazole in patients with esophageal candidiasis

CONTEXT: Esophageal candidiasis is often observed in patients with risk factors for its development and fluconazole is the therapeutic choice for the treatment of this disease. OBJECTIVES: To determine its frequency, by performing upper digestive endoscopy; to determine Candida species involved in its pathogenesis and verify their distribution according with the predisposing factors and to determine susceptibility to fluconazole in the samples. METHODS: From March 2006 to April 2007, all patients submitted to esophagogastroduodenoscopy at the Digestive Endoscopy Unit in the Oswaldo Cruz University Hospital, Recife, PE, Brazil, were eligible for the study. Samples were collected from patients who presented lesions consistent with esophageal candidiasis in order to identify Candida species and verify their susceptibility to fluconazole. The predisposing factors for the occurrence of esophageal candidiasis were described. RESULTS: Of 2,672 patients referred to upper endoscopy at the Digestive Endoscopy Unit, 40 (1.5%) had endoscopic findings compatible with esophageal candidiasis. The average age was 49.1 years. Twenty one patients (52.5%) were less than 50 years old, of which 82.6% were infected with HIV. Most of them (52.5%) were males and 65.0% were inpatients. Diseases were identified in 90% of the patients and 21 (52.5%) were HIV positive. Concerning endoscopic findings, severe forms of esophagitis were found in 50% of the patients with CD4 count <200. Non-albicans Candida species were isolated in 22.7% of HIV positive and in 45% HIV negative patients. A total of 6 (14.28%) samples were resistant to fluconazole, while 2 (4.76%) samples had dose depending susceptibility to this drug. CONCLUSIONS: Esophageal candidiasis prevalence was low, although within the results described by other authors. Male and inpatients were the most affected. The species isolated varied according to the characteristics of each group studied. Both, resistance and dose-depending susceptibility to fluconazole were considered high.

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Antimalarial drug resistance markers in human immunodeficiency virus (HIV)-positive and HIV-negative adults with asymptomatic malaria infections in Port Harcourt, Nigeria

Transactions of the Royal Society of Tropical Medicine and Hygiene ◽

10.1093/trstmh/trab061 ◽

2021 ◽

Author(s):

Ifeyinwa Chijioke-Nwauche ◽

Mary C Oguike ◽

Chijioke A Nwauche ◽

Khalid B Beshir ◽

Colin J Sutherland

Keyword(s):

Human Immunodeficiency Virus ◽

Drug Resistance ◽

Drug Susceptibility ◽

Blood Film ◽

University Hospital ◽

Hiv Positive ◽

Asymptomatic Malaria ◽

Immunodeficiency Virus ◽

Before And After ◽

Hiv Negative

Abstract Background In Nigeria, indiscriminate use of antimalarial drugs may contribute to the threat of drug resistance, but this has not been evaluated among people living with human immunodeficiency virus (HIV). Methods HIV-positive adults attending a university hospital HIV clinic and HIV-negative adult volunteers from the university hospital community with a positive blood film were treated with artemether–lumefantrine. Parasite DNA from before and after treatment was polymerase chain reaction amplified to identify molecular markers of drug susceptibility. Results The pfcrt76T genotype was prevalent among both HIV-positive and HIV-negative participants (78.6% and 68.2%, respectively). Three new mutations in the pfmdr1 gene—F73S, S97L and G165R—and the uncommon pfdhps S436F variant were detected, whereas pfdhps K540E and pfdhfr I164L were absent. The A437G allele of pfdhps predominated (62/66 [94%]). The I431 V mutation was found in 19 of 66 pretreatment pfdhps sequences (28.8%). The pfmdr1 86N allele was significantly more common at day 3 post-treatment than at baseline (odds ratio 8.77 [95% confidence interval 1.21 to 380]). Conclusions We found evidence of continued chloroquine use among HIV-positive individuals. Selection for the pfmdr1 86N after artemether–lumefantrine treatment was observed, indicating a possible threat to antimalarial efficacy in the study area. The complexity of pfdhps haplotypes emphasises the need for careful monitoring of anti-folate susceptibility in Nigeria.

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UPPER GI ENDOSCOPY

The Professional Medical Journal ◽

10.29309/tpmj/2014.21.03.2148 ◽

2014 ◽

Vol 21 (03) ◽

pp. 460-464

Author(s):

Muhammad Zakria ◽

Awais Shuja

Keyword(s):

Epigastric Pain ◽

University Hospital ◽

Persistent Vomiting ◽

Gi Endoscopy ◽

Endoscopic Findings ◽

Upper Gi ◽

Endoscopy Unit ◽

Unit Design ◽

Upper Gi Endoscopy ◽

Independent University

Objective: To document various endoscopic findings in patients undergoingupper GI endoscopy in our endoscopy unit. Design: Observational. Patients and methods: Thedata of 100 patients who underwent upper GI endoscopy in Endoscopy Unit of IndependentMedical College/ Independent University Hospital from April 2010 to December 2012 wasanalyzed. Demographic features, reasons for referral and endoscopic diagnoses were noted.Results: Among 100 patients, 35% were referred due to persistent vomiting, 28% due toepigastric pain / discomfort, 18 % due to dyspepsia and 7% due to retrosternal burning and uppergastrointestinal bleeding. Common endoscopic diagnoses were gastritis (28%), duodenitis(14%), gastroesophageal reflux disease / esophagitis (6%), esophageal varices (5%) andesophageal growth (4%). Conclusions: The most common presenting complaint was persistentvomiting followed by epigastric pain / discomfort and the most common endoscopic finding wasgastritis.

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Epidemiology and Hospital Course of Patients With Acute Salpingitis and Coincident HIV

Infectious Diseases in Obstetrics and Gynecology ◽

10.1155/s1064744993000213 ◽

1993 ◽

Vol 1 (2) ◽

pp. 91-93

Author(s):

Iris Ayala-Rodriguez ◽

Joseph Apuzzio

Keyword(s):

Hospitalized Patients ◽

University Hospital ◽

Hiv Positive ◽

Negative Group ◽

Positive Group ◽

Immunodeficiency Virus ◽

The Mean ◽

Wbc Count ◽

Hiv Seropositive ◽

Hiv Negative

Objective: To compare the epidemiology and hospital course of patients with acute salpingitis with and without coincident human immunodeficiency virus (HIV) seropositivity.Methods: Patients admitted to the UMDNJ-University Hospital in Newark, New Jersey from January 1, 1991, to December 31, 1991, with acute salpingitis were studied.Results: Eight percent of all hospitalized patients with acute salpingitis were HIV-positive. The mean age of the HIV-negative group was 25.4 compared with 29.6 years in the HIV-positive group. Gonorrhea and chlamydia were present in 49% and 22%, respectively, in HIV-negatives and in 40% and 20% of HIV-positives. Two of 5 (40%) HIV-positive patients had tuboovarian abscesses compared with 12 of 59 (20%) HIV-negative patients. Three of 5 (60%) HIV-positive patients had admission WBC counts fewer than 10,000/mm3 compared to 6 of 59 (12%) of HIV-negatives (P = 0.024). The hospital stay was 5.4 days for HIV-positives and 5.8 days for HIV-negatives.Conclusions: Eight percent of hospitalized patients with acute salpingitis were HIV-seropositive. Neisseria gonorrhoeae and chlamydia were commonly found organisms in both groups. The initial WBC count was lower for HIV-positive patients. The hospital course of both groups was similar.

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Evaluation of upper gastro intestinal endoscopy among HIV positive and negative patients at a tertiary care hospital: a comparative study

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20183896 ◽

2018 ◽

Vol 5 (5) ◽

pp. 1213

Author(s):

Ramapriya Rengaswamy ◽

Thayumanavan L.

Keyword(s):

Helicobacter Pylori ◽

Comparative Study ◽

Tertiary Care ◽

General Medicine ◽

Hiv Positive ◽

Control Group ◽

Case Group ◽

Care Hospital ◽

Endoscopic Findings ◽

Hiv Negative

Background: Endoscopy is the diagnostic test of choice for most HIV-associated GI diseases, as endoscopic and histopathologic evaluation can render diagnoses in patients with non-specific symptoms. The objective of the present research was to study the gastrointestinal endoscopic findings among HIV positive patients and compare them with HIV negative patients.Methods: A comparative study was carried out in the department of General Medicine to study the gastrointestinal endoscopic findings among HIV positive patients and compare them with HIV negative patients for a period of two years. 101 cases who were HIV positive were compared with equal number of HIV negative subjects. The subjects in the case group as well as control group were chosen randomly.Results: There was a significant lower incidence of Helicobacter pylori positivity (38.6%) among HIV positive patients when compared to controls (73.6%). There were overall 63 patients with abnormal biopsy findings in HIV group and 75 patients with abnormal biopsy findings in the control group. Among HIV positive patients who were also RUT positive approximately 80% had abnormal histopathological findings. Similarly, among the RUT positive control 81% of the patients had abnormal biopsy findings. Incidence of normal biopsy findings was more in the control group (57.1%) compared to the study group (48.4%). But this difference was not found to be statistically significant.Conclusions: The histology of gastric mucosa was no different in Helicobacter pylori positive or negative subjects with HIV. But Helicobacter pylori incidence was significantly less in HIV positive persons compared to HIV negative.

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Should syphilis be treated differently in HIV-positive and HIV-negative individuals? Treatment outcomes at a university hospital, Brighton, UK

International Journal of STD & AIDS ◽

10.1258/ijsa.2008.008173 ◽

2009 ◽

Vol 20 (4) ◽

pp. 229-230 ◽

Cited By ~ 14

Author(s):

Z Warwick ◽

G Dean ◽

M Fisher

Keyword(s):

Treatment Outcomes ◽

University Hospital ◽

Hiv Positive ◽

Hiv Negative

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Incidence of Cytological Abnormalities in Pap's Smear in HIV Positive Women

Journal of Medical Research and Innovation ◽

10.15419/jmri.136 ◽

2018 ◽

Vol 2 (S1) ◽

pp. e000136

Author(s):

Suhana Jotva ◽

Hemani Desai ◽

Hansa Goswami

Keyword(s):

Trichomonas Vaginalis ◽

Clinical History ◽

Hiv Positive ◽

Squamous Intraepithelial Lesions ◽

Squamous Cells ◽

Medical College ◽

Hiv Positive Women ◽

Cytological Abnormalities ◽

Intraepithelial Lesions ◽

Hiv Negative

Aims and Objectives: The aim of present study is to estimate the frequency of abnormal PAP’s smears and mainly to detect precancerous and cancerous lesions as well as inflammatory lesions in HIV infected women. Methodology: Our study was a retrospective study of total 130 cases and PAP’s smears were examined in cytology section in Department of Pathology, BJ Medical College, Ahmedabad from 1st March 2017 to 31st August 2017. Both HIV positive and HIV negative patients were included in the study. 80 patients were HIV negative and 50 patients were HIV positive. The clinical history and relevant parameters were noted. All the smears were processed by a conventional method using Papanicolaou stain. Results: Out of 130 cases, 118 cases were reported negative for intraepithelial lesions or malignancy (NILM). Five cases were positive for squamous intraepithelial lesions (SIL) out of which four were HIV positive. Seven cases were of atypical squamous cells of undetermined significance (ASCUS) out of which 5 were HIV positive. Three cases were showing bacterial vaginosis. 1 case was showing Trichomonas Vaginalis. 19 cases were showing changes of non-specific inflammation. 6 cases were showing atrophic changes. Conclusion: HIV infected women are at more risk to develop cervical cytological abnormalities. The study revealed a maximum number of non-specific inflammatory smears followed by smears showing atrophic changes. Smears suspicious for malignancy (ASCUS) and smears showing squamous intraepithelial lesions (SIL) were more common in HIV positive patients. Thus regular PAP’s smears screening as recommended by National AIDS Control Organization (NACO) will help in early detection of cervical abnormalities in HIV positive women.

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