Identification of Candida dubliniensis in a HIV-positive South African population

Candida dubliniensis was identified as a distinctly separate species of the genus Candida in 1995. Since then the yeast has attracted considerable interest due to its prevalence in HIV/AIDS patients and its ability to develop fluconazole resistance in HIV-seropositive individuals. Although C. dubliniensis has been identified in many centres around the world it has not yet been isolated in Africa. The purpose of this study was to identify C. dubliniensis in an HIV-positive population in the Western Cape, South Africa. A cohort of 50 tuberculosis patients co-infected with HIV was selected on admission to the Brooklyn Chest Hospital, Western Cape. The inclusion criteria for patients accepted for the study were: confirmed HIV seroconversion with a diagnosis of tuberculosis obtained from chest X-rays and sputum microscopy. C. dubliniensis was identified in 6 of the 50 patients accepted onto the study. The prevalence of C. dubliniensis in our study population was lower than that reported in similar North American and European studies. These results confirm the presence of C. dubliniensis in the South African HIV/AIDS population and indicate the urgent need for further investigations into the prevalence and pathogenesis of this clinically important species in both adult and paediatric HIV-positive patients.