Epidemiology and Infectious DiseasesEpidemiology and Infectious DiseasesЭпидемиология и инфекционные болезни3034-20073034-2015Eco-Vector4101510.18821/1560-9529-2018-23-3-114-118ArticlesСтатьиResearch ArticleRESEARCH ANTIFUNGAL THERAPY OF OROPHARYNGEAL CANDIDIASIS IN HIV-INFECTED PATIENTSАНТИМИКОТИЧЕСКАЯ ТЕРАПИЯ ОРОФАРИНГЕАЛЬНОГО КАНДИДОЗА У ВИЧ-ИНФИЦИРОВАННЫХ ПАЦИЕНТОВFilinaY. SФилинаЮ. С

doctor in Infectious Diseases hospital № 2, postgraduate student in I.M. Sechenov first Moscow State Medical University, Ministry of health of russia (Sechenov University)

соискатель каф. инфекционных болезней МПФ, ФГАОУ ВО Первый МГМУ им. И.М. Сеченова Минздрава России (Сеченовский Университет)

Julia.s.f@mail.ruVolchkovaElena V.ВолчковаЕ. В

MD, professor, head of Department of Infectious Diseases, Faculty of Preventive Medicine, I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)

NesvizhskiyYuri V.НесвижскийЮ. В

MD, Professor of the Microbiology, Virology and Immunology department, I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)

BelayaO. FБелаяО. Ф

MD, professor of Department of Infectious Diseases, Faculty of Preventive Medicine, I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)

State budgetary healthcare institution Infectious Clinical Hospital № 2Государственное бюджетное учреждение здравоохранения города Москвы «Инфекционная клиническая больница № 2 Департамента здравоохранения города Москвы»Federal State Autonomous Educational Institution for the Higher Education I.M. Sechenov First Moscow State Medical University Ministry of health of RussiaФГАОУ ВО «Первый Московский Государственный медицинский университет имени И.М. Сеченова» Минздрава России (Сеченовский Университет)15062018233VOL 23, NO3 (2018)ТОМ 23, №3 (2018)11411823072020Copyright ©; 2018, Eco-vectorCopyright ©; 2018, ООО "Эко-вектор"2018Eco-vectorООО "Эко-вектор"https://rjeid.com/1560-9529/article/view/41015

Modern medicine has made significant advances in the treatment of fungal infections. The problem of drug resistance of such a common conditional pathogen as Candida remains relevant for the last decade. The aims of the study were: 1) analysis of species and strain drift of Candida in patients with HIV/AIDS from oropharynx and intestine in two years; 2) the analysis of the dynamics of the sensitivity of Candida to standard antimycotic drugs. Treatment of candidiasis in HIV-infected patients leads to changes in the species and strain composition of Candida. After eradication of C. albicans which is sensitive to fluconazole, more resistant strains of other species (glabratae, krusei. tropicalis) takes its place in the biotope, which is one of the reasons for the low effectiveness of antimycotic therapy.

Представители рода Candida - это возбудители оппортунистической инфекции, многократно усиливающие свой патогенный потенциал в условиях нарушений в иммунной системе хозяина, вследствие чего может не только ухудшаться прогноз основного заболевания у ВИЧ-инфицированных пациентов, но может стать причиной летального исхода. Вместе с тем, нарастающая антимикотикорезистентность Candida spp. у ВИЧ-инфицированных пациентов, нередко получающих длительное время антифунгальные препараты, как с профилактической, так и с лечебной целью обуславливают необходимость разработки эффективных схем лечения на основе изучения устойчивости Candida spp. к противогрибковым препаратам на видовом и генетическом уровнях.

candidiasisHIVantimycotic resistanceCandidaкандидозрезистентностьантимикотическая терапияВИЧ-инфекцияHoog G.S. de, Guarro J., Gene J., Figueras M. J. Atlas of clinical fungi. Utrecht, Reus, 2011. [СD-ROM: electronic version 3.1.]Zverev V.V., Boychenko M.N. Fundamentals of microbiology and immunology: a textbook / Osnovy mikrobiologii i immunologii. Uchebnik. ed. V.V. Zvereva, M.N. Boychenko, Moscow; GEOTAR-Media, 2014.Colombo A.L., Guimarães T., CamargoL.F., Richtmann R., Queiroz-Telles Fd., Salles M.J., Cunha C.A., Yasuda M.A., Moretti M.L., Nucci M. Brazilian guidelines for the management of candidiasis - a joint meeting report of three medical societies: Sociedade Brasileira de Infectologia, Sociedade Paulista de Infectologia and Sociedade Brasileira de Medicina Tropical. Brazilian J Inf Dis. May-June 2013. 17(3): 283-312. http //: doi:10.1016/j.bjid.2013.02.001.Prilepskaya V.N. Vulvovaginal candidiasis. Clinic, diagnosis, principles of therapy / Vul’vovaginal’nyj kandidoz: klinika, diagnostika, principy terapii. Moscow: GEOTAR-Media, 2010.Stock I. Fungal diseases of vulva and vagina caused by Candida species. Med. Monatsschr. Pharm. 2010. 33(9): 324-33.Vazquez J.A., Patton L.L., Epstein J.B., Ramlachan P., Mitha I., Noveljic Z., Fourie J., Conway B. et al. SMiLES Study Group. Randomized, comparative, double-blind, double-dummy, multicenter trial of miconazole buccal tablet and clotrimazole troches for the treatment of oropharyngeal candidiasis: study of miconazole Lauriad(R) efficacy and safety (SMiLES). HIV Clin Trials. Jul-Aug 2010; 11(4): 186-96. http//: doi: 10.1310/hct1104-186.Viljoen J., Azie N., Schmitt-Hoffmann A.H., Ghannoum M. A phase 2, randomized, double-blind, multicenter trial to evaluate the safety and efficacy of three dosing regimens of isavuconazole compared with fluconazole in patients with uncomplicated esophageal candidiasis. Antimicrob Agents Chemother. Mar 2015; 59(3): 1671-9. http//: doi:10.1128/aac.04586-14.Reinhardt S.W., Spec A., Meléndez J. AIDS-Defining Illnesses at Initial Diagnosis of HIV in a Large Guatemalan Cohort. Open Forum Infect Dis. 2017 Fall; 4(4): ofx249. http//: doi:10.1093/ofid/ofx249.Alczuk Sde S., Bonfim-Mendonça Pde S., Rocha-Brischiliari S.C., Shinobu-Mesquita C.S., Martins H.P., Gimenes F. et al. Antiretroviral therapy on vaginal candida spp. isolation in HIV-infected compared to HIV-uninfected women. Rev Inst Med Trop Sao Paulo. 2015 Mar-Apr; 57(2): 169-174. http//: doi:10.1590/s0036-46652015000200012.Mazus A.I., Kaminskij G.D., Zimina V.N. Nacional’nye klinicheskie rekomendacii po diagnostike i lecheniyu VICH-infekcii u vzroslyh, 2014: 33-6.Enoch D., Yang H., Aliyu S.H., Micallef C.The Changing Epidemiology of Invasive Fungal Infections. Methods Mol Biol. 2017; 1508:17-65. http//: doi:10.1007/978-1-4939-6515-1_2.Patel P.K., Erlandsen J.E., Kirkpatrick W.R., Berg D.K., Westbrook S.D., Louden C., Cornell J.E., Thompson G.R., Vallor A.C., Wickes B.L., Wiederhold N.P., Redding S.W., Patterson T.F. The Changing Epidemiology of Oropharyngeal Candidiasis in Patients with HIV/AIDS in the Era of Antiretroviral Therapy. AIDS Res Treat. 2012; 2012:262471. http//: doi:10.1155/2012/262471.Thanyasrisung P., Kesakomol P., Pipattanagovit P., Youngnak-Piboonratanakit P., Pitiphat W., Matangkasombut O. Oral Candida carriage and immune status in Thai human immunodeficiency virus-infected individuals. J Med Microbiol. May 2014; 63(5): 753-9. http//: doi:10.1099/jmm.0.069773-0.Mushi M.F., Mtemisika C.I., Bade rO., Bii C., Mirambo M.M., Groß U., Mshana S.E. High Oral Carriage of Non-albicans Candida spp. among HIV-infected individuals. Int J Infect Dis. Aug 2016; 49: 185-8. http//: doi:10.1016/j.ijid.2016.07.001Clark-Ordonez I., Callejas-Negrete O.A., Arechiga-Carvajal E.T., Mourino-Perez R.R. Candida species diversity and antifungal susceptibility patterns in oral samples of HIV/AIDS patients in Baja California, Mexico. Med Mycol. Sep 14 2016. http//: doi:10.1093/mmy/myw069Beloborodova N.V., Vostrikova T.U. Monitoring gribkovyh infekcij v ORIT. Klinicheskaya mikrobiologiya, antimikrobnaya khimioterapiya. 2009. 1(11): 22-30.