Candidal colonization, strain diversity, and antifungal susceptibility among adult diabetic patients

Abstract

BACKGROUND AND OBJECTIVES:Candidal colonization in diabetics is a matter of debate. The aim of this study is to investigate oral candidal colonization, strain diversity, antifungal susceptibility, and the influence of local and systemic host factors on candidal colonization in adult diabetics.METHODS:We conducted a case-control study that compared 150 diabetics (49 type 1, 101 type 2) with 50 healthy controls. Two salivary samples were collected, using the oral rinse sampling method: one for salivary flow rate and pH determination, and the other for candidal colonization assessment. The candidal isolates were identified and tested in vitro for antifungal susceptibility using the commercial kit, Candifast. The relationship between specific host factors and candidal colonization was also investigated.RESULTS:Diabetics had a higher candidal carriage rate compared to controls, but not density. Candida albicans was the most frequently isolated species, but diabetics had a variety of other candidal species present. None of the control samples were resistant to any tested antifungal, while the diabetic samples had differing resistances to azole antifungals. Although there was a significant positive correlation between glycemic control and candidal colonization in type 2 diabetics, there was a negative correlation between salivary pH and candidal carriage in the controls versus density in type 2 diabetics.CONCLUSION:Diabetic patients not only had a higher candidal carriage rate, but also a variety of candidal species that were resistant to azole antifungals. Oral candidal colonization was significantly associated with glycemic control, type of diabetes, and salivary pH.

A comparative study of carrier state of Candida and its speciation in oral flora – Among healthy individuals, persons with DM and HIV sero positive individuals

“…Combination of Candida species in our study was 6% as in other studies [18][19][20]. Candida albicans was commonest in the present study (68%) like other studies [3][4][5][6][7][8][9][10][20][21][22][23]. Our results, in oral carriage rate of candida in healthy individuals were in agreement with other studies [3,[18][19][20][21][22][23].…”

“…Safia A. AL-Attas and Soliman O. Amro from Jeddah, Saudi Arabia observed 33.3% carriage rate in diabetics with Candida albicans in 68.9% and 14.3% in healthy individuals with Candida albicans in 40% [10]. Carriage rate in diabetics in our study (44%) was a little higher than in some studies [3][4][5][6][7][8][9][10][18][19][20][21][22][23]. Combination of Candida species in our study was 6% as in other studies [18][19][20].…”

“…The factors predispose people to candidiasis include AIDS, burns, pregnancy, high fruit diet, steroids, antibiotic treatment, immunosuppressants, cancer treatment, heart surgery, diabetes mellitus and use of catheter [2]. The frequent occurrence of candida infections in patients with DM has been recognized for many years and oral candidiasis in particular is thought to be more prevalent among these individuals [3][4][5][6][7][8][9][10][11]. With introduction of antifungal agents, the cause of candida infection shifted from Candida albicans to Candida glabrata and other non albicans species, as Candida glabrata and Candida krusei develop resistance to fluconazole [1,5].…”

Tip 2 diyabetli hastalarda mukokutanöz fungal infeksiyonlar için risk faktörleri

“…Al-Attas ve ark. 16 Tip 2 diyabet hastalarında glisemik kontrol bozukluğu ile oral kandida infeksiyonu arasında yakın ilişkili bulmuşlardır. Bu sonuçlar bizim sonuçlarımız ile benzerdir.…”

Порушення Функціонального Та Морфологічного Стану Слинних Залоз При Цукровому Діабеті Та Їх Роль В Ушкодженні Слизової Оболонки Ротової Порожнини

“…Остання, через підвищене злущення епіте-ліальних клітин, здатна спричинити низку змін у слизовій оболонці ротової порожнини: порушен-ня мови та погіршання смакового сприйняття [6,10]; високу схильність до поширення патогенних мікроорганізмів некандидозного характеру та ін-фекційні ускладнення [7,8,11]; розвиток орально-го кандидозу [11]; обкладений язик; неприємний запах із рота [12,13]; захворювання пародонта; демінералізацію зубів і появу білих плям [8,14]; карієс, уповільнене загоєння ран; тріщини язика [15]; розвиток червоного плоского лишаю; вираз-ки слизової оболонки [16,17]; слизові кисти, пе-техії, гіперкератоз і атрофію сосочків язика [6, 10]; кутовий хейліт, гіперплазію ясен [8]. Найчастіше, за даними літератури, у хворих на цукровий діа-бет спостерігається варикозне розширення вен язика і еритематозний кандидоз [11][12][13].…”