Jeahani Trisya Oktawati1, Irna Sufiawati2, Tina Rostinawati3, Anas Subarnas3 1Undergraduate Program, Faculty of Dentistry, Universitas Padjadjaran, Bandung, Indonesia
2Faculty of Dentistry, Universitas Padjadjaran, Bandung, Indonesia
3Faculty of Pharmacy, Universitas Padjadjaran, Bandung, Indonesia
Introduction: Oropharyngeal candidiasis (OPC) is the most common opportunistic infection found in HIV/AIDS patients and is caused by colonization of Candida albicans. The use of antifungals such as fluconazole as therapy and prophylaxis for OPC may lead to the emergence of antifungal resistance. Hence, the use of natural ingredients as an alternative is widely developed, one of which is Curcuma xanthorrhiza. This study aims to determine in vitro antifungal susceptibility of Curcuma xanthorrhiza extract against Candida albicans isolated from HIV-infected patients
Methods: Samples were obtained from the oral cavities of four HIV-positive patients with Oropharyngeal candidiasis and an HIV-negative patient as control subject at Dr. Hasan Sadikin General Hospital, West Java, Indonesia. Samples were then identified microscopically, culture in CHROMagarTM Candida, genomic isolation, and amplification- sequencing of the 18S rRNA gene. Antifungal susceptibility was determined by MIC and MFC of Curcuma xanthorrhiza extract and fluconazole as control through broth microdilution method according to EUCAST E.Def 7.3.1 and CLSI M27-A3 against four clinical isolates of Candida albicans and one isolate Candida albicans ATCC 10231 as a control strain.
Results: Species found were C. albicans (57.14%), Candida tropicalis (14,28%), [Candida] intermedia (14,28%), and Kodamaea ohmeri (14,28%). The MIC of Curcuma xanthorrhiza extract was visually detected by all C. albicans isolates with concentration range of HIV-positive 7.8125-15,625 µg/mL, HIV-negative 31.25-62.5 µg/mL, and ATCC 15,625-31.25 µg/mL, however the MIC90 and MFC98-99.9 only indicated by two out of three and one out of three of HIV-positive C. albicans isolates, respectively. Furthermore, all C. albicans isolates showed regrowth at a concentration of 2: 250 µg/mL. All C. albicans isolates were categorized as sensitive to fluconazole with a MIC90 range of 0.25-1 µg/mL, MFC98-99.9 0.5-2 µg/mL, MFC100 2-4 µg/mL.