Abstract
Oral candidiasis, in the form of Candida-associated denture stomatitis, represents a common disease in a large percentage of denture wearers, and Candida albicans remains the most commonly isolated species. In this study, we aimed to evaluate biofilm production, coagulase and hemolytic activity of Candida species isolated from denture stomatitis patients. This study included 70 patients (31 female, 39 male). Forty-eight of the patients were found to have a positive culture. A total of 48 Candida isolates representing five species, C. albicans (n=17), C. glabrata (n=10), C. krusei (n=9), C. kefyr (n=7) and C. parapsilosis (n=5), were tested. Their coagulase activities were evaluated by a classical tube coagulase test with rabbit plasma. A blood plate assay on 3% enriched sheep blood Sabouraud-dextrose agar (SDA) was used to determine their in vitro hemolytic activities. Biofilm production was determined by a visual tube method. Twenty-one Candida isolates exhibited coagulase activity, and the coagulase activities of the C. albicans (64.7%) isolates were higher than other species. C. albicans, C. glabrata, C. kefyr and C. krusei species demonstrated beta hemolysis. C. parapsilosis strains failed to demonstrate any hemolytic activities. Fifteen (88.0%) of the C. albicans strains were biofilm positive. Six (35.2%) of these strains were strongly positive, 8 (47.0%) C. albicans strains were moderately positive and 1 (5.8%) C. albicans strain was weakly positive. Sixteen (51.6%) of the non-albicans Candida strains were biofilm positive while 15 (48.3%) did not produce biofilms. The results of this present study indicate coagulase, hemolytic activity and biofilm production by Candida spp. isolated from patients with denture stomatitis. Investigations of these virulence factors might be helpful in gaining information about the possible virulence of oral Candida species related to denture stomatitis.
Highlights
Candida is a commensal fungus that harmlessly inhabits various niches of the human body, including the oral cavity, gastrointestinal tract, vagina and skin of healthy individuals [1]
Twenty-one Candida isolates exhibited coagulase activity, and the coagulase activities of the C. albicans (64.7%) isolates were higher than other species
Sixteen (51.6%) of the non-albicans Candida strains were biofilm positive while 15 (48.3%) did not produce biofilms. The results of this present study indicate coagulase, hemolytic activity and biofilm production by Candida spp. isolated from patients with denture stomatitis. Investigations of these virulence factors might be helpful in gaining information about the possible virulence of oral Candida species related to denture stomatitis
Summary
Candida is a commensal fungus that harmlessly inhabits various niches of the human body, including the oral cavity, gastrointestinal tract, vagina and skin of healthy individuals [1]. The fungus is frequently isolated from various oral sites, including the tongue, cheek, palatal mucosa, dentures, dental plaque, dental caries and subgingival flora [2]. It is estimated that the oral cavity is colonized by Candida in 40 to 60% of the population. Changes in the oral environment, which can be affected by tooth loss or denture wearing, can cause changes in the oral microflora [3]. When considering only those who wear dentures, the proportion of the population colonized by Candida increase to 60-100%. C. albicans is the most common species, and its various strains account for almost 70% of Candida isolates. In addition to C. albicans, other species including C. tropicalis, C. glabrata, C. kefyr, C. krusei and C. parapsilosis are typically isolated from denture and non-denture wearers [4,5,6,7,8]
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