Oral Candidal Carriage Research Articles

Oral Candida carriage and resistance against common antifungal agents in hematopoietic stem cell transplantation recipients

PurposeAllogeneic hematopoietic stem cell transplant (HSCT) recipients receiving long-term and high-dose immunosuppressive medications suffer commonly from oral candida infections. This prospective cohort study examined oral fungal carriage in HSCT recipients and screened the susceptibility against commonly used antifungal agents. An increasing oral occurrence of Candida spp. and the development of resistance against clinically administered fluconazole were hypothesized.MethodsTwo hundred HSCT recipients were included and followed up for 2 years post-HSCT. Oral microbiological specimens were analyzed with matrix-assisted laser desorption/ionization-time of flight mass spectrometry assays (MALDI-TOF). The colorimetric method was applied for the susceptibility testing by commercially available Sensititre YeastOne (SYO®, TREK Diagnostics Systems, Thermo-Fisher, UK).ResultsThe prevalence of oral Candida spp. carriage increased statistically significantly after a year post-HSCT being 30, 26, 35, 44, and 47%, pre-HSCT, 3, 6, 12, and 24 months post-HSCT, respectively. Altogether, 169 clinical oral Candida strains were isolated. Fourteen Candida spp. were identified, and C. albicans was predominant in 74% of the isolates pre-HSCT with a descending prevalence down to 44% 2 years post-HSCT. An increasing relative proportion of non-albicans species post-HSCT was evident. No development of resistance of C. albicans against fluconazole was found. Instead, a shift from C. albicans towards non-albicans species, especially C. dubliensis, C. glabrata, and relatively seldom found C. krusei, was observed.ConclusionOral Candida carriage increases after HSCT. Instead of the expected development of resistance of C. albicans against fluconazole, the relative proportion of non-albicans strains with innate resistance against azole-group antifungals increased.

Oral Candida Colonization Among Adults in Morocco: Prevalence and Risk Factors

Candida is a commensal microorganism of the oral cavity and part of the normal microbial flora. Oral carriage of Candida can be influenced by several factors and may lead to the development of oral candidiasis. Oral swabs were collected from 46 onsultants at the stomatology department and then sent to the mycology laboratory for identification of isolates. The specimens were cultured on CandiSelect medium plates as well as on Sabouraud dextrose agar plates containing chloramphenicol. 38% of cultures were positive. Candida albicans was the most encountered specie (87.5% of positive cultures). Oral Candida colonization was more frequent in the following categories of patients: immunocompromised subjects, patients with malignancy, those undergoing chemotherapy, type 2 diabetics patients, smokers, and patients brushing their teeth irregularly (less than twice a day or occasionally). All of these associations were statistically significant. (p <0,05). The diagnosis of oral Candida carriage prior to the presentation of clinical symptoms could prevent patients at risk of serious complications. The promotion of oral health and hygiene education could help stop the spread of yeast colonization.

Oral Candidal Carriage and its Correlation with Salivary Oxidative Stress in Smokeless Tobacco Users

Background: Smokeless tobacco use, particularly the consumption of Naswar, is prevalent in Pakistan and has been associated with various chronic diseases, including oral cancer. Naswar is known to contain toxic heavy metals, carcinogenic substances, and microbial contaminants. This study aims to assess the oral Candida carriage and biofilm formation in Candida albicans isolates from Naswar users and its association with salivary oxidative stress. Methods: A cross-sectional study was conducted involving 150 participants, divided into Naswar users (n=75) and Non-users (n=75). Socio-demographic data, oral health, hygiene practices, and Naswar usage patterns were collected through a standardized questionnaire. Salivary samples were collected, and Candida strains were identified using culture techniques. Salivary oxidative stress was assessed using a DPPH solution-based free radical system. Results: The mean age of participants was 30 ± 7.3 years for Naswar users and 30.2 ± 7.1 years for non-users. No significant differences were observed in oral health and hygiene practices between the two groups. Among Naswar users, the most common type of product used was green moist Naswar (77.3%). Oral Candida carriage was significantly higher in Naswar users, particularly those with fungal infections of C. albicans, C. krusei, or both. These participants also exhibited elevated levels of salivary oxidative stress. Practical Implication: Public health interventions and oral health education programs should be implemented to raise awareness about the risks associated with Naswar and promote good oral hygiene practices among users. Conclusion: This study reveals significant differences in oral Candida carriage and salivary oxidative stress between Naswar users and non-users, indicating potential implications for the oral health of Naswar users. These findings underscore the need for larger prospective studies to validate the detrimental effects of Naswar use. Public health interventions targeting smokeless tobacco users should prioritize oral health promotion and emphasize the risks associated with Naswar consumption. Keywords: Candida species, smokeless tobacco, oral health, oxidative stress

Association between Candida species and caries index in children

Background: candida species is one of the most important opportunistic oral fungal flora that contributed to oral candidal infections. Recently some studies indicate the association between increased caries incidence in children with oral candidal carriage. Objective: To candida species is one of the most important opportunistic oral fungal flora that contributed to oral candidal infections. Recently some studies indicate the association between increased caries incidence in children with oral candidal carriage. Patients and Methods: Sixty-one children with ages 6 to 12 years , DMFT, dmft, and OHI-S were measured and oral swabs were tested on three different surfaces (lingual, occlusal, and buccal) then cultured on SDA as a primary medium, and selective medium on CHROMagar, also germ tube test was done and for more precision, pure colonies were identified up to species based on their carbohydrate assimilation pattern by the VITEK 2 compact Results: 22 (36.1%) children with candida carriage, C.albicans 12, (54%), C.dubliniensis 4,( 18.18%), C.krusei 4, (18.18%), C. tropicalis 2, ( 9.1%). There was no association between candidal species in the oral cavity and caries index (DMFT, dmft). Conclusion: Non-significant weak negative correlation appeared between candidal species in the oral cavity and caries index in children. The most predominant candidal species was C.albicans.

Association between Candida species and caries index in children

Background: candida species is one of the most important opportunistic oral fungal flora that contributed to oral candidal infections. Recently some studies indicate the association between increased caries incidence in children with oral candidal carriage.
 Objective: To candida species is one of the most important opportunistic oral fungal flora that contributed to oral candidal infections. Recently some studies indicate the association between increased caries incidence in children with oral candidal carriage.
 Patients and Methods: Sixty-one children with ages 6 to 12 years , DMFT, dmft, and OHI-S were measured and oral swabs were tested on three different surfaces (lingual, occlusal, and buccal) then cultured on SDA as a primary medium, and selective medium on CHROMagar, also germ tube test was done and for more precision, pure colonies were identified up to species based on their carbohydrate assimilation pattern by the VITEK 2 compact
 Results: 22 (36.1%) children with candida carriage, C.albicans 12, (54%), C.dubliniensis 4,( 18.18%), C.krusei 4, (18.18%), C. tropicalis 2, ( 9.1%). There was no association between candidal species in the oral cavity and caries index (DMFT, dmft).
 Conclusion: Non-significant weak negative correlation appeared between candidal species in the oral cavity and caries index in children. The most predominant candidal species was C.albicans.

Predominance of non-Candida albicans species oral colonisation among patients on anticancer therapy: findings from a cross-sectional study in Tanzania

ObjectivesThis study aimed to determine the oral carriage prevalence of Candida species and identify factors associated with the carriage of Candida species among patients with cancer on treatment.DesignA hospital-based cross-sectional...

High-Throughput Sequencing of Oral Microbiota in Candida Carriage Sjögren’s Syndrome Patients: A Pilot Cross-Sectional Study

This study sought to characterize the saliva microbiota of Candida carriage Sjögren's syndrome (SS) patients compared to oral candidiasis and healthy patients by high-throughput sequencing. Fifteen patients were included, with five Candida carriage SS patients (decayed, missing, and filled teeth (DMFT) score 22), five oral candidiasis patients (DMFT score 17), and five caries active healthy patients (DMFT score 14). Bacterial 16S rRNA was extracted from rinsed whole saliva. PCR amplification generated DNA amplicons of the V3-V4 hypervariable region, which were sequenced on an Illumina HiSeq 2500 sequencing platform and compared and aligned to the SILVA database. Taxonomy abundance and community structure diversity was analyzed using Mothur software v1.40.0. A total of 1016/1298/1085 operational taxonomic units (OTUs) were obtained from SS patients/oral candidiasis patient/healthy patients. Treponema, Lactobacillus, Streptococcus, Selenomonas, and Veillonella were the primary genera in the three groups. The most abundant significantly mutative taxonomy (OTU001) was Veillonella parvula. Microbial diversity (alpha diversity and beta diversity) was significantly increased in SS patients. ANOSIM analyses revealed significantly different microbial compositional heterogeneity in SS patients compared to oral candidiasis and healthy patients. Microbial dysbiosis differs significantly in SS patients independent of oral Candida carriage and DMFT.

Influence of oral biofilm index, caries experience, and laboratory markers of disease progression on the oral carriage of Candida in HIV-infected and non-infected children: a cross-sectional study.

The present study aimed to compare the oral Candida rate between infected and uninfected children with the human immunodeficiency virus (HIV), as well as analyze the association between Candida spp. and predisposing factors of colonization, like oral biofilm index, caries experience, and laboratory markers of AIDS progression. A cross-sectional study was employed. Candida species were identified and quantified from saliva samples of 50 HIV-infected and 50 uninfected children. Biofilm index and decayed, missing, and filled teeth (dmft/DMFT) indices were assessed by oral clinical examinations. Additionally, CD4+ T lymphocyte count and viral load were obtained from medical records of the HIV-infected children. Candida species were cultured from 74% of the HIV-infected children and 46% of uninfected ones (p = 0.0076). Candida albicans and Candida parapsilosis were the most frequently isolated species in both studied groups. The isolation of Candida species was significantly higher in HIV-infected children with CD4 ≤ 15% (p = 0.0146); it had influence of mature oral biofilm and the caries index (dmft + DMFT ≥ 8) (p < 0.05) and was associated with the plasma viral load. The present data show that the HIV infection, oral biofilm index, caries experience, and laboratory markers of AIDS progression exert an influence on the prevalence of oral Candida in children.

P350 Oropharyngeal candidiasis in HIV infected patients: associated risk factors and antifungal susceptibility testing of candida species by disc diffusion method

Poster session 3, September 23, 2022, 12:30 PM - 1:30 PM ObjectivesTo isolate and identify Candida species by the standard microbiological method.To estimate the frequency of oral Candidiasis according to age, sex, and other factors [CD4 + count, ART, tobacco consumption, diabetes, upper respiratory tract infection (URTI), recent antibiotic consumption] in HIV-positive patients.To determine the Antifungal Susceptibility pattern of the Candida species by Disc Diffusion Method.MethodologyA hospital-based cross-sectional study was conducted for 6 months in the Department of Microbiology of Sukraraj Tropical and Infectious Disease Hospital, Kathmandu, Teku, Nepal. A total of 408 HIV-positive patients attending the ART center of the hospital of different age and sex were included in the study. Study variables like CD4 + count, tobacco consumption, diabetes, URTI, and recent antibiotic consumption were noted.Standard microbiological guidelines were followed for the oral swab collection and transportation. Specimen was seeded on SDA agar plates (SDA with chloramphenicol and cycloheximide). Preliminary identification of the Candida was done on the basis of colony characteristics, gram staining, and germ tube test. Further for the speciation of Candida species, HiCrome™ Candida Differential Agar (HImedia, India) was applied where on the basis of coloration and colony morphology speciation was done. Similarly, Cornmeal Agar (Dalmau plate culture technique) and sugar Fermentation test were applied to confirm the Candida species.Muller-Hinton agar supplemented with 2% glucose and 0.5 μg/ml methylene blue dye (GMB) medium was used to perform the antifungal susceptibility testing of Candida isolates. Antifungal susceptibility testing (AST) of isolates was performed and interpreted according to Clinical and Laboratory Standards Institute (CLSI) M44-A document. Candida albicans ATCC 90028 was taken as the reference strain. All the data were entered in Microsoft excel and Chi-square was used to find out the association between the frequency of oral candidiasis and study variables.ResultsAmong 408 studied subjects, 225 (55.1%) were males and 183 (44.9%) were females. Of the participants, 116 (28.4%) had regular tobacco smoking habit, diabetes 10 (2.5%), URTIs 30 (7.4%), antibiotic consumption 44 (10.8%) and ART use 394 (96.6%). The CD4 + cell count of respondents ranged from 12 - 2425 cells/mm³. Candida albicans 53 (81.5%) was the most frequently encountered species followed by C. tropicalis 3 (4.6%), C. krusei 2 (3.1%), C. glabrata 1 (1.5%) and 6 (9.2%) other Candida species. A total of 26 patients had CD4+ ≤200 cells/mm3 and 39 patients had CD4+ >200 cells/mm3. There was no significant association in the occurrence of oral candidiasis among males and females (P = .966), tobacco consumption (P = .051), ART use (P = .188), diabetes (P = .722). Whereas, there was a significant association between oral Candida carriage and CD4 + cell count ≤ 200 cells/mm3 (P <.001), URTI (P = .029), and recent antibiotic consumption (P = .002). Amphotericin B was the most potent antifungal followed by voriconazole, itraconazole, and conversely fluconazole the most resistant.Conclusion Candida albicans was the common species isolated in our study. Candida Chrome Agar can be used as a routine media for rapid identification and Candida speciation. AST needs to be done routinely to know the susceptibility pattern of isolates and initiate proper treatment of patients. Since oral yeast colonization was associated with low CD4 + count (<200 cells/mm3). Thus, oral lesions can serve as early markers for HIV infection.

Is Oral Candida associated with Dental Caries in Children - A Cross Sectional Analysis.

BACKGROUND: Dental caries is a world-wide public health issue and is considered the most common of all non-communicable disease. There has been a growing interest in association between oral fungal flora especially candida and dental caries. Hence the aim of the study was to assess the correlation between active caries status and oral candida carriage in children aged twelve years.MATERIALS AND METHODS: This is a cross-sectional study where a multiphase sampling was done and a total of thirty children were selected randomly among children screened previously. Data was collected through clinical oral examinations and structured interviews. The oral rinse technique described by Samaranayake et al. was used for extracting candida spp. The correlation between candida spplevel and caries experience was performed by the Pearsons correlation coefficient.RESULTS: The mean DMFS and defs scores of the children were 3.70±4.61 and 5.83±5.51 respectively. Significant association with decay scores for deciduous teeth (P&lt;0.05) and defs (p= &lt;0.001) was demonstrated. Candida species was associated highly with caries prevalence and significant positive correlation was found between Candida (CFU/plate) and defs scores (r=0.790) (p= &lt;0.001)CONCLUSION: The study results suggested that there is a significant positive correlation between candida carriage and caries, especially in children in the age group of 12 years.

Association of oral candidal carriage, candidal density and CD4 count among normal, HIV patients with HAART and without HAART

ObjectivesOral candidiasis is considered one of the most frequent opportunistic infections in Human Immunodeficiency Virus (HIV) individuals. Symptomatic candida colonization of the oral and vaginal mucosal surfaces is closely correlated with the severity of cellular immunodeficiency in HIV infection. HAART is considered as the mainstay treatment that shows a decrease in the incidence of opportunistic diseases, including oral lesions. The current study was designed to analyse the candidal carriage rate and candidal density in HIV patients undergoing HAART and without HAART. MethodsThe study population comprised of 120 subjects and was equally distributed into 3 groups: Group 1 (HIV patients with HAART), Group 2 (HIV patients without HAART), and Group 3 (healthy subjects as controls). The oral rinse samples from all the groups were collected and incubated for candidal growth. The complete growth of any candidal colonies on the culture plates was recorded as a positive candidal carriage. The number of colonies forming units per mL was calculated for candidal density. ResultsThe candidal carriage rate in the HIV patients undergoing HAART was higher than in subjects naïve to HAART. A higher number of patients with HAART therapy showed candidal density <2000 CFUs/mL. There was a reduction of oral candidiasis seen in patients with non-protease inhibitor HAART therapy. There was no significant association found between the candidal carriage rates and candidal density with CD4 lymphocyte count. HIV individuals undergoing HAART therapy showed higher candidal carriage rate and lower candidal density than the non-HAART group. ConclusionCandidal density is a more valuable marker in predicting the development of oral candidiasis than candidal carriage rate. Reduction in the occurrence of oral candidiasis is also seen in patients who are on NNRTI HAART therapy.

Clinical study of risk factors for adherence of Candida to dentures

We aimed to identify the time of adherence, predicting factors, and species of Candida adhering to the mucosal surface of new maxillary dentures fabricated and placed in our department. Three types of oral samples from 32 patients were collected at the time of new denture placement (baseline) and at five follow-up visits (1, 3, 6, 9, and 12 months). Candida adherence, indicated by a positive culture originating from the mucosal surface of the denture base (MSDB) at any time during follow-up, was tested for its associations with several putative predictors. The protocols of a second, additional study were identical to the initial study except that, at each visit, all 22 participants received an educational intervention regarding denture cleaning and maintenance. Of the 14 patients with extensive oral Candida colonization at baseline, 11 already had Candida -positive MSDB swabs at the 1-month follow-up. Candida carriage, xerostomia, and denture cleaning habits were associated with MSDB Candida colonization. In the additional study, when subjects consistently cleaned and maintained their dentures, Candida was detected at a lower rate on the MSDB at follow-up visits after 6 months than that observed in the initial study (18% [4/22] vs. 56% [18/32], p < 0.05). Candida carriage at the time of new denture placement is strongly predictive of subsequent adherence to the MSDB. Regardless of the oral Candida carriage state, patients can limit this colonization by consistently following good cleaning and maintenance habits, starting from the time of new denture placement.

Effect of statin therapy on oral Candida carriage in hyperlipidemia patients: A pioneer study.

Hyperlipidemia affects about 25% of the adult population globally. Statins are the most commonly used drugs in the management of hyperlipidemia. Laboratory and retrospective clinical studies have observed the inhibitory effects of statins on the growth of different Candida species. The effect of statin therapy on oral Candida carriage has not yet been investigated. This pioneer controlled study aimed to assess and compare asymptomatic oral Candida carriage in a group of 50 hyperlipidemic patients who were on regular statin therapy (HLS group) and in a control group of 50 subjects, matched in terms of gender, age and dental status, who were hyperlipidemic, but not on statin therapy (HLNS group). The patients were recruited from the outpatient clinics of 2 university hospitals. The concentrated oral rinse technique was used to isolate oral Candida species in both groups. Candida species were identified using the germ tube test and the VITEK® 2 system. The Candida prevalence and colony count were significantly lower in the HLS group as compared to the HLNS group (n = 20, 40% vs. n = 30, 60%, respectively; p = 0.040). There was no significant difference in the oral Candida prevalence or colony count between different age groups in either the statin or control subjects. Statin therapy is associated with a reduction in oral Candida carriage in both prevalence and the colony count in hyperlipidemic patients.

Oral frailty and carriage of oral Candida in community-dwelling older adults (Check-up to discover Health with Energy for senior Residents in Iwamizawa; CHEER Iwamizawa).

To examine the association between oral frailty and oral Candida carriage as a general indicator of deteriorating oral function in older adults. Older adults exhibit an elevated risk of oral candidiasis caused by Candida. Although many studies have identified factors associated with oral Candida carriage, none have evaluated its relationship with oral function. This study included 210 community-dwelling older adults aged ≥60years who participated in wellness checks. Fungal flora expression in saliva samples was evaluated to identify oral C.albicans and C.glabrata. Participants were categorised by detection of neither strain (group 1), either one of the strains (group 2), or both strains (group 3). The relationship between oral Candida carriage and oral frailty was evaluated by multinomial logistic regression analysis. The participants included 58 men and 152 women with a mean age of 74.2±6.1years. A total of 88 (41.9%), 94 (44.8%) and 28 (13.3%) participants were assigned to groups 1, 2 and 3 respectively. In the multinomial logistic regression analysis, significant associations were observed between group 1 and group 2 for "Have you choked on your tea or soup recently?" and the number of applicable oral frailty items. Between group 1 and group 3, significant associations were observed for the number of remaining teeth, masticatory performance and the number of applicable oral frailty items. We obtained basic data useful for intervention studies aimed at verifying whether oral function management prevents deterioration of the oral bacterial flora.

Relationship of Clinical Features with Candidal Carriage in Oral Submucous Fibrosis Patients: A Case-control Study.

Background and Objectives:Oral submucous fibrosis (OSF) is extensively prevalent in India and South-East Asia owing to the habit of arecanut (AN) use. Epithelial atrophy, hyposalivation, and immune alterations in OSF may predispose to increased Candidal carriage. Stomatopyrosis in OSF can result from multiple causes, which may also include Candidal infection. Hence, this study is aimed to assess Candidal carriage, species characterization, salivary flow rate (SFR) and its relationship with the clinical features (stomatopyrosis and mouth opening [MO]) in OSF patients alongwith the response to antifungal treatment in patients with higher Candidal carriage.Methodology:In this case-control study, 60 OSF patients and 30 age- and sex-matched control subjects were enrolled. SFR was assessed using modified Schirmer test. Samples for Candidal assessment were collected with the oral rinse technique and cultured. The isolated yeast species were counted and identified based on Gram staining, germ tube test, and CHROMagar. Data were analyzed with Chi-square test, Pearson's correlation test, and one-way ANOVA test.Results:The distribution of mean visual analog scale (VAS) score, SFR and MO was significantly varied (P < 0.001) in the study and control groups. Candida was found to be present significantly (P = 0.048) in OSF group as compared to control group. Candida albicans was the predominant species. No statistically significant association was obtained regarding Candidal isolation and SFR, burning sensation and MO in OSF patients. Only 1 patient in the study group yielded a high Candidal carriage (>400 CFU/mL) and reported relief in burning sensation (VAS score) with antifungal therapy.Conclusions:OSF patients yielded a significant higher oral Candidal carriage. Although it was not found to be associated directly, its role as a “cause and effect” in SFR and clinical features (stomatopyrosis and MO) of OSF cannot be ignored.

Quantification of Oral Candidal Carriage Rate and Prevalence of Oral Candidal Species in HIV Patients with and Without Highly Active Antiretroviral Therapy.

Background:Most documents review decrease in the prevalence of HIV related oral lesions to the tune of 10-50% following the advent of HAART. However long term use of HAART on oral health status of HIV infected subjects is poorly documented. Also antifungal agents can effectively treat mucosal candidiasis. However their use can lead to colonization with less susceptible strains among normal susceptible strains.Aims and Objectives:To know the candidal carriage rate (i.e. presence/absence of candidal growth), candidal density(CFUs/ml) & species variations (species diversity) in HIV positive individuals with and without highly active anti-retroviral therapy (HAART), attending the regional voluntary Counselling and Confidential Testing Centre (VCCTC).Materials and Methods:The study population were categorized into 3 groups. Method followed were Germ tube test, Chlamydospore formation test, CHROM-Agar test.Results:Quantification comparison study of candidal carriage rate, density with detection of various candidal species in the oral cavity of HIV-positive individuals with and without HAART therapy was conducted.Conclusion:HIV positive individuals with HAART therapy treatment prooved higher candidal carriage rate and lower density than Non-HAART category.

Oral candidal carriage and its association with dental carious lesions in asymptomatic adults: a cross-sectional study from the UAE

BackgroundCandida’s potential association with dental caries has previously been reported in children. This research aimed at investigating the associations between Candida species in whole saliva and dental and periodontal health indices in a sample of adult patients.MethodsA cross-sectional study involving 160 patients investigated the associations between Candida species collected by oral rinse technique, and Decayed, Missing, and Filled Surfaces (DMFS), and periodontal health indices. Chi-square and Independent Samples t-test were used to assess the associations between Candida carriage and confounding variables. Binary logistic regression was used to assess association strengths between Candida carriage and DMFS, adjusted for socio-demographic variables, diabetes mellitus and plaque index.ResultsCandida colonies were identified in 49 (30.6%) patients with CFUs ranging from 103 to 105 colonies per mL. The quantity of Candida CFUs increased with age (r = 0.200; p < 0.05). Among all dental and periodontal health indices, only DMFS was significantly associated with higher values of Candida carriage (p = 0.034), and this association was independent from sex, age, smoking, diabetes mellitus and plaque index (OR: 1.014; 95% CI 1.0–1.03; p = 0.048).ConclusionThe association between Candida species in whole saliva and DMFS reported here supports an etiological role of Candida in dental cariogenesis among adults.

A Comparison of the Prevalence Rate of Oral Candida Colonization between Opium Users and Cigarette Smokers in Kerman, Iran.

BackgroundCandidiasis is the most common opportunistic oral infection and smoking is considered as one of its well-known risk factors. However, it remains unknown whether opium users are susceptible to increased oral candida colonization. The aim of the present study is to compare the prevalence rate of oral candida colonization between opium users and cigarette smokers in Kerman, Iran.MethodsThis case-control study included 75 healthy male respondents divided into three groups (25 in each group): cigarette smokers, cigarette and opium users, and non-smokers as control group. The samples were obtained from oral mucosa by scraping the mucosa with a sterile cotton swab then inoculated into Sabouraud Dextrose Agar (SDA) and CHROMagar plates and also examined with the light microscope.FindingsCandida was identified in 38.70% of respondents. The most frequently isolated species was Candida albicans (90.66%). The highest prevalence of candida carriage was found in cigarette smokers (52.00%). The difference of candida carriage between the two groups of cigarette smokers and cigarette plus opium users and the control group was statistically significant (P = 0.007 and P = 0.015, respectively).ConclusionIn the present study, it was revealed that the prevalence of oral candida carriage was significantly higher among cigarette and opium users in comparison to the non-users.

Prevalence of species-specific candidiasis and status of oral hygiene and dentition among diabetic patients: A hospital-based study.

The study was undertaken to estimate the species-specific prevalence of oral candidiasis in diabetic individuals in India, and further find the relationship of oral carriage of Candida in diabetes with degree of diabetic control, duration of disease, type of diabetes and its effect on the status of oral hygiene status and decayed, missing and filled teeth (DMFT) score. The prospective cross-sectional study involved 900 individuals (470 diabetic and 430 non-diabetic) visiting a tertiary care hospital. Informed consent was obtained from all the individuals participating in the study. The demographic details, medical history and oral cavity examination were recorded in a specially designed proforma. Swabs were taken for microbiological evaluation for specific prevalence of Candida. The overall prevalence of Candida in diabetics was 22.1% as compared to 9.7% in non-diabetic individuals. However, among the type 1 and type 2 diabetics, the prevalence of Candida was equally distributed as 22.6% and 20.8%, respectively. C. albicans was the most common species (97.1%), while isolated cases of other species like C. rugosa, C. tropicalis, C. glabrata were also observed. The individuals with higher glycaemic score (HbA1c >7) showed higher prevalence of oral candidiasis. Oral hygiene status was observed to be lower among diabetics as compared to non-diabetic individuals. Oral candidiasis was more prevalent in diabetic patients, and C. albicans was the most common species. The diabetics also showed higher mean DMFT with lower oral hygiene status as compared to non-diabetic individuals.

Oropharyngeal Candidiasis (OPC) in hiv infected patients and its antifungal susceptiblity pattern by disc diffusion method

Background: Oropharyngeal candidiasis (OPC) is an opportunistic fungal infection commonly found in Human Immunodeficiency Virus infected patients. Acquired Immunodeficiency syndrome a disease of human immune system caused by HIV, has emerged as a global crisis since its discovery in summer of 1981 in United States. The low absolute CD4+ T-lymphocyte count has traditionally been cited as the greatest risk factor for the development of OPC and current guidelines suggest increased risk once CD4+T-lymphocyte counts fall below 200 cells/mm3. Rampant, indiscriminate and long-term use of antifungals has led to the development of antifungal resistance among Candida species and hence the need of study. Methods and materials: A total of 408 Throat swab collected aseptically from patients using sterile cotton swab were seeded on Sabouraud's Dextrose Agar (SDA) and incubated at 37 °C. Any whitish, creamy, pasty colonies on SDA was suspected to be candida, gram staining and germ tube test was done for preliminary identification, further speciation was done based on colony morphology and color production on Candida Chrom Agar (HiMedia), pattern of blastoconida and chlamydospores on Cornmeal agar, and sugar fermentation test. Antifungal susceptibility testing (AST) of isolates was performed and interpreted according to Clinical and Laboratory Standards Institute (CLSI) M44-A document. Results: Among the 65 candida species isolated, Candida albicans 53 (81.5%), was the most common species followed by Candida tropicalis 3 (4.6%), Candida krusei 2 (3.1%), Candida glabrata 1 (1.5%) and 6 (9.2%) other Candida species. 26 patients had CD4+ ≤ 200 cells/mm3 and 39 patients had CD4+ ˃200 cells/mm3. There was a significant association between oral Candida carriage and CD4+ cell count ≤ 200 cells/mm3 (p < 0.001).Amphotericin B was the most potent antifungal followed by voriconazole, Itraconazole and conversely Fluconazole the most resistant. Conclusion: C. albicans was the common species isolated in our study. Candida Chrome Agar can be used as a routine media for rapid identification and candida speciation. AST needs to be done routinely to know the susceptibility pattern of isolates and initiate proper treatment of patients. Since Oral yeast colonization was associated with low CD4+ count (<200 cells/mm3). Thus oral lesion can serve as early marker for HIV infection.