Thesis (MSc)--Stellenbosch University, 2002. / ENGLISH ABSTRACT: The aim of this study at the Brooklyn Chest Hospital (BCH) was to assess the
change in the oral carriage of Candida species in twenty-nine patients co-infected
with the Human Immunodeficiency Virus (HIV) and Tuberculosis (TB), before and
after anti-fungal treatment.
Each patient accepted onto the study underwent a comprehensive oral and peri-oral
examination where the presence, site and clinical features of all oral and peri-oral
lesions were recorded. The purpose of the examination was to provide a clinical
diagnosis of oral candidasis.
Each patient was also asked to provide a sample of oral fluid for laboratory analysis.
This was collected using an oral rinse. The results of a variety of laboratory
investigations were used to identify the species of Candida obtained from the oral
rinse. Both the oral and peri-oral examination and the oral rinse procedure were
repeated after one month and at three months.
A sample from each oral rinse was inoculated on CHROMagar Candida chromogenic
medium (CHROMagar Candida, France, Paris).
CHROMagar is used for the isolation and presumptive identification of Candida sp.
from other yeasts on the basis of strongly contrasted colony colours, which are
produced by the reactions of species-specific enzymes with a proprietary
chromogenic substrate.
After forty-eight hours the CHROMagar plate was examined for growth, when a
record of colony morphology and colour was made. A single sample from each
different colour-coded colony was taken and streaked onto a Sabouraud plate
(Oxoid, Basingstake, England) and then incubated for forty eight hours at thirty-seven
degrees centigrade.
A variety of laboratory investigations were subsequently carried out on a single
colony taken from the Sabouraud agar plate (Oxoid). The results of these tests were
used to identify the individual species of Candida isolated from each oral rinse.
Oral candidasis was the most prevalent oral lesion observed on admission and at
three months.
Six different species of Candida were identified during this study, namely Candida
albicans, Candida dubliniensis, Candida krusei, Candida glabrata, Candida
parapsilosis, and Candida tropicalis. C.albicans was the most commonly identified
species in study population. Candida dubliniensis was isolated and identified for the
first time in a South African HIV population.
Each specimen of Candida sp. identified by laboratory analysis was tested for
sensitivity to Nystatin, Amphotericin B and Fluconazole anti-fungal agents. An
additional sensitivity test was performed using Ajoene and Allicin (extracts of garlic)
to assess the comparative antifungal properties of these compounds. / AFRIKAANSE OPSOMMING: Die doelwit van hierdie studie by die Brooklyn Borshospitaal (BCH) was om die
verandering in orale draerstatus van die Kandida spesies in nege-en-twintig HIVfTB
koïnfekteerde pasiënte vas te stel, voor- en na antifungale behandeling.
Elke pasiënt in die studie het 'n volledige intra- en ekstra-orale ondersoek
ondergaan. Die teenwoordigheid, area en kliniese voorkoms van alle letsels is
noteer.
Die doel van die ondersoek was om 'n kliniese diagnose van orale kandidiase te
verkry.
'n Monster orale vloeistof is geneem van elke pasiënt vir laboratorium analise. Die
monster is in die vorm van 'n mondspoel geneem. Verskeie toetse is gedoen om die
verskillende Kandida spesies in elke monster te identifiseer.
Die orale- en ekstra-orale ondersoek sowel as die mondspoelmonster is na 1 en 3
maande herhaal. Elke mondspoelmonster is op CHROMagar Kandida chromogene
medium (CHROMagar Candida, France) inokuleer.
CHROMagar word gebruik vir die vermoedelike identifikasie en isolasie van Kandida
spesies teenoor ander swamme. Dit word gedoen op die basis van kontrasterende
koloniekleure, wat teweeggebring word deur spesie-spesifieke ensiemreaksies op 'n
chromogene substraat.
Die CHROMagar plate is na 48 uur ondersoek vir groei en die kolonie-morfologie en -
kleur is noteer.
'n Enkel monster. is geneem van elke verskillende kolonie (geskei op kleur) en is
uitgestreep op 'n Saboraud plaat (Oxoid, Basingstoke, England). Dit is dan vir 48 uur
inkubeer teen 37°C.
Verskeie laboratorium ondersoeke is daarna uitgevoer op 'n enkel kolonie geneem
vanaf die Saboraud agar plaat (oxoid). Die resultate van die ondersoeke is gebruik
om individuele spesies van Kandida te identifiseer.
Orale Kandidiase was die mees algemene orale letsel geïdentifiseer by toelating en 3
maande ondersoeke. Ses verskillende spesies Kandida is identifiseer tydens die
studie, naamlik: Kandida albicans, K.dubliniensis, K.Krusei, K.glabrata,
K.parapsilosis en K.tropicalis. K.albicans was die mees algemeen identifiseerde
spesie in die studiepopulasie.
K.dubliniensis is vir die eerste keer in Suid-Afrika in 'n HIV<+lpopulasie isoleer en
geïdentifiseer. Elke monster van identifiseerde Kandida spesies is getoets vir
sensitiwiteit teenoor Nistatien, Amfotensien B en Flukonasool. Addisioneel is ook
getoets vir sensitiwiteit teenoor Ajoene en Allicin (knoffelekstrakte).
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:sun/oai:scholar.sun.ac.za:10019.1/52706 |
| Date | 03 1900 |
| Creators | Fisher, Julian Marcus |
| Contributors | Basson, N. J., Van Zyl, A. W., Stellenbosch University. Faculty of Medicine & Health Sciences. Dept. of Dentistry. |
| Publisher | Stellenbosch : Stellenbosch University |
| Source Sets | South African National ETD Portal |
| Language | en_ZA |
| Detected Language | English |
| Type | Thesis |
| Format | 106 p. : ill. |
| Rights | Stellenbosch University |
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