In Vitro Antifungal Susceptibility of Candida Albicans Isolated from Yemeni Patients with Denture Stomatitis

Abstract

Background and aims: Candida-associated denture stomatitis (CADS) is a common fungal infection in people who wear dentures. The main objectives of this study were to identify the causative agents of CADS and in vitro antifungal susceptibility testing (AFST) for Candida albicans in Yemeni patients with denture stomatitis. Methods: A total of 88 Candida spp. obtained from patients with denture stomatitis. Candida spp were identified using standard microbiological methods. The in-vitro antifungal susceptibility of Candida albicans. to fluconazole (FCZ), itraconazole (ICZ), voriconazole (VCZ), and amphotericin B (AMB) was evaluated using the E test strips. Interpretive sensitivity criteria for antifungal breakpoints were adapted from the Clinical and Laboratory Standards Institute (CLSI). Results: Overall, C. albicans was the most commonly isolated species (𝑛 = 60; 68.2%), followed by C. glabrata (𝑛 = 9; 10.2%), C. tropicalis (𝑛 = 7; 8%), and C. parapsilosis (𝑛 = 3; 3.4%). Voriconazole had the lowest geometric mean minimum inhibitory concentration which was 0.0418 𝜇g/ml for MIC50, and 0.957 𝜇g/ml for MIC90; followed by amphotericin B (AMB) in which MIC50 was 0.518 𝜇g/ml and for MIC90 was 1.06 𝜇g/ml. Conclusion: Our study showed that Candida albicans was the most prevalent Candida species in Yemeni patients with CADS and was susceptible to both azoles and amphotericin B. In addition, voriconazole could be a suitable alternative to antifungal agents currently used in the treatment of CADS, as well as in the treatment of recurrent Candidasis.