Oral Candida Species Research Articles

Antimicrobial Activity of Olive Leaf Extract to Oral Candida Isolates.

The aim of this study was to determine the antifungal activity of olive leaf extract (OLE) and the synergistic effect of standard antifungal therapy and OLE against clinical oral Candida species' isolates. The susceptibility of 60 clinical isolates of the Candida species (36 C. albicans, 16 C. krusei, 5 C. glabrata and 3 C. tropicalis) was tested with four concentrations of OLE (60 µg/µL, 120 µg/µL, 240 µg/µL and 333 µg/µL) and the synergistic effect of standard antifungal therapy and OLE (miconazole (MIC) + 333 µg/µL OLE and nystatin (NYS) + 333 µg/µL OLE). The antimicrobial activity was tested using the disk diffusion method. All concentrations (60 µg/µL, 120 µg/µL, 240 µg/µL and 333 µg/µL) of OLE showed a statistically significant effect on all Candida species compared to the control (DMSO) except for the lowest concentration (60 µg/µL) tested on C. glabrata. There was a dose-dependent effect of OLE on tested samples. Concentrations of 240 µg/µL and 333 µg/µL showed statistically significant higher antifungal activity compared to the lowest concentration of 60 µg/µL. No statistically significant synergistic effect of OLE and standard antifungal therapy was found compared with standard therapy alone. The results of this study present the significant antimicrobial effect of OLE against all tested Candida species except for the lowest concentration on C. glabrata. Increasing the concentration of OLE also increases its effect on Candida species. This indicates the possible potential effect of OLE in the treatment of Candida-related oral diseases.

PREVALENCE, TYPING, AND ASSOCIATED FACTORS OF ORAL CANDIDA COLONIZATION IN DENTURE WEARING AND FIXED ORTHODONTIC APPLIANCE COMPARING TO NORMAL TEETH INDIVIDUALS

Background and objectives: Oral Candida colonization (OCC) is one of the most common opportunistic fungal infections among people who wear dentures and have FOA. The prevalence of OCC and Candida among denture patients and FOA patients may change due to the presence of these dental appliances. This study aims to identify the different Candida species, determine the prevalence of OCC in 3 groups of individuals with removable or fixed dentures and fixed orthodontic appliances (FOA) compared with a control group of people with natural teeth and study the risk factors associated with contracting oral Candida species among these groups. Subjects and methods: The investigational group was selected from denture and orthodontic patients who were clinically examined at the earliest time to obtain basic information before any effective treatment of dental infection. The group included 104 dental patients; 104 fixed orthodontic appliance (FOA) patients and 102 controls. The oral mucosa of each participant was first swabbed and then placed in a liquid medium. Then, after creating successive dilutions and applying them to Sabouraud dextrose agar, the isolates were diagnosed by culturing them on Candida agar with color, observing the colony characteristics of the species, in addition to studying the biochemical reactions to confirm the species. Results: Of the 108 persons with OCC, 44 (34.8%) had a positive OCC. 148 oral Candida spp. were found in 108 OCC patients. C. albicans (49.1%) was the most frequently isolated species, followed by C. glabrata (35.2%) and C. dubliniensis (13%). C. kefyr, C. krusei, C. famata, C. africana, and C. stellatoidea were initially isolated for the first time in the oral cavities of Yemeni dentistry patients. A higher rate of colonization was observed in the male group (48.5%) versus 25% in the female group, with odds ratio equal to 2.8, CI=1.7–4.6, X2=18, and p<0.001. Also there was association of denture wearing (44.2%, OR= 1.8, p =0.01) and older ages, (52.5%, OR= 2.3, p=0.01) with high rate of oral candida colonization. Conclusion: Candida colonization remains a major problem in the oral cavity. Although the prevalence of non-albicans Candida (NAC) species is increasing, C. albicans was still the dominant species. A higher rates and significant risk factors of OCC were observed in the male group, denture patients and the elderly. Peer Review History: Received 2 December 2023; Revised 29 January 2024; Accepted 28 February; Available online 15 March 2024 Academic Editor: Dr. Iman Muhammad Higazy, National Research Center, Egypt, imane.higazy@hotmail.com Average Peer review marks at initial stage: 6.0/10 Average Peer review marks at publication stage: 7.0/10 Reviewers: Dr. Vanina Doris Edo’o, University of Yaounde I, Yaounde, Cameroun, vanina_edoo@yahoo.com Dr. Taiwo O Elufioye, University of Ibadan, Nigeria, toonitaiwo@yahoo.com

Oral candida lesions and Candida tropicalis: Potential prognostic markers in end-of-life cancer patients.

Oral candidosis is common in patients with end-of-life cancer; however, its prognosis is unclear. We aimed to assess oral candidosis and Candida species as prognostic indicators in palliative care for these patients. We consecutively included palliative care patients, assessed for candidosis via microbiological techniques, and classified into three groups by the extent of oral lesions. The association between oral candidosis and overall survival was assessed using a Cox proportional hazards model adjusted by performance status (PS). We studied 142 patients (median age 77; 52.8% women) with a 76.1% oral candidosis prevalence. Candida albicans (80.6%) was the most common species. Oral lesions were classified as none, grade 1 (28.7%), or ≥ grade 2 (14.8%). During follow-up, Cox models identified ≥grade 2 lesions (aHR=2.04; 95% CI: 1.18-3.54; p=.011) and Candida tropicalis (aHR=2.38; 95% CI: 1.03-5.55; p=.044) as predictors. The extent of oral candidosis lesions or the presence of C. tropicalis may serve as prognostic indicator in patients with end-of-life cancer. Therefore, solely concentrating on the prevalence and frequency of fungal species may be insufficient for predicting life prognosis; it is advisable to assess these parameters through both visual examination and culture.

Oral Findings, Salivary Copper, Magnesium, and Leptin in Type II Diabetic Patients in Relation to Oral Candida Species.

Type 2 diabetes is a condition in which the body becomes resistant to the effects of insulin, leading to reduced insulin production in the pancreas. It has genetic- and family-related risk factors that cannot be changed, along with modifiable lifestyle factors. The precise genetic causes of type 2 diabetes are still unknown. However, individuals can potentially slow or stop the progression of the condition by making dietary adjustments and increasing physical activity levels. Material and Methods. Forty-five type II diabetic patients in the study included participants between 40 and 60 years old, with a minimum duration of one year, as well as 45 healthy control subjects who were matched in terms of age and sex, and had no underlying systemic diseases. Oral examination is done for the symptoms including burning sensation, candidiasis, and a reduction in the production of saliva. The rate of saliva flow (in milliliters per minute) was measured in samples of saliva that were not stimulated. The salivary trace elements and levels of adipocytokines were evaluated using colorimetric and Ethylenediaminetetraacetic acid (ELISA) testing. The quantification of Candida colony numbers, an enrichment and culture approach, was used to achieve a concentration of 100,000 colony-forming units per milliliter (CFU/ml). The ShowNovo WG1 halimeter was used to measure volatile sulfur compounds in breath. The salivary glucose oxidase assay was conducted using a colorimetric technique, while the determination of trace elements was also performed using a colorimetric assay method. The diabetic group exhibited a significant increase in the number of Candida spp colonies due to elevated levels of glucose in the saliva (p > 0.05). However, the variables being examined, such as body mass index (BMI), burning mouth syndrome (BMS), salivary flow rate (SFR), salivary leptin, salivary copper, and salivary magnesium, did not exhibit any significant variations in quantities between the diabetic and healthy groups (p > 0.05). The data collected in this research aid in the creation of a preventative program for oral fungal infections in individuals with type 2 diabetes. The program utilizes saliva and its constituents.

Evaluation of the Various Oral Candida Species among Patients on Hemodialysis: A Clinical Study.

Oral candidiasis develops as a result of an opportunistic infection. In patients on hemodialysis who may be immune-compromised, candida can change from a commensal to a pathogen. Identification and classification of Candida species are crucial for the treatment of these patients. To distinguish between distinct species of candida found in hemodialysis patients with chronic renal failure's oral cavity. A total of 100 people were investigated, including 50 patients with "Chronic Renal Failure (CRF)" on hemodialysis and 50 healthy controls. Using "Sabouraud's Dextrose Agar (SDA)" and "CHROM Agar Culture Media", salivary samples were incubated for 24, 48, or 72 hours at 37°C to develop candida species. Colony forming units/milliliter, a unit of measurement for colonies, were counted and calculated (CFU). On SDA and CHROM agar medium, positive candidal growth was seen in the CRF with HD and Control Groups. There was a significant variance in the growth and the subspecies distribution of the colonies among the groups. The most common species was c.albicans followed by c. cruzi and tropical. Other subspecies were negligible. The number of colonies was also greater than 400 CFU in the majority of the dialysis subjects, while it was only 200 CFU for the majority of the controls. Patients with chronic renal failure receiving hemodialysis showed significantly higher levels of candida isolation and differentiation than healthy individuals (P 0.05).

Phenotypic and genotypic characterization of virulence markers and antifungal susceptibility of oral Candida species from diabetic and non-diabetic hemodialysis patients

BackgroundPatients with chronic kidney disease undergoing hemodialysis are often colonized by Candida species with high possibility of fungal infections. The purposes of this study were to determine the prevalence of Candida species, evaluate antifungal susceptibility profile, biofilm formation, proteinase and phospholipase activities, and the frequency of virulence genes in the Candida species isolated from the oral mucosa of hemodialysis diabetic (DM) and non-diabetic (non-DM) patients.MethodsThis study identified several species of Candida isolated from 69 DM and 58 non-DM patients on hemodialysis using phenotypic methods and PCR–RFLP technique. The identification of C. albicans and C. glabrata complex was performed by HWP1 gene and four oligonucleotides (UNI-5.8S, GLA-f, BRA-f, and NIV-f), respectively. Antifungal susceptibility to amphotericin B, fluconazole, itraconazole, voriconazole, and caspofungin was assessed according to CLSI M27-A3/S4. The biomass, metabolic activity of biofilm, proteinase (Prz), phospholipase (Pz), and molecular study for virulence genes were assessed using crystal violet, XTT assay, agar-based hydrolytic enzyme, and PCR technique, respectively.ResultsCandida prevalence was 44.9% with 47.8% and 41.4% among DM and non-DM patients, respectively (P = .045). The species identified were C. albicans (49.5%), C. glabrata (16.5%), C. tropicalis (12%), C. kefyr (8.8%), C. parapsilosis (6.6%), C. dubliniensis (3.3%), and C. lusitaniae (3.3%). The antifungal susceptibility profile showed that all Candida isolates were sensitive to amphotericin B, itraconazole, voriconazole, and caspofungin whereas fluconazole resistance was observed in 6.3% (MIC ≥ 64 μg/mL) of C. albicans and 6.6% of C. glabrata (MIC ≥ 64 μg/mL). The susceptible- dose-dependent rate was found in 10.5% of C. albicans. The Prz values of C. albicans ranged from 0.37 to 0.66 for the DM and 0.44–0.73 for the non-DM group (P < 0.05). The non-albicans Candida (NAC) species produced higher degree of biomass and metabolic activity compared to C. albicans (P < 0.05). Furthermore, significant (p < 0.05) correlations were detected between the biofilm formation with Prz values and fluconazole MICs. The most detected virulence factors were ALS3 and Sap5.ConclusionsThese results showed the importance of prevalence of NAC species in hemodialysis patients. Investigating antifungal susceptibility profile made a better understanding of the role of virulence markers in the pathogenesis of Candida strains.

Prevalence and identification of oral candida species in patients with type 2 diabetes in Yogyakarta

Patients with diabetes are prone to recurring and even resistant Candidiasis, making treatment challenging. Many hypotheses proposed related to susceptibility of diabetic patients to Candida. The prevalence and species of Candida in a particular diabetic community might be different compared to other diabetic community. This study aimed to determine the prevalence of Candida colony and its species in the oral cavity of diabetic patients included in the CDM (Chronic Disease Management) program in Yogyakarta. One hundred patients with type 2 diabetes (n= 100) were recruited as the subjects of this study. The subjects were classified into controlled and uncontrolled Diabetes mellitus (DM). Samples of oral rinse solution were collected to determine the species of Candida and number of Candida colonies using CHROMagar Candida medium. There were 47 and 53 of subjects with controlled and uncontrolled DM, respectively. The mean number of Candida colony in the subjects with controlled diabetes (1003.13) was higher than that in the subjects with uncontrolled diabetes (478.43). The Candida colony most commonly identified in the subjects with controlled and uncontrolled diabetes were C. albicans and C. glabrata, respectively. Female patients had higher mean number of Candida colony (859.51) compared to male (299.21). The Candida colony most often identified in both genders was C. albicans. In addition, the subjects of this study consisted of 83 geriatric subjects and 17 non geriatric subjects, in which the mean number of Candida colony in the geriatric subjects (761.77) was higher than that in the non-geriatric subjects (545.71). The Candida colony most often identified in the geriatric subjects and non-geriatric subjects was C. albicans and C. glabrata, respectively. The Mann Whitney test demonstrated that there was a significant difference (p = 0.009) of the mean number of Candida colony between male and female. However, there was no significant difference of the mean number of Candida colony between ages (p = 0.060) and diabetic status (p=0.175). It can be concluded that the Candida species most commonly identified in all the subjects was Candida albicans with the mean colony number of 349.96, followed by C. glabrata (225.97), C. krusei (144.91), C. tropicalis (3.67), and other species (2.02).

Evaluation of antifungal activity of Miswak (Salvadora persica) and toothpaste against oral cavity Candida species

Evaluation of antifungal activity of Miswak (Salvadora persica) and toothpaste against oral cavity Candida species

Effects of Nystatin oral rinse on oral Candida species and Streptococcus mutans among healthy adults

ObjectivesTo examine the effect of Nystatin oral rinse on oral Candida species and Streptococcus mutans carriage.Materials and methodsTwenty healthy adults with oral candidiasis participated in the single-arm clinical trial and received Nystatin oral rinse for 7 days, 4 applications/day, and 600,000 International Units/application. Demographic-socioeconomic-oral-medical conditions were obtained. Salivary and plaque Candida species and Streptococcus mutans were assessed at baseline and 1-week and 3-month follow-ups. Twenty-four salivary cytokines were assessed. Candida albicans isolates underwent Nystatin susceptibility test.ResultsHalf of participants (10/20) were free of salivary C. albicans after using Nystatin rinse. Salivary S. mutans was significantly reduced at 3-month follow-up (p < 0.05). Periodontal status reflected by bleeding-on-probing was significantly improved at 1-week and 3-month follow-ups (p < 0.05). Plaque accumulation was significantly reduced at 1-week follow-up (p < 0.05). Interestingly, the responses to Nystatin oral rinse were not associated with race, gender, age, oral hygiene practice, adherence to Nystatin rinse, or sweet consumption (p > 0.05). No C. albicans isolates were resistant to Nystatin. Furthermore, salivary cytokine eotaxin and fractalkine were significantly reduced at 3-month follow-up among participants who responded to Nystatin rinse (p < 0.05).ConclusionsThe study results indicate that oral antifungal treatment had an effect on S. mutans salivary carriage. Future clinical trials are warranted to comprehensively assess the impact of antifungal treatment on the oral flora other than S. mutans and Candida.Clinical relevanceDue to the potential cariogenic role of oral Candida species, antifungal approaches shed new light on the prevention and management of dental caries from a fungal perspective.

The potential impact of delivery mode and breastfeeding on oral Candida species carriage in a population of young adults.

In early life, children are exposed to microorganisms from maternal and environmental sources, which influence the development of their microbiome throughout life. Several studies have demonstrated the influence of the delivery mode and breastfeeding on the oral microbiome of children, mostly regarding bacterial colonization. However, their influence on the oral fungal carriage is still underexplored. This study aimed to assess the association of the delivery and feeding mode with the oral carriage of yeasts in adulthood. Fungal oral carriage was evaluated by collecting unstimulated saliva in 185 healthy dental students (mean age of 21.51±1.55 years old; 81.6% females). Yeast identification was performed by culture in ChromAgar Candida medium and sequencing of the 18S genes and ITS regions for determination of the species. Demographic and clinical data of each participant was recorded through questionnaires and oral examinations were performed in a subgroup of participants (n=49). Candida species were isolated in 37.5% of all participants. The prevalence of yeasts in the oral cavity was significantly higher in those who were born by vaginal delivery compared to those born by caesarean-section (p=0.035), whereas no statistically significant differences were observed regarding breastfeeding (p=0.398). Low salivary flow rate and frequency of dental visits also were associated with oral yeast carriage (p<0.05). Our study suggests a possible impact of the type of delivery on fungal colonization, which is sustained throughout life due to oral health-related factors.

Role of mutans streptococci, acid tolerant bacteria and oral Candida species in predicting the onset of early childhood caries.

Early childhood caries is the most common chronic infectious disease in children in the United States. This study, which is part of a larger, longitudinal study exploring oral microbiological components of caries development in children, reports on the impact of total mutans streptococci (MS), total acid tolerant bacteria and Candida species on the development of dental caries in a subset of these children. Of particular interest was the relationship between caries development and co-colonization of mutans streptococci and Candida species. Children between the ages of 12 and 47 months displaying no evidence of dental caries were recruited for a longitudinal study (n = 130). Twelve age- and gender-matched pairs were selected. In each pair, one child developed caries during the study, and one did not. Whole mouth plaque samples were collected by swab at baseline and every 6 months thereafter for a duration of 18 months and spiral plated for microbial counts (CFU/ml). Cut-offs based on percent of total cultivable flora were designated for all microbial measures. A scoring system designated the Plaque Microbial Index (PMI) was developed for use in statistical analyses to assess potential predictive factors for caries risk assessment. Children who developed caries were significantly more likely to harbor higher percentages of acid tolerant bacteria (p = 0.003), MS (p < 0.001) and have Candida species present (p < 0.001) at ≥1 visit leading up to caries onset. Mean PMI scores derived from the aforementioned microbial measures, were higher for caries active children than caries free children (p = 0.000147). Co-colonization of MS and Candida species was significantly associated with caries development (p < 0.001) and detection of both at the same visit had a 100% positive predictive value and 60% negative predictive value for caries development. In children who developed caries, there was a statistically significant association with the percent of total flora that was acid tolerant, the percent of MS, the presence of Candida and co-colonization of MS and Candida species. Combining these microbial measures into PMI scores further delineated children who developed caries from those who remained caries-free. These microbiological measures show potential as predictive factors and risk assessment tools for caries development.

The synergistic effects of hydroxychavicol and amphotericin B towards yeast-hyphae transition and the germination of Candida albicans

ObjectivesDimorphic transformation from yeast cells to hyphae is considered one of the major virulence factors of candidal species. The development of antifungal resistance against several candida diseases has led researchers to find plant derived alternatives. We aimed to determine the effect of hydroxychavicol (HC), Amphotericin B (AMB), and their combination (HC + AMB) on the transition and germination of oral Candida species. MethodsThe antifungal susceptibility of hydroxychavicol (HC) and Amphotericin B (AMB) separately and in a mixture (HC + AMB) against Candida albicans ATCC 14053, Candida parapsilosis ATCC 22019, Candida tropicalis ATCC 13803, and Candida dubliniensis ATCC MYA-2975 was determined by broth microdilution technique. Minimal Inhibitory Concentration was calculated based on the CLSI protocols. The MIC50, fractional inhibitory concentration (FIC) index, and IC50 were also determined. The IC50 values were used as the treatment concentration of HC, AMB, and HC + AMB to study the effect of antifungal inhibition on yeast hypha transition (gemination). The germ tube formation percentage of candida species was calculated at several intervals using a colorimetric assay. ResultsThe MIC50 range of HC alone against Candida species was between 120-240 µg per mL while that of AMB was between 2-8 µg per mL, respectively. The combination of HC + AMB at 1:1 and 2:1 demonstrated the strongest synergistic activity against C. albicans with an FIC index of 0.07. Moreover, within the first hour of treatment, the total percentage of germinating cells was significantly reduced by 79% (p < 0.05). ConclusionThe combination of HC + AMB displayed synergism and inhibited C. albicans hyphal growth. HC + AMB combination slowed the germination process and exhibited consistent prolonged effect up to 3 h post-treatment. The results of this study will pave the way for potential in vivo studies.

Novel vinegar solution for denture-cleansing agent.

To study the antimicrobial effects of a novel vinegar-based denture cleansing agent on oral Streptococci and Candida species and the inhibitory effects on pre-formed bacterial and Candida biofilms on denture base. The microorganisms used in this study were Streptococcus mutans (S. mutans), Streptococcus sobrinus (S. sobrinus), Streptococcus sanguinis (S. sanguinis), Candida albicans (C. albicans), and Candida glabrata (C. glabrata). The antimicrobial activity of novel vinegar solution was evaluated by time kill assay and biofilm grown on denture base. Time kill assay showed that vinegar exhibited the highest antibacterial effect on S. sobrinus, S. sanguinis, and S. mutans after 15 min of treatment. A 99.9% reduction in C. glabrata and C. albicans required more than 4 and 6 h of treatment, respectively. Vinegar significantly inhibited streptococcal biofilm, with an approximately 6 log-reduction at 30 min of treatment. The results demonstrated that viable Candida cells in biofilm reduced in excess of 6-log CFU/mL after 3 h treatment with vinegar. Moreover, the vinegar-based denture cleanser inhibited bacterial and Candida biofilm formation compared to the control group without treatment with statistical significance. A novel vinegar-based denture cleansing agent showed moderate antibacterial properties, but required a slightly longer immersion time to attain anticandidal effects compared to Polident and 0.2% CHX.

Incidence and prevalence of oral candidal colonization in patients with cleft lip and palate.

This study aims to assess and compare the incidence and rate of oral candidal colonization in patients with cleft lip and palate and collate it with healthy individuals. The objectives of this study were to evaluate the factors that may affect the incidence, rate, and polycolonity of colonization of oral Candida species in patients with cleft lip and palate (CLP) as compared to healthy individuals. The current prospective study involved the collection and assessment of oral samples from 50 CLP patients and compared it with oral samples from 50 healthy individuals. Colonies of Candida albicans and other Candida species were identified by using germ tube test and differential chromogenic media. Assessment of the distribution trend of various Candida species and their variation based on age, gender, type of cleft, number of surgeries, and oral hygiene status were recorded. A highly significant (P value < 0.001) statistical difference was seen in the oral carriage rate of Candida species between the two groups with values more in the study group (60.75 ± 71.43) than in controls (1.62 ± 2.22). Individually comparing the different Candida species, significant difference in presence of C albicans (P value = 0.004), C parapsilosis (P value = 0.015), and C dubliensis (P value = 0.027) was seen as compared to other species. In the context of the type of cleft and the presence of Candida species Candida albicans was the most prevalent in patients with the cleft alveolus (60.0% n = 15), unilateral CLP (66.7% n = 8), and bilateral CLP (100.0% n = 3) respectively. Nonsignificant variation in prevalence was seen in the various fungal species based on an individual's gender and oral hygiene and the number of surgeries status was observed. The anatomical alteration in the oral cavity of patients with CLP contributes to the high incidence and prevalence of Candida species.

Real-time Assessment of Interspecies Candida Biofilm Formation

Background: Candida infections are responsible for increased morbidity and mortality in immunocompromised patients, with Candida having the ability to form highly structured biofilms that protect them from the external environment and the action of antifungals. Few studies have reported on real-time interactions between Candida species. Objective: This study aimed to investigate the interspecies biofilm changes of oral Candida species using the xCELLigence system and the CV staining technique. Methods: This study demonstrated the mixed biofilm interactions of Candida species using an impedance-based biofilm monitoring system and crystal violet staining. Results: When using the xCELLigence system, the maximum cell index increased in most mixed biofilms, except for the C. glabrata/C. parapsilosis and C. albicans combinations. Bulk biofilm formation measured by CV staining was the highest in C. albicans and C. tropicalis combinations and the lowest in the C. glabrata/C. parapsilosis combination. Pseudohyphae were observed in C. albicans and C. glabrata in combination with C. tropicalis or C. parapsilosis. Conclusion: This study is the first to report on the real-time interactions of Candida species using the xCELLigence system and suggests that the presence of specific species influences the biofilm formation of commonly isolated Candida species.

Comparison of the in vitro susceptibility of isolated oral Candida species of uncontrolled diabetic patients to Nystatin and Fluconazole

Comparison of the in vitro susceptibility of isolated oral Candida species of uncontrolled diabetic patients to Nystatin and Fluconazole

Comparison of Effect of Aloe vera Gel and Nystatin on Candida Species: An In Vitro Study

Background: Oral candidiasis is an opportunistic fungal infection that leads to acute and chronic infections in the mouth and gastrointestinal tract. According to studies, common antifungal drugs have some side effects and sometimes fail in Candida albicans candidiasis infections. Objectives: This study aimed to compare the efficacy of Aloe vera to that of nystatin on oral Candida species in vitro. Methods: This laboratory study was prepared in vitro from a collection of fungi and bacteria in Iran. The measured inhibitory concentration was within the range of 1:1 to 1:2048. The data were analyzed using SPSS software (version 24). Results: In C. albicans species, the inhibitory concentration of Aloe vera gel was 312.5 μL/mL. The inhibitory concentrations for Candida glabrata and Candida tropicalis were 1250 and 625 μL/mL, respectively. In all groups, there was a significant relationship between Aloe vera and nystatin. Conclusions: Aloe vera gel showed antifungal properties in all tested species. The inhibitory concentrations of Aloe vera were much higher than nystatin. Therefore, to use this plant for humans, the concentration of its toxicity to humans should be estimated beforehand to avoid possible harm.

Molecular Identification and Caspofungin Susceptibility Profile in Comparison to Oregano Antifungal Effects on Oral Candida Isolates

Background: Candida species have an unstable resistance to common antifungal drugs. The treatment of oral candidiasis requires the identification of new anti-Candida agents with no side effects like medicinal plants. Objectives: The present study aims to investigate the antifungal effects of caspofungin and oregano essential oil on oral Candida species isolated from cancer patients. Methods: Seventy-three Candida species were identified and isolated by conventional and microbiological tests from cancer patients (n = 100) suspected of oral candidiasis. The minimum inhibitory concentrations (MICs) of the oregano essential oil and caspofungin were determined by microdilution assay and evaluated according to the Clinical and Laboratory Standards Institute (CLSI-2017). The gene regions of samples were studied using the polymerase chain reaction (PCR) method. Results: Candida glabrata (35, 47.9%) was the predominant species. Most of the Candida strains were isolated from patients with stomach cancer (35, 47.9%). The highest resistance to caspofungin was reported for C. albicans (5.5%). Also, FKS mutant isolates were associated with resistance to caspofungin. MIC90 value for oregano essential oil against C. albicans was 4096 µL/mL, which was equal to MIC90 value against C. glabrata. There was a significant difference between the MICs of caspofungin and oregano essential oil, that inhibits the growth of Candida isolates. Conclusions: The results of this study showed that the caspofungin has high antifungal effect on Candida species, specially non-albicans Candida. As the findings indicated, the oregano had good anti-Candida potent. Therefore, we could hope to treat fungal diseases by producing an appropriate herbal medicine.

Effect of fluocinolone acetonide (0.1%) treatment in oral lichen planus patients on salivary lactoferrin levels and Candida colonization: a prospective study

BackgroundAlthough topical steroids are an effective treatment for oral lichen planus, they can have suppressive effects on oral immunity and predispose the patients to Candida overgrowth. Lactoferrin is a crucial local immunity protein in the oral cavity with important antimicrobial activity. The aim of this study was to prospectively investigate salivary lactoferrin secretion levels and Candida colonization in oral lichen planus patients treated with fluocinolone acetonide 0.1% in orabase.MethodsSaliva samples were collected from 15 oral lichen planus subjects who had never received topical steroid treatment prior to this study and 15 healthy volunteers to determine their salivary lactoferrin levels using an enzyme-linked immunosorbent assay and to investigate the presence of oral Candida species at baseline and 3 months after treatment with fluocinolone acetonide 0.1% in orabase. Statistical analysis was performed to compare lactoferrin secretion and Candida colonization levels between the groups using the Mann–Whitney U test for independent data or the Wilcoxon Signed-Rank test for paired data.ResultsThe salivary lactoferrin secretion level was not significantly different between the control group and oral lichen planus patients or between before and after treatment with fluocinolone acetonide 0.1% in orabase (P > 0.05). Candida was detected in 11 (73.33%) healthy volunteers, 8 (53.33%) oral lichen planus patients before treatment, and 9 (60%) oral lichen planus patients after treatment with fluocinolone acetonide 0.1% in orabase. There was no significant difference in Candida counts between the groups (P > 0.05).ConclusionOur study indicates that using fluocinolone acetonide 0.1% in orabase to treat oral lichen planus for 3 months did not affect salivary lactoferrin protein secretion or Candida carriage.Trial registration The trial was registered at the Thai Clinical Trials Registry (TCTR identifier: TCTR20200723002).

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.