Antifungal Effects of Common Mouthwashes on Candida Strains Colonized in the Oral Cavities of Liver Transplant Recipients in South Iran in 2014

Abstract

Background:Among the opportunistic microorganisms, fungi, particularly Candida, play an important role in the mortality of transplant recipients. Thus, controlling and preventing fungal colonizations in various parts of the body, including the oral cavity, can reduce the possibility of post-transplant invasive fungal infections. This can be done simply by using mouthwashes.Objectives:The current study aimed to determine the prevalence of fungal species of Candida within the oral cavities of liver transplant recipients, and to evaluate the effects on Candida colonization of different exposure times to common mouthwashes.Patients and Methods:Specimens were taken from the oral cavities of 101 liver transplant recipients who were referred to our clinic for their first monthly examination. After cultivation and DNA extraction, yeast strains were identified with the RFLP technique. Each strain’s susceptibility to 0.2% chlorhexidine, Vi-One, Oral-B, Nanosil D1, and Nystatin mouthwashes was determined based on the CLSI M27-A2 standard method.Results:The obtained data were analyzed using SPSS. Out of 101 samples from liver transplant recipients, 68 cases showed fungi growing within the culture media (67.4%). C. albicans and C. glabrata, respectively, were the first and second most frequent types. Mouthwash susceptibility tests revealed that their antifungal effects over 60 seconds were significantly higher than with an exposure time of 30 seconds. At both 30 and 60 seconds, chlorhexidine was significantly the most efficient.Conclusions:Chlorhexidine mouthwash with an exposure time of 60 seconds or more is suggested as an effective antifungal agent to be included in the medication regimen of liver transplant patients pre- and postoperatively, in order to prevent fungal colonization and subsequent systemic infections.

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“…10 Using fluconazole as prophylaxis in all patients may have led to selection pressure and an increased rate of isolation of nonCandida albicans species, which can be fluconazole resistant. 12 In contrast to most studies, Hjortrup and associates reported gram-positive bacteria as the predominant causative agents (67%) in post-LT infection. 13 In our study, the most common grampositive bacteria were Enterococcus species, of which vancomycin-resistant enterococci were the majority (74%), consistent with other reports from Iran.…”

Influence of Eugenia uniflora Extract on Adhesion to Human Buccal Epithelial Cells, Biofilm Formation, and Cell Surface Hydrophobicity of Candida spp. from the Oral Cavity of Kidney Transplant Recipients

“…Nevertheless, a limitation in our study is the number of representative strains of each species. We have used strains obtained from a kidney transplant recipients cohort previous investigation from our group and the prevalence of C. albicans was higher than the other species, as described everywhere [ 37 , 38 ]. Therefore, for this reason, the number of NCAC strains is lower and definitely may have influenced our results.…”

Comparative Evaluation of Conventional and Nanosilver-Containing Leucocyte and Platelet-Rich Fibrin/Biomaterial in the Anti-Biofilm Formation of Standard Species of Candida and Streptococcus

“…Oral candidiasis was diagnosed in 8% of the pediatric patients, and 46.8% of the patients with hematologic disorders were colonized with Candida species (23,24). Candida albicans is the most commonly implicated organism recovered from 60% of dentate patient's mouth over the age of 60 and 50.5% of Candida species isolated from the oral cavity of liver transplant recipients (25)(26)(27). However, other Candida species like C. parapsilosis and C. glabrata may be identified as the cause of infection (28).…”