ANTIFUNGAL SUSCEPTIBILITY OF BIOFILM PRODUCING Candida albicans ISOLATED FROM ORAL CAVITY OF DIABETIC AND NON-DIABETIC POPULATION OF DHARAN, NEPAL

Abstract

Background: Candida are almost universal on normal adult skin and C. albicans is part of the normal flora of the mucous membranes of the respiratory, gastrointestinal, and female genital tracts. It is acknowledged that diabetic patients are more susceptible to infections caused by Candida albicans due to increased blood glucose and inability of immune system in eradicating the fungus. Studies suggest that Gutkha consumers are also at high risk of oral Candida carriage . Materials and methodology The participants were provided 10 ml of Normal saline and were asked to oral rinse for 1 minute. Oral rinse was collected in a sterile screw capped container and was transported in cold chain to microbiology laboratory. The oral rinse sample was inoculated onto the Sabouraud dextrose agar with Chloramphenicol and was incubated at 37°C for 3-4 days. The Colony forming Unit of candida was compared among diabetic and healthy controls. The candida albicans were identified by Germ tube formation. The Candida albicans isolates were subjected to Biofilm assay, Antifungal susceptibility Test, Haemolysin assay, Haemolysis degree and phospholipase assay. Result: This study reported 31.5% prevalence of oral Candida.The Candida carriage in CFU of diabetic population was statistically significant (p<0.05). The maximum isolates were found to be Biofilm producers. There was significant association between Gutkha consumers with oral Candida carriage. The study suggests that there is higher colonization of Candida in diabetic populations than in healthy population. The result also concludes that frequency of Candida in Oral cavity of Gutkha consumers was also higher (p<0.05). All isolated strains of Candida albicans were tested for antifungal susceptibility testing and 76.19% were found to be Resistant to Fluconazole and 50% were found to be resistant to Amphotericin B. There was statistical significance in Biofilm formation and fluconazole Drug resistance. Conclusion The findings indicated highest colonization of oral Candida in diabetic population and in Gutkha consumers. The greatest numbers of isolated Candida albicans were biofilm producer which showed greater frequency of Fluconazole drug resistance.

Oral Mucosal Complications and Oral Hygiene Practice Among Diabetic and Non-Diabetic Patients

“…The link between diabetes and dry mouth has also been stated in additional studies. In one study of patients with diabetes, the outcomes contradict with our study, in which 5.4% of subjects testified dry mouth [15][16] . BMS is a chronic pain syndrome that has been testified with systemic ailments like diabetes and postmenopausal females 17 .…”

“…Statistics from the diabetics and nondiabetic group exhibited that both groups had insufficient information of overall oral well-being [12][13] . Research on the awareness and knowledge of oral hygiene in patients with diabetes mellitus has shown that diabetic patients have deficiencies in this area.…”

“…Dental hospitals are friendly places for screening tests for diabetes, where people may come for regular treatment and dental follow-ups 12 . There is a lack of information on the consequences of diabetes and complications in the oral cavity among diabetic patients 13 . The research will help healthcare providers to intervene, improve and provide oral health education for diabetic and nondiabetic patients, thereby treating diabetes and eventually enhancing life quality.…”