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What Is Candida Doing in My Food? A Review and Safety Alert on Its Use as Starter Cultures in Fermented Foods. Microorganisms 2022; 10:microorganisms10091855. [PMID: 36144457 PMCID: PMC9502980 DOI: 10.3390/microorganisms10091855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 09/02/2022] [Accepted: 09/07/2022] [Indexed: 12/02/2022] Open
Abstract
The use of yeasts as starter cultures was boosted with the emergence of large-scale fermentations in the 20th century. Since then, Saccharomyces cerevisiae has been the most common and widely used microorganism in the food industry. However, Candida species have also been used as an adjuvant in cheese production or as starters for coffee, cocoa, vegetable, meat, beer, and wine fermentations. A thorough screening of candidate Candida is sometimes performed to obtain the best performing strains to enhance specific features. Some commonly selected species include C. pulcherrima (teleomorph Metschnikowia pulcherrima) (wine), C. parapsilosis (teleomorph Monilia parapsilosis) (coffee), C. famata (teleomorph Debaryomyces hansenii) (cheese), and C. zeylanoides (teleomorph Kurtzmaniella zeylanoides) and C. norvegensis (teleomorph Pichia norvegensis) (cocoa). These species are associated with the production of key metabolites (food aroma formation) and different enzymes. However, safety-associated selection criteria are often neglected. It is widely known that some Candida species are opportunistic human pathogens, with important clinical relevance. Here, the physiology and metabolism of Candida species are addressed, initially emphasizing their clinical aspects and potential pathogenicity. Then, Candida species used in food fermentations and their functional roles are reported. We recommended that Candida not be used as food cultures if safety assessments are not performed. Some safety features are highlighted to help researchers choose methods and selection criteria.
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Mussi MCM, Fernandes KS, Gallottini MHC. A call for further research on the relation between type 2 diabetes and oral candidiasis. Oral Surg Oral Med Oral Pathol Oral Radiol 2022; 134:206-212. [PMID: 35422408 DOI: 10.1016/j.oooo.2022.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Revised: 02/18/2022] [Accepted: 02/22/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVE This study aimed to evaluate the relationship between oral candidiasis with salivary features, neutrophil function, and glycemic control in type 2 diabetes (T2D). DESIGN Twenty-nine individuals were included, 16 with T2D and 13 without the disease. The participants underwent clinical examination, neutrophilic function tests, fasting glycemia and glycated hemoglobin (A1c), stimulated and unstimulated saliva collection, and swab and exfoliative cytology. Salivary flow, pH, and total fungi count were evaluated on saliva, and identification of the Candida species was performed in saliva and swab samples. RESULTS There was no difference in unstimulated salivary flow and pH of the stimulated and unstimulated saliva for participants with T2D and controls (P > .05). Individuals from both groups presented no candidal lesions. The salivary fungal growth in the T2D group was higher than that in controls (P < .05). Only individuals with T2D presented alterations in the neutrophilic functions (14/16; 87.5%; P < .05). There was no relationship between high A1c values and neutrophil dysfunction with the presence of Candida spp. in both saliva and mucosa (P > .05). CONCLUSIONS High A1c level, reduction in neutrophil activity, salivary flow and pH, and increase in total salivary Candida spp. counts were not related to oral candidiasis in patients with T2D.
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Roudbar Mohammadi S, Zarei N, Roudbary M, dos Santos AS, Nikoomanesh F, Mohammadi R, Shirvan B, Yaalimadad S. Prevalence, molecular identification, and genotyping of Candida species recovered from oral cavity among patients with diabetes mellitus from Tehran, Iran. Adv Biomed Res 2022; 11:29. [PMID: 35722454 PMCID: PMC9201225 DOI: 10.4103/abr.abr_26_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 05/28/2021] [Accepted: 11/15/2021] [Indexed: 11/04/2022] Open
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Duggal R, Goswami R, Xess I, Duggal I, Talwar A, Mathur VP. Prevalence of species-specific candidiasis and status of oral hygiene and dentition among diabetic patients: A hospital-based study. Indian J Dent Res 2021; 32:292-298. [PMID: 35229766 DOI: 10.4103/ijdr.ijdr_827_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Objective 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. Methodology 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. Results 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. Conclusion 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.
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Affiliation(s)
- Ritu Duggal
- Division of Orthodontics & Dentofacial Deformities, CDER, All India Institute of Medical Sciences, New Delhi, India
| | - Ravinder Goswami
- Department of Endocrinology & Metabolism, CDER, All India Institute of Medical Sciences, New Delhi, India
| | - Immaculata Xess
- Department of Microbiology, CDER, All India Institute of Medical Sciences, New Delhi, India
| | - Isha Duggal
- Division of Orthodontics & Dentofacial Deformities, CDER, All India Institute of Medical Sciences, New Delhi, India
| | - Aditya Talwar
- Division of Orthodontics & Dentofacial Deformities, CDER, All India Institute of Medical Sciences, New Delhi, India
| | - Vijay Prakash Mathur
- Division of Pedodontics & Preventive Dentistry, CDER, All India Institute of Medical Sciences, New Delhi, India
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Potential Pathogenicity of Candida Species Isolated from Oral Cavity of Patients with Diabetes Mellitus. BIOMED RESEARCH INTERNATIONAL 2021; 2021:9982744. [PMID: 34136578 PMCID: PMC8175137 DOI: 10.1155/2021/9982744] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 04/18/2021] [Accepted: 05/12/2021] [Indexed: 01/12/2023]
Abstract
Introduction In the recent decade, the increased immunocompromised population such as diabetic patients makes a high incidence of invasive Candida infections. Diabetes mellitus is the most common endocrine metabolic disorder, and diabetic patients are more susceptible to oral candidiasis infection. Candidiasis is an opportunistic fungal infection caused by many species of Candida. Secretion of exoenzymes plays an important role in the virulence and pathogenesis of Candida species. The aim of this study was to evaluate the potential role of phospholipase, esterase, and hemolytic activity of Candida species isolated from oral cavity lesions of diabetic patients. Methods A total of 108 Candida species including 75 Candida albicans and 33 non-Candida albicans species were recovered from the oral cavity of diabetic patients included in our study. Egg yolk agar, Tween 80 opacity medium, and blood agar plate assays were used for determining phospholipase, esterase, and hemolytic activities, respectively. Results Candida albicans species had the most exoenzyme activity in comparison to non-albicans isolates. Candida albicans isolates showed 97.3%, 100%, and 77.3% phospholipase, hemolysin, and esterase activities, respectively. The difference between Candida albicans and non-Candida albicans was significant in phospholipase (P < 0.001) and hemolytic activity (P = 0.027), but not significant in esterase activity (P = 0.076). Conclusion This study showed that most of the isolates had different enzymatic patterns, and Candida albicans isolates had the most exoenzyme activity. So due to the potential effects of these enzymes in pathogenesis and virulence effects of Candida species, we can conclude that the severity of extracellular enzymes may play a role in the severity of signs and symptoms of Candida oral cavity infections in diabetic patients.
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Vijayalakshmi L, Raj JS, Kavitha J, Krishnaraj S, Manovijay B, Manikandan D. A case–control study to evaluate candidal parameters in the oral cavity of patients with type 2 diabetes mellitus. J Pharm Bioallied Sci 2020; 12:S389-S393. [PMID: 33149492 PMCID: PMC7595499 DOI: 10.4103/jpbs.jpbs_115_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 02/06/2020] [Accepted: 04/28/2020] [Indexed: 11/18/2022] Open
Abstract
Aim: The aim of this study was to evaluate candidal parameters in the oral cavity of patients with type 2 diabetes mellitus (DM). Materials and Methods: The samples included in the study were divided into two groups: group A, comprises 50 patients with type 2 DM, and group B, comprises 30 subjects who were nondiabetic. A nonrandom consecutive sampling technique was used to enroll the subjects for the study. The χ2 test was used to examine the characteristics of the samples. Results: The results found that there is a significant difference in saliva and swab for Candida growth between patients with type 2 DM and normal healthy individuals. Swab had shown slightly more Candida growth than saliva in group A (type 2 DM). No significant variation in Candida growth was found. Candida krusei was seen in normal healthy individuals alone. In antifungal susceptibility pattern to various antifungal agents, Candida tropicalis has shown a significant result for various antifungal agents whereas Candida albicans and Candida dubliniensis did not show any significant result for various antifungal agents used in group A (patients with type 2 DM). Conclusion: Diabetic individuals who are prone to a hyperglycemic state favors the growth and establishment of Candida species. Although a smaller percentage of multidrug-resistant Candida species has been observed in the saliva of patients with type 2 DM.
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Impact of Cigarette Smoke Condensate on Adhesion-Related Traits and Hemolysin Production of Oral Candida dubliniensis Isolates. Mycopathologia 2019; 185:289-297. [PMID: 31792662 DOI: 10.1007/s11046-019-00411-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 11/25/2019] [Indexed: 12/19/2022]
Abstract
BACKGROUND Cigarette smoke is associated with higher oral Candida carriage and possible predisposition and increased susceptibility to oral candidal infection. Candida dubliniensis is associated with oral candidosis. Candidal adherence to buccal epithelial cells (BEC) and denture acrylic surfaces (DAS), germ tube (GT) formation, cell surface hydrophobicity (CSH) and hemolysin production are pathogenic traits of Candida. OBJECTIVES The impact of exposure to cigarette smoke on the aforementioned pathogenic attributes of oral C. dubliniensis has not been studied. Hence, the impact of cigarette smoke condensate (CSC) on adhesion to BEC and DAS, GT formation, CSH and hemolysin production of 20 oral C. dubliniensis isolates after exposure to CSC for 24, 48 and 72 h was ascertained. METHODS After preparation of the CSC, using an in-house smoking device, the Candida isolates were exposed to the CSC for 24, 48 and 72 h, by a previously described in vitro method. Thereafter, the adhesion to BEC and DAS, GT formation, CSH and hemolysin production of C. dubliniensis isolates was investigated by hitherto described in vitro assays. RESULTS Exposure to CSC significantly increased the ability of C. dubliniensis oral isolates to adhere to BEC, DAS, GT formation, CSH and produce hemolysin following 24-h, 48-h and 72-h exposure periods to CSC (P < 0.001 for all attributes tested). CONCLUSIONS Exposure of oral C. dubliniensis isolates to CSC may significantly promote in vitro adhesion traits and hemolysin production of these isolates, thereby augmenting its pathogenicity in vitro in the presence of cigarette smoke.
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Taei M, Chadeganipour M, Mohammadi R. An alarming rise of non-albicans Candida species and uncommon yeasts in the clinical samples; a combination of various molecular techniques for identification of etiologic agents. BMC Res Notes 2019; 12:779. [PMID: 31783903 PMCID: PMC6883655 DOI: 10.1186/s13104-019-4811-1] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 11/14/2019] [Indexed: 01/26/2023] Open
Abstract
OBJECTIVE Yeasts are unicellular microorganisms may cause systemic infection in immunocompromised patients. The aim of this study was to identify yeast strains isolated from clinical specimens using molecular techniques. RESULTS A total of 202 yeast strains isolated from 341 clinical samples between February 2017 and May 2019. All clinical isolates were identified using phenotypic and molecular tests including PCR-RFLP, duplex-PCR, multiplex-PCR, and PCR-sequencing. The most yeast fungal isolates were obtained from urine (66.8%), nail (9.4%), skin lesion (7.9%), bronchoalveolar lavage (5.9%), and blood (3.9%). One hundred and twenty-one Candida species were identified as non-albicans versus 76 Candida albicans. Trichosporon asahii, and Pichia terricola were uncommon non-Candida yeasts isolated from urine samples. For the first time, we isolated P. terricola as etiological agent of urinary tract infection in a pregnant female. Since Candida species show different levels of resistance to antifungal agents, precise identification of clinical isolates is critical for better treatment of infection.
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Affiliation(s)
- Monireh Taei
- Department of Medical Parasitology and Mycology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mostafa Chadeganipour
- Department of Medical Parasitology and Mycology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Rasoul Mohammadi
- Department of Medical Parasitology and Mycology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran. .,Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
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Candida sp. Infections in Patients with Diabetes Mellitus. J Clin Med 2019; 8:jcm8010076. [PMID: 30634716 PMCID: PMC6352194 DOI: 10.3390/jcm8010076] [Citation(s) in RCA: 123] [Impact Index Per Article: 24.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 12/27/2018] [Accepted: 01/03/2019] [Indexed: 02/07/2023] Open
Abstract
Candidiasis has increased substantially worldwide over recent decades and is a significant cause of morbidity and mortality, especially among critically ill patients. Diabetes mellitus (DM) is a metabolic disorder that predisposes individuals to fungal infections, including those related to Candida sp., due to a immunosuppressive effect on the patient. This review aims to discuss the latest studies regarding the occurrence of candidiasis on DM patients and the pathophysiology and etiology associated with these co-morbidities. A comprehensive review of the literature was undertaken. PubMed, Scopus, Elsevier’s ScienceDirect, and Springer’s SpringerLink databases were searched using well-defined search terms. Predefined inclusion and exclusion criteria were applied to classify relevant manuscripts. Results of the review show that DM patients have an increased susceptibility to Candida sp. infections which aggravates in the cases of uncontrolled hyperglycemia. The conclusion is that, for these patients, the hospitalization periods have increased and are commonly associated with the prolonged use of indwelling medical devices, which also increase the costs associated with disease management.
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Ellepola ANB, Dassanayake RS, Khan Z. In vitro Post-Antifungal Effect of Posaconazole and Its Impact on Adhesion-Related Traits and Hemolysin Production of Oral Candida dubliniensis Isolates. Med Princ Pract 2019; 28:552-558. [PMID: 31247626 PMCID: PMC6944866 DOI: 10.1159/000501764] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Accepted: 06/27/2019] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Candidal adherence to denture acrylic surfaces (DAS) and oral buccal epithelial cells (BEC), formation of candidal germ tubes (GT), candidal cell surface hydrophobicity (CSH), and hemolysin production are important pathogenic traits of Candida. The antifungal drug-induced post-antifungal effect (PAFE) also impacts the virulence of Candida. Candida dubliniensis isolates are associated with the causation of oral candidiasis which could be managed with posaconazole. Thus far there is no evidence on posaconazole-induced PAFE and its impact on adhesion-related attributes and production of hemolysin by C. dubliniensis isolates. Hence, the PAFE, adhesion to DAS and BEC, formation of GT, CSH, and hemolysin production of 20 oral C. dubliniensis isolates after brief exposure to posaconazole was ascertained. MATERIALS AND METHODS The PAFE, adherence to DAS and BEC, formation of GT, candidal CSH, and hemolysin production were investigated by hitherto described in vitro assays. RESULTS The mean PAFE (h) induced by posaconazole on C. dubliniensis isolates was 1.66. Exposure to posaconazole suppressed the ability of C. dubliniensis to adhere to DAS, BEC, formation of candidal GT, candidal CSH and to produce hemolysin by a reduction of 44, 33, 34, 36, and 15% (p < 0.005 to p < 0.001), respectively. CONCLUSION Exposure of C. dubliniensis isolates to posaconazole for a brief period induced an antimycotic impact by subduing its growth in addition to suppressing pathogenic adherence-associated attributes, as well as production of hemolysin.
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Affiliation(s)
| | | | - Ziauddin Khan
- Faculty of Medicine, Health Sciences Center, Kuwait University, Kuwait, Kuwait
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Andrade MRTC, Curvelo JADR, de Moraes DC, Portela M, Ferreira-Pereira A, Soares RMDA, Primo LG. Salivary pH and colonization by oral Candida in children and adolescents submitted to haemodialysis. Int J Paediatr Dent 2018; 28:533-539. [PMID: 29974548 DOI: 10.1111/ipd.12403] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Fungal infections are a serious problem among haemodialysis patients. AIM The aims of this study were to estimate the frequency of oral Candida species among children and adolescents undergoing haemodialysis (HD), to identify the isolated species, and to study the relationship between haemodialysis duration, amounts of colony-forming units, and salivary pH. DESIGN A matched sample of 52 patients undergoing HD and 52 healthy individuals were selected. The samples were obtained from the dorsum of the tongue, and the colonies were identified through a substrate assimilation test. Stimulated whole saliva was collected from each patient for evaluation of salivary pH. RESULTS The frequency of oral Candida species was 34.6% (18/52) and 46.20% (24/52) in the HD and control groups (P = 0.23), respectively. Candida parapsilosis complex was the most frequently isolated fungi species in the HD group (P = 0.03). A HD therapy duration of more than 1 year was statistically correlated with a higher number of colony-forming units (P = 0.03) but was not statistically related to salivary pH. CONCLUSIONS Candida parapsilosis complex was the most frequently isolated fungal species in the young HD patients, and the duration therapy was associated with higher oral colonization.
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Affiliation(s)
| | | | - Daniel Clemente de Moraes
- Institute of Microbiology Professor Paulo de Goés, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
| | - Maristela Portela
- Department of Clinics and Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal Fluminense, Niteroi, RJ, Brasil
| | - Antonio Ferreira-Pereira
- Institute of Microbiology Professor Paulo de Goés, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
| | | | - Laura Guimarães Primo
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
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Costa AL, Silva BMA, Soares R, Mota D, Alves V, Mirante A, Ramos JC, Maló de Abreu J, Santos-Rosa M, Caramelo F, Gonçalves T. Type 1 diabetes in children is not a predisposing factor for oral yeast colonization. Med Mycol 2018; 55:358-367. [PMID: 27664993 DOI: 10.1093/mmy/myw092] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Accepted: 08/06/2016] [Indexed: 12/16/2022] Open
Abstract
Type 1 diabetes mellitus (T1D) is considered a risk factor associated with oral yeast infections. The aim of this study was to evaluate the yeast oral carriage (in saliva and mucosal surface) of children with T1D and potential relation with host factors, particularly the subset of CD4+ T cells. Yeasts were quantified and identified in stimulated saliva and in cheek mucosal swabs of 133 diabetic T1D and 72 healthy control subjects. Salivary lymphocytes were quantified using flow cytometry. The presence of yeasts in the oral cavity (60% of total patients) was not affected by diabetes, metabolic control, duration of the disease, salivary flow rate or saliva buffer capacity, by age, sex, place of residence, number of daily meals, consumption of sweets or frequency of tooth brushing. Candida albicans was the most prevalent yeast species, but a higher number of yeast species was isolated in nondiabetics. T1D children with HbA1c ≤ 7.5 (metabolically controlled) presented higher number of CD4+ T salivary subsets when compared with the other groups of children (non-diabetic and nonmetabolically controlled) and also presented the highest number of individuals without oral yeast colonization. In conclusion, T1D does not predisposes for increased oral yeast colonization and a higher number of salivary CD4+T cells seems to result in the absence of oral colonization by yeasts.
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Affiliation(s)
- Ana L Costa
- FMUC, Faculty of Medicine, University of Coimbra, Portugal
| | - Branca M A Silva
- CNC, Centre for Neurosciences and Cell Biology, University of Coimbra, Portugal
| | - Rui Soares
- FMUC, Faculty of Medicine, University of Coimbra, Portugal.,CNC, Centre for Neurosciences and Cell Biology, University of Coimbra, Portugal
| | - Diana Mota
- FMUC, Faculty of Medicine, University of Coimbra, Portugal
| | - Vera Alves
- FMUC, Faculty of Medicine, University of Coimbra, Portugal
| | | | - João C Ramos
- FMUC, Faculty of Medicine, University of Coimbra, Portugal
| | | | | | - Francisco Caramelo
- FMUC, Faculty of Medicine, University of Coimbra, Portugal.,Laboratory of Biostatistics and Medical Informatics, IBILI
| | - Teresa Gonçalves
- FMUC, Faculty of Medicine, University of Coimbra, Portugal.,CNC, Centre for Neurosciences and Cell Biology, University of Coimbra, Portugal
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Ellepola ANB, Dassanayake RS, Khan Z. Impact of Brief Exposure to Drugs with Antifungal Properties on the Susceptibility of Oral Candida dubliniensis Isolates to Lysozyme and Lactoferrin. Med Princ Pract 2018; 27:523-530. [PMID: 30173211 PMCID: PMC6422280 DOI: 10.1159/000493391] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2018] [Accepted: 09/02/2018] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Lysozyme and lactoferrin have anti-candidal activity. Candida dubliniensis is associated with oral candidiasis. Candida infections are managed with nystatin, amphotericin B, caspofungin, ketoconazole, fluconazole, and chlorhexidine. Candida species undergo a brief exposure to therapeutic agents in the mouth. There is no data on the influence of limited exposure to antimycotics on the sensitivity of C. dubliniensis to lactoferrin and lysozyme. Hence, this study observed the changes in the sensitivity of C. dubliniensis to anti-candidal action of lactoferrin and lysozyme after transitory exposure to sub-lethal concentrations of antifungals. MATERIALS AND METHODS After determination of the minimum inhibitory concentration (MIC), 20 C. dubliniensis isolates were exposed to twice the concentration of MIC of nystatin, amphotericin B, caspofungin, ketoconazole, fluconazole, and chlorhexidine for 1 h. Drugs were removed by dilution and thereafter the susceptibility of these isolates to lysozyme and lactoferrin was determined by colony-forming unit quantification assay. RESULTS Exposure of C. dubliniensis to nystatin, amphotericin B, caspofungin, ketoconazole, fluconazole, and chlorhexidine resulted in an increase in susceptibility to lysozyme by 9.45, 30.82, 30.04, 50.64, 55.60, and 50.18%, respectively (p < 0.05 to p < 0.001). Exposure of C. dubliniensis to nystatin, amphotericin B, caspofungin, ketoconazole, fluconazole, and chlorhexidine resulted in an increase in susceptibility to lactoferrin by 13.54, 16.43, 17.58, 19.60, 21.32, and 18.73, respectively (p < 0.05 to p < 0.001). CONCLUSION Brief exposure to nystatin, amphotericin B, caspofungin, ketoconazole, fluconazole, and chlorhexidine enhances the antifungal effect of lysozyme and lactoferrin on C. dubliniensis isolates in vitro.
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Affiliation(s)
| | | | - Ziauddin Khan
- Faculty of Medicine, Health Sciences Center, Kuwait University, Safat, Kuwait
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14
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Patel PN, Sah P, Chandrashekar C, Vidyasagar S, Venkata Rao J, Tiwari M, Radhakrishnan R. Oral candidal speciation, virulence and antifungal susceptibility in type 2 diabetes mellitus. Diabetes Res Clin Pract 2017; 125:10-19. [PMID: 28131069 DOI: 10.1016/j.diabres.2017.01.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Revised: 12/17/2016] [Accepted: 01/06/2017] [Indexed: 11/21/2022]
Abstract
OBJECTIVES To determine the oral candidal carriage (OCC), activity of virulent factors and fluconazole susceptibility in subjects with type 2 diabetes mellitus (T2DM) and investigate their association with HbA1c measurements. MATERIALS AND METHODS A cross sectional study was conducted on 100 diabetics and 100 healthy volunteers. The virulence was assessed by measuring the phospholipase activity and proteolysis index. Fluconazole susceptibility was performed using the gradient diffusion method. The OCC, virulence factors and antifungal susceptibility were correlated with patients' HbA1c measurements. RESULTS The OCC and candidal density carriage was significantly higher in diabetics. Candida albicans (C. albicans) was the most frequently isolated species followed by Candida tropicalis (C. tropicalis). Relatively uncommon species, Candida lusitaniae (C. lusitaniae) and Candida lipolytica (C. lipolytica) were isolated from the diabetics. Prevalence of virulence factor, proteinase, was greater in diabetic group (p<0.05). Reduced fluconazole susceptibility was noted among the isolates from diabetics; however it was not statistically significant (p=0.593). Except one, all the susceptible-dose dependent and resistant isolates were Candida no-albicans (C. non-albicans). CONCLUSION C. albicans remains the predominant pathogen in diabetics, although other species are on the rise. Compared to control group, the isolated species from T2DM group had higher proteinase activity. Resistance to fluconazole was considerably greater among the C. non-albicans isolates from T2DM group. These findings warrant effective treatment modalities to reduce the occurrence of oropharyngeal candidiasis.
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Affiliation(s)
- Pratik N Patel
- Department of Oral Pathology and Microbiology, MCODS, Manipal, Manipal University, Karnataka, India
| | - Parul Sah
- Department of Oral Pathology and Microbiology, MCODS, Manipal, Manipal University, Karnataka, India
| | - Chetana Chandrashekar
- Department of Oral Pathology and Microbiology, MCODS, Manipal, Manipal University, Karnataka, India
| | - Sudha Vidyasagar
- Department of Medicine, KMC, Manipal, Manipal University, Karnataka, India
| | - J Venkata Rao
- Department of Pharmaceutical Biotechnology and Microbiology, MCOPS, Manipal, Manipal University, Karnataka, India
| | - Mradul Tiwari
- Department of Pharmaceutical Biotechnology and Microbiology, MCOPS, Manipal, Manipal University, Karnataka, India
| | - Raghu Radhakrishnan
- Department of Oral Pathology and Microbiology, MCODS, Manipal, Manipal University, Karnataka, India.
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Ellepola ANB, Jayathilake JAMS, Sharma PN, Khan ZU. Impact of short-term exposure of antifungal agents on hemolysin activity of oral Candida dubliniensis isolates from Kuwait and Sri Lanka. JOURNAL OF INVESTIGATIVE AND CLINICAL DENTISTRY 2016; 7:424-430. [PMID: 26059506 DOI: 10.1111/jicd.12167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2015] [Accepted: 05/16/2015] [Indexed: 06/04/2023]
Abstract
OBJECTIVE Ability to produce hemolysin by Candida species is an important determinant of its pathogenicity. Candida dubliniensis is implicated in the causation of oral candidosis, which can be treated with polyene, echinocandin, and azole groups of antifungal agents as well as chlorhexidine. After oral application, however, the concentrations of these agents tend to decrease quickly to subtherapeutic levels due to the peculiarity of the oral environment. In this study, we have evaluated the effect of short-term exposure of sublethal concentrations of these drugs on hemolysin production by oral C. dubliniensis isolates obtained from two different geographical locale. MATERIALS AND METHODS Twenty C. dubliniensis oral isolates obtained from Kuwait and Sri Lanka were exposed to sublethal concentrations of nystatin, amphotericin B, caspofungin, ketoconazole, fluconazole, and chlorhexidine for 1 h. Thereafter, the drugs were removed by dilution and the hemolysin production determined by a previously described plate assay. RESULTS Hemolysin production of these isolates was significantly suppressed with a percentage reduction of 17.09, 16.45, 17.09, 11.39, 8.23 and 12.03 following exposure to nystatin, amphotericin B, caspofungin, ketoconazole, fluconazole, and chlorhexidine, respectively. CONCLUSION Brief exposure to sublethal concentrations of drugs with antifungal properties appears to reduce the pathogenic potential of C. dubliniensis isolates by suppressing hemolysin production.
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Affiliation(s)
- Arjuna N B Ellepola
- Faculty of Dentistry, Health Sciences Center, Kuwait University, Jabriya, Kuwait.
| | | | - Prem N Sharma
- Faculty of Medicine, Health Sciences Center, Kuwait University, Jabriya, Kuwait
| | - Zia U Khan
- Faculty of Medicine, Health Sciences Center, Kuwait University, Jabriya, Kuwait
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16
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Lydia Rajakumari M, Saravana Kumari P. Prevalence of Candida species in the buccal cavity of diabetic and non-diabetic individuals in and around Pondicherry. J Mycol Med 2016; 26:359-367. [PMID: 27601306 DOI: 10.1016/j.mycmed.2016.08.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Revised: 07/29/2016] [Accepted: 08/02/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVES The aim of the present study was to determine the prevalence of Candida in the buccal cavity of diabetic and non-diabetic individuals in and around Pondicherry, India and to analyse the antifungal susceptibility profile of the selected isolates. MATERIALS AND METHODS A total of 400 buccal samples, 200 each from diabetic and non-diabetic healthy individuals were included in the study. Sabouraud's dextrose agar was used for isolation of Candida species. Identification was performed through microscopy, germ tube test, sugar fermentation test, sugar assimilation test and by using Hichrome agar. Distinct and phenotypically representative colonies were selected and subjected to ITS analysis. In vitro antifungal susceptibility testing for the isolated Candida species was performed using E-test. RESULTS Results revealed that the prevalence of Candida species in diabetic individuals was higher when compared with non-diabetic healthy individuals. The most predominantly isolated species in diabetic and non-diabetic individuals from buccal cavity was Candida albicans. C. tropicalis was predominant among the non-albicans Candida isolated from both diabetic and non-diabetic individuals. Among denture wearers C. glabrata was predominant. In vitro antifungal susceptibility testing shows that ketoconazole, fluconazole and itraconazole were effective against the isolated Candida species. CONCLUSIONS The rate of candidal carriage in diabetic individuals is higher. Different species of Candida are present in the oral cavity of diabetic individuals. There may be a positive correlation between glycemic control and candidal colonization. In vitro antifungal susceptibility testing of Candia species are required for proper management and treatment of candidal infections.
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Affiliation(s)
- M Lydia Rajakumari
- Research and Development Centre, Bharathiar University, Coimbatore, Tamil Nadu, India; Department of Microbiology, Indira Gandhi College of Arts and Science, Kathirkamam, Pondicherry 605009, India.
| | - P Saravana Kumari
- Department of Microbiology, Sree Narayana Guru College, Coimbatore, Tamil Nadu, India
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17
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Minea B, Nastasa V, Kolecka A, Mares M, Marangoci N, Rosca I, Pinteala M, Hancianu M, Mares M. Etiologic Agents and Antifungal Susceptibility of Oral Candidosis from Romanian patients with HIV-infection or type 1 diabetes mellitus. Pol J Microbiol 2016; 65:123-9. [PMID: 27282005 DOI: 10.5604/17331331.1197327] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
This is the first Romanian investigation of oral candidosis in patients suffering of HIV-infection or type 1 diabetes mellitus (T1DM). Candida albicans was the dominant species in both types of isolates: n = 14 (46.7%) in T1DM, n = 60 (69.8%) in HIV. The most frequent non-albicans Candida spp. were Candida kefyr (n = 6; 20%) in T1DM and Candida dubliniensis (n = 8; 9.3%) in HIV. Resistance to fluconazole was detected only in the HIV non-albicans Candida group (n = 8; 9.3%). All isolates were susceptible to VOR. The experimental drug MXP had MIC values equal or close to the ones of VOR. Echinocandin resistance was more frequent than azole resistance.
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18
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Prevalence of oral Candida colonization in patients with diabetes mellitus. J Mycol Med 2016; 26:103-110. [PMID: 26879707 DOI: 10.1016/j.mycmed.2015.12.008] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Revised: 12/21/2015] [Accepted: 12/26/2015] [Indexed: 11/21/2022]
Abstract
OBJECTIVES OF THE STUDY We aimed to assess the prevalence of oral Candida colonization in patients with diabetes and its relationship with factors such as Candida species, serum glucose level, and the susceptibility rate of isolated yeasts to antifungals. PATIENTS Random samples were obtained from 113 patients with type 2 diabetes, 24 patients with type 1 diabetes, and 105 healthy controls. MATERIALS AND METHODS The samples were taken by swabbing the oral mucosa of patients with diabetes mellitus and healthy individuals. Afterwards the samples were inoculated onto CHROMagar-Candida. The growing colonies were counted, and the isolated yeasts were identified by PCR-RFLP and RapID methods. Various isolated species of Candida were also subjected to susceptibility testing of antibiotic drugs. Blood samples were taken to evaluate glycosylated hemoglobin (HbA1c). RESULTS Although the Candida carriage rate and density were statistically higher in diabetics than healthy individuals, no direct association was found between having high Candida-burden and glycosylated hemoglobin. The most commonly isolated species in both diabetics and controls was Candida albicans. Of the tested antifungal drugs, the highest rate of resistance was found against itraconazole, followed in frequency by ketoconazole and fluconazole. CONCLUSIONS This study identified a significant association between the poor glycemic control and the higher prevalence rates of Candida carriage and density in diabetic patients. In addition, a high prevalence of C. dubliniensis in diabetic patients was found, which might be misdiagnosed with its morphologically related species, C. albicans.
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Ellepola ANB, Chandy R, Khan ZU, Samaranayake LP. Caspofungin-induced in-vitro post-antifungal effect and its impact on adhesion related traits of oral Candida dubliniensis and Candida albicans isolates. Microbiol Immunol 2016; 60:160-7. [PMID: 26850765 DOI: 10.1111/1348-0421.12362] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Revised: 01/31/2016] [Accepted: 02/02/2016] [Indexed: 11/29/2022]
Abstract
Adhesion to buccal epithelial cells (BEC) and denture acrylic surfaces (DAS), germ tube (GT) formation and cell surface hydrophobicity (CSH) are all virulence traits involved in the pathogenicity of Candida. Post-antifungal effect (PAFE) also have a bearing on pathogenicity and virulence of Candida. Candida dubliniensis is associated with oral and systemic candidosis, which can be managed with caspofungin. There is no published information on caspofungin-induced PAFE and its impact on adhesion traits of C. dubliniensis isolates. Thus, the purpose of this investigation was to determine the in vitro duration of PAFE on 20 C. dubliniensis isolates following transient exposure to caspofungin. Furthermore the impacts of caspofungin-induced PAFE on adhesion to BEC and DAS, GT formation and CSH of these isolates were also determined. After establishing the minimum inhibitory concentration (MIC) of caspofungin, C. dubliniensis isolates were exposed to sub-lethal concentrations (×3 MIC) of caspofungin for 1 hr. Thereafter the duration of PAFE, adhesion to BEC and DAS, GT formation and CSH were determined by previously described in-vitro assays. MIC (μg/mL) of C. dubliniensis isolates to caspofungin ranged from 0.004 to 0.19. Caspofungin-induced mean PAFE on C. dubliniensis isolates was 2.17 hr. Exposure to caspofungin suppressed the ability of C. dubliniensis isolates to adhere to BEC and DAS, form GT and CSH by 69.97%, 71.95%, 90.06% and 32.29% (P < 0.001 for all), respectively. Thus, transient exposure of C. dubliniensis isolates to caspofungin produces an antifungal effect not only by suppressing its growth but also by altering its adhesion traits.
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Affiliation(s)
| | - Rachel Chandy
- Department of Microbiology, Faculty of Medicine, Health Sciences Center, Kuwait University, Kuwait
| | - Zia Uddin Khan
- Department of Microbiology, Faculty of Medicine, Health Sciences Center, Kuwait University, Kuwait
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20
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Ellepola ANB, Chandy R, Khan ZU. In vitro postantifungal effect, adhesion traits and haemolysin production of Candida dubliniensis isolates following exposure to 5-fluorocytosine. Mycoses 2015. [PMID: 26201447 DOI: 10.1111/myc.12353] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The phenomenon of postantifungal effect (PAFE), which is the suppression of candidal growth following brief exposure to antifungal agents, is linked with candidal pathogenicity. Adhesion to buccal epithelial cells (BEC), germ tube (GT) formation and relative cell surface hydrophobicity (CSH) are all adhesion traits of candidal pathogenicity. Ability to produce haemolysin by Candida species is also a determinant of its pathogenicity. There is no information on either the PAFE or its impact on adhesion traits and haemolysin production of oral Candida dubliniensis isolates following exposure to 5-fluorocytosine (5-FC). Hence, the focus of this investigation was to research the in vitro PAFE, adhesion to BEC, GT formation, relative CSH and haemolysin production on 20 C. dubliniensis isolates following exposure to 5-FC. Following obtaining the minimum inhibitory concentration (MIC) of 5-FC, isolates of C. dubliniensis were exposed to sub-lethal concentrations (×3 MIC) of 5-FC for 1 h. After this brief exposure, the antimycotic was removed and PAFE, adhesion to BEC, GT formation, relative CSH and haemolysin production was determined by formerly described in vitro methods. MIC (μg/ml) of C. dubliniensis isolates to 5-FC ranged from 0.002 to 0.125. The mean PAFE (hours) elicited by 5-FC on C. dubliniensis isolates was approximately 1 h. Exposure to 5-FC suppressed the ability of C. dubliniensis isolates to adhere BEC, GT formation, relative CSH and haemolysin activity by a mean percentage reduction in 50.98%, 29.51%, 36.79% and 12.75% (P < 0.001 for all) respectively. Therefore, brief exposure of C. dubliniensis isolates to 5-FC appears to exert an antifungal effect by subduing its growth, adhesion traits as well as haemolysin production.
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Affiliation(s)
- Arjuna N B Ellepola
- Faculty of Dentistry, Department of Bioclinical Sciences, Health Sciences Center, Kuwait University, Safat, Kuwait
| | - Rachel Chandy
- Faculty of Medicine, Department of Microbiology, Health Sciences Center, Kuwait University, Safat, Kuwait
| | - Zia U Khan
- Faculty of Medicine, Department of Microbiology, Health Sciences Center, Kuwait University, Safat, Kuwait
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Fatahinia M, Poormohamadi F, Zarei Mahmoudabadi A. Comparative Study of Esterase and Hemolytic Activities in Clinically Important Candida Species, Isolated From Oral Cavity of Diabetic and Non-diabetic Individuals. Jundishapur J Microbiol 2015; 8:e20893. [PMID: 25861439 PMCID: PMC4386073 DOI: 10.5812/jjm.20893] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2014] [Revised: 11/10/2014] [Accepted: 02/16/2015] [Indexed: 01/12/2023] Open
Abstract
Background: Diabetes mellitus as a chronic metabolic disease occurs in patients with partial or complete deficiency of insulin secretion or disorder in action of insulin on tissue. The disease is known to provide conditions for overgrowth of Candida species. Candida spp. cause candidiasis by many virulence factors such as esterase, hemolysin and phospholipase. Objectives: This study aimed to compare esterase and hemolytic activity in various Candida species isolated from oral cavity of diabetic and non-diabetic individuals. Patients and Methods: Swab samples were taken from 95 patients with diabetes (35 men and 60 women) and 95 normal persons (42 men and 53 women) and cultured on Sabouraud dextrose agar. Identification of isolated yeasts was performed by germ tube test, morphology on CHROMagar Candida medium, corn meal agar and ability to grow at 45°C. Hemolysin activity was evaluated using blood plate assay and esterase activity was determined using the Tween 80 opacity test. Results: Different Candida species were isolated from 57 (60%) diabetic and 24 (25%) non-diabetic individuals. Esterase activity was detected in all Candida isolates. Only 21.6% of C. albicans from patients with diabetes had esterase activity as + 3, while it ranged from + 1 to + 2 in others. Hemolytic activity was determined in C. albicans, C. dubliniensis, C. glabrata and C. krusei as 0.79, 0.58, 0.66 and 0.74, respectively. Hemolytic activity was significantly different in the two groups of diabetics and non-diabetics. Conclusions: Oral carriage of C. albicans in the diabetic group (n = 42; 66.7%) was significantly greater than the control group (n = 16; 57.1%). Esterase activity of C. albicans in diabetic group was higher than non-diabetic group. Although C. albicans remains the most frequently pathogenic yeast for human, but other species are increasing.
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Affiliation(s)
- Mahnaz Fatahinia
- Department of Medical Mycology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran
- Corresponding author: Mahnaz Fatahinia, Department of Medical Mycology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran. Tel: +98-6113367543 , Fax: +98-6113332036, E-mail:
| | - Farzad Poormohamadi
- Department of Medical Mycology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran
| | - Ali Zarei Mahmoudabadi
- Department of Medical Mycology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran
- Tropical and Infectious Disease Research Center, Department of Medical Mycology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran
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22
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Ellepola AN, Joseph BK, Altarakemah Y, Samaranayake LP, Anil S, Hashem M, Khan ZU. In vitro adhesion of oral Candida dubliniensis isolates to acrylic denture surfaces following brief exposure to sub-cidal concentrations of polyenes, azoles and chlorhexidine. Med Princ Pract 2015; 24:58-64. [PMID: 25471106 PMCID: PMC5588188 DOI: 10.1159/000369019] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2014] [Accepted: 10/13/2014] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES We aimed to investigate the effect of brief exposure to sub-cidal concentrations of nystatin, amphotericin B, ketoconazole, fluconazole and chlorhexidine gluconate on the adhesion of oral Candida dubliniensis isolates to the surface of acrylic dentures. METHODS After determining the minimum inhibitory concentration of each drug, 20 oral isolates of C. dubliniensis were exposed to sub-cidal concentrations of the drugs for 1 h. The drugs were then removed by dilution, and the adhesion of the isolates to denture acrylic strips was assessed by an in vitro adhesion assay. RESULTS Compared to the controls, exposure to nystatin, amphotericin B, ketoconazole, fluconazole and chlorhexidine gluconate suppressed the ability of C. dubliniensis isolates to adhere to acrylic denture surfaces with a reduction of 74.68, 74.27, 57.31, 44.57 and 56.53% (p < 0.001 for all drugs), respectively. CONCLUSIONS Brief exposure to sub-cidal concentrations of anti-mycotics suppressed the adhesion of C. dubliniensis oral isolates to acrylic denture surfaces.
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Affiliation(s)
- Arjuna N.B. Ellepola
- Department of Bioclinical, Diagnostics and Restorative Sciences, Faculty of Dentistry, Health Sciences Center, Kuwait University, Jabriya, Kuwait
- *Dr. Arjuna Ellepola, BDS, PhD, Associate Prof. in Oral Microbiology, Department of Bioclinical Sciences, Faculty of Dentistry, Kuwait University, PO Box 24923, Safat 13110 (Kuwait), E-Mail
| | - Bobby K. Joseph
- Department of Bioclinical, Diagnostics and Restorative Sciences, Faculty of Dentistry, Health Sciences Center, Kuwait University, Jabriya, Kuwait
| | - Yacoub Altarakemah
- Department of Bioclinical, Diagnostics and Restorative Sciences, Faculty of Dentistry, Health Sciences Center, Kuwait University, Jabriya, Kuwait
| | - Lakshman P. Samaranayake
- Oral Microbiomics and Infection, School of Dentistry, University of Queensland, Brisbane, Qld., Australia
| | - Sukumaran Anil
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Mohamed Hashem
- Dental Health Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Zia U. Khan
- Department of Microbiology, Faculty of Medicine, Health Sciences Center, Kuwait University, Jabriya, Kuwait
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23
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Albaina O, Sahand IH, Brusca MI, Sullivan DJ, Fernández de Larrinoa I, Moragues MD. Identification and characterization of nine atypical Candida dubliniensis clinical isolates. J Med Microbiol 2014; 64:147-156. [PMID: 25480879 DOI: 10.1099/jmm.0.078832-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Candida dubliniensis is a pathogenic yeast of the genus Candida closely related to Candida albicans. The phenotypic similarity of these two species often leads to misidentification of C. dubliniensis isolates in clinical samples. DNA-based methods continue to be the most effective means of discriminating accurately between the two species. Here, we report on the identification of nine unusual Candida isolates that showed ambiguous identification patterns on the basis of their phenotypic and immunological traits. The isolates were categorized into two groups. Group I isolates were unable to produce germ tubes and chlamydospores, and to agglutinate commercial latex particles coated with a mAb highly specific for C. dubliniensis. Group II isolates grew as pink and white colonies on CHROMagar Candida and ChromID Candida, respectively. Carbohydrate assimilation profiles obtained with API/ID32C together with PCR amplification with specific primers and DNA sequencing allowed reliable identification of the nine unusual clinical isolates as C. dubliniensis.
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Affiliation(s)
- Olatz Albaina
- Departamento de Inmunología, Microbiología y Parasitología, Facultad de Medicina y Odontología, University of the Basque Country UPV/EHU, Bilbao, Spain
| | - Ismail H Sahand
- Department of Microbiology, Faculty of Medicine, Hawler Medical University, Hawler, Kurdistan, Iraq
- Departamento de Inmunología, Microbiología y Parasitología, Facultad de Medicina y Odontología, University of the Basque Country UPV/EHU, Bilbao, Spain
| | - María I Brusca
- Departamento de Microbiología y Parasitología, Facultad de Odontología, Universidad de Buenos Aires, Argentina
| | - Derek J Sullivan
- Microbiology Research Laboratory, Division of Oral Biosciences, School of Dental Science and Dublin Dental University Hospital, Trinity College, Dublin 2, Ireland
| | - Iñigo Fernández de Larrinoa
- Departamento de Química Aplicada, Facultad de Ciencias Químicas, University of the Basque Country UPV/EHU, Donostia-San Sebastián, Spain
| | - María D Moragues
- Departamento de Enfermería I, Escuela Universitaria de Enfermería, University of the Basque Country UPV/EHU, Bilbao, Spain
- Departamento de Inmunología, Microbiología y Parasitología, Facultad de Medicina y Odontología, University of the Basque Country UPV/EHU, Bilbao, Spain
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Ellepola ANB, Joseph BK, Samaranayake LP, Bandara HMHN, Khan ZU. Impact of brief and sequential exposure to nystatin, amphotericin B, ketoconazole, and fluconazole in modulating adhesion traits of oral Candida dubliniensis isolates. ACTA ACUST UNITED AC 2014; 7:149-57. [PMID: 25388637 DOI: 10.1111/jicd.12132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2014] [Accepted: 08/17/2014] [Indexed: 11/28/2022]
Abstract
AIM Candida adherence is implicated in the pathogenesis of oral candidosis. Adhesion to buccal epithelial cells (BEC), germ tube (GT) formation, and relative cell surface hydrophobicity (CSH) are colonization attributes of candidal pathogenicity. Candida dubliniensis (C. dubliniensis) is allied with recurrent oral candidosis, which can be treated with nystatin, amphotericin B, ketoconazole, and fluconazole. Due to the diluent effect of saliva and the cleansing effect of the oral musculature in the oral cavity C. dubliniensis isolates undergo brief and sequential exposure to antifungal agents during therapy. Thus, in the present study, we evaluated the adhesion to BEC, GT formation, and the CSH of oral isolates of C. dubliniensis following brief and sequential exposure to nystatin, amphotericin B, ketoconazole, and fluconazole. METHODS After determining the minimum inhibitory concentration (MIC) of the aforementioned drugs, 20 oral isolates of C. dubliniensis were briefly (1 h), and sequentially (10 days) exposed to subcidal concentrations of these drugs. Following drug removal, adhesion to BEC, GT formation, and CSH of these isolates were determined. RESULTS The percentage reduction of adhesion to BEC, GT formation, and CSH of the isolates following exposure to antifungal agents were as follows: nystatin: 53.55%, 33.98%, and 29.83% (P < 0.001); amphotericin B: 53.84%, 36.23%, and 28.97% (P < 0.001); ketoconazole: 37.43%, 20.51%, and 16.49% (P < 0.001); and fluconazole: 8.93% (P < 0.001), 1.6%, and 0.63% (P > 0.05). CONCLUSIONS Brief and sequential exposure of C. dubliniensis to antifungal agents would continue to wield an antifungal effect by altering its adhesion attributes, and elucidate possible pharmacodynamics by which antifungal agents might operate in modulating candidal adherence.
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Affiliation(s)
- Arjuna N B Ellepola
- Departments of Bioclinical and Diagnostic Sciences, Faculty of Dentistry, Kuwait University, Jabriya, Kuwait
| | - Bobby K Joseph
- Departments of Bioclinical and Diagnostic Sciences, Faculty of Dentistry, Kuwait University, Jabriya, Kuwait
| | | | - H M H N Bandara
- College of Pharmacy, University of Texas at Austin, Austin, TX, USA
| | - Zia U Khan
- Department of Microbiology, Faculty of Medicine, Kuwait University, Jabriya, Kuwait
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Ellepola ANB, Chandy R, Khan ZU. Post-antifungal effect and adhesion to buccal epithelial cells of oral Candida dubliniensis isolates subsequent to limited exposure to amphotericin B, ketoconazole and fluconazole. ACTA ACUST UNITED AC 2014; 6:186-92. [PMID: 24850753 DOI: 10.1111/jicd.12095] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2013] [Accepted: 01/29/2014] [Indexed: 11/27/2022]
Abstract
AIM The post-antifungal effect (PAFE) of Candida and its adherence to oral mucosal surfaces are important determinants of candidal pathogenicity. Candida dubliniensis is allied with recurrent oral candidosis. Oral candidosis can be treated with amphotericin B, ketoconazole and fluconazole. There is no information on the PAFE and its impact on adhesion to oral buccal epithelial cells (BEC) of oral C. dubliniensis isolates. Therefore, the main objective was to reconnoiter the PAFE and adhesion to BEC of 20 C. dubliniensis isolates following brief exposure to aforementioned antimycotics. METHODS After determining the minimum inhibitory concentration (MIC), C. dubliniensis isolates were exposed to sub-lethal concentrations of these drugs for 1 h. Following subsequent drug removal, the PAFE and adhesion to BEC, was determined by a turbidometric method, and an adhesion assay, respectively. RESULTS Minimum inhibitory concentration (μg/mL) to amphotericin B, ketoconazole and fluconazole, ranged from 0.002 to 0.125, 0.002 to 0.012 and 0.016 to 0.38, respectively. Amphotericin B and ketoconazole induced mean PAFE (hours) were 2.21 and 0.6, respectively. Fluconazole failed to produce a detectable PAFE. Compared to controls, amphotericin B, ketoconazole and fluconazole suppressed the ability to adhere to BEC with a mean percentage reduction of 74.31%, 49.80% (P < 0.0001) and 29.36% (P < 0.05), respectively. CONCLUSIONS Brief exposure to sub-lethal concentrations of aforementioned drugs would exert an antifungal effect by modifying the growth and adhesion of C. dubliniensis isolates.
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Affiliation(s)
- Arjuna N B Ellepola
- Department of Bioclinical Sciences, Faculty of Dentistry, Health Sciences Center, Kuwait University, Jabriya, Kuwait
| | - Rachel Chandy
- Department of Microbiology, Faculty of Medicine, Health Sciences Center, Kuwait University, Jabriya, Kuwait
| | - Zia U Khan
- Department of Microbiology, Faculty of Medicine, Health Sciences Center, Kuwait University, Jabriya, Kuwait
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In vitro evaluation of the enzymatic activity profile of non-albicans Candida species isolated from patients with oral candidiasis with or without diabetes. Oral Surg Oral Med Oral Pathol Oral Radiol 2014; 118:84-91. [PMID: 24908598 DOI: 10.1016/j.oooo.2014.03.020] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2013] [Revised: 03/12/2014] [Accepted: 03/22/2014] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate the expression of phospholipase (PL) and secreted aspartyl proteinase (SAP) by Candida glabrata and C tropicalis obtained from the denture biofilms of healthy participants (16 isolates), patients with oral candidiasis with diabetes (10 isolates), and patients with oral candidiasis without diabetes (25 isolates). STUDY DESIGN After incubation, the supernatants and pellets of the isolates were used for the enzymatic assays and quantification of colony-forming units (CFU), respectively. Colorimetric tests were used with phosphatidylcholine as a substrate for PL and azocasein as a substrate for SAP, and the absorbances of the samples were measured. Enzymatic rates were calculated, and values were normalized by CFU. Results were analyzed with factorial analyses of variance (α = .05). RESULTS C tropicalis and C glabrata were proteolytic and phospholipolytic. The clinical sources of isolates had no significant effect on the enzymatic activities (P > .05). C tropicalis had significantly higher enzymatic activity for both PL and SAP (P < .001) than did C glabrata. CONCLUSIONS C tropicalis isolates produced significantly higher amounts of both enzymes than did the C glabrata isolates.
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Pereira CA, Toledo BC, Santos CT, Pereira Costa ACB, Back-Brito GN, Kaminagakura E, Jorge AOC. Opportunistic microorganisms in individuals with lesions of denture stomatitis. Diagn Microbiol Infect Dis 2013; 76:419-24. [DOI: 10.1016/j.diagmicrobio.2013.05.001] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2013] [Revised: 05/01/2013] [Accepted: 05/02/2013] [Indexed: 01/02/2023]
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Ellepola ANB, Joseph BK, Chandy R, Khan ZU. The postantifungal effect of nystatin and its impact on adhesion attributes of oral Candida dubliniensis isolates. Mycoses 2013; 57:56-63. [PMID: 23773155 DOI: 10.1111/myc.12102] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2013] [Revised: 04/28/2013] [Accepted: 05/24/2013] [Indexed: 11/29/2022]
Abstract
The postantifungal effect (PAFE) has an impact on candidal pathogenicity. However, there is no information on either the PAFE or its impact on adhesion traits of oral Candida dubliniensis isolates. Oral candidosis can be treated topically with nystatin. Adhesion to buccal epithelial cells (BEC), germ tube (GT) formation and relative cell surface hydrophobicity (CSH) are all colonisation attributes of candidal pathogenicity. Hence, the main objective of this study was to investigate the in vitro PAFE on 20 C. dubliniensis isolates following exposure to nystatin. In addition, the impact of nystatin-induced PAFE on adhesion to BEC, GT formation and relative CSH of C. dubliniensis isolates were also evaluated. After determining the minimum inhibitory concentration (MIC) of nystatin, C. dubliniensis isolates were exposed to sublethal concentrations of nystatin for 1 h. Following this exposure, the drug was removed and PAFE, adhesion to BEC, GT formation and relative CSH were determined by a previously described turbidometric method, adhesion assay, germ tube induction assay and biphasic aqueous-hydrocarbon assay respectively. MIC (μg/ml) of C. dubliniensis isolates to nystatin ranged from 0.09 to 0.78. The nystatin-induced mean PAFE (hours) on C. dubliniensis isolates was 2.17. Compared with the controls, exposure to nystatin suppressed the ability of C. dubliniensis isolates to adhere BEC, GT formation and relative CSH by a mean percentage reduction of 74.45% (P < 0.0001), 95.92% (P < 0.0001) and 34.81 (P < 0.05) respectively. Hence, brief exposure of C. dubliniensis isolates to nystatin would continue to wield an antifungal effect by suppressing growth as well as its adhesion attributes.
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Affiliation(s)
- Arjuna N B Ellepola
- Department of Bioclinical Sciences, Faculty of Dentistry, Kuwait University, Safat, Kuwait
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Al Mubarak S, Robert AA, Baskaradoss JK, Al-Zoman K, Al Sohail A, Alsuwyed A, Ciancio S. The prevalence of oral Candida infections in periodontitis patients with type 2 diabetes mellitus. J Infect Public Health 2013; 6:296-301. [PMID: 23806705 DOI: 10.1016/j.jiph.2012.12.007] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2012] [Revised: 12/24/2012] [Accepted: 12/28/2012] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES The purpose of this study was to determine the prevalence of Candida spp. in periodontitis patients with type 2 diabetes mellitus. METHODS This cross-sectional study included 42 diabetic patients with periodontitis (aged 21-70 years; 18 males and 24 females). Clinical measurements included probing pocket depth (PPD), clinical attachment level (CAL) and hemoglobin A1c (HbA1c) levels. Sub-gingival samples were collected from the mesio-buccal aspect of 3 teeth for fungal analysis. Candida species, including Candida albicans, Candida dubliniensis, Candida tropicalis and Candida glabrata, were identified using Gram staining, the germ tube test, CHROMagar, Staib agar and API 20C AUX. RESULTS The overall prevalence of Candida in diabetic patients with periodontitis observed in our study was 52%. The most common spp. of Candida identified were C. albicans (38%), followed by C. dubliniensis (9.5%), C. tropicalis (4.7%) and C. glabrata (4.7%). Compared to females, male patients were characterized by increased levels of Candida infections. Our results also indicate that individuals over the age of 40 had increased levels of Candida infections compared to patients younger than 40. Candida infections were higher among subjects with elevated blood sugar levels (HbA1c>9) compared to individuals with well-controlled blood sugar levels (HbA1c<6). Patients with PPDs≥5 had an increased risk of Candida infection compared to patients with PPDs between 3 and 4. CONCLUSION This study indicates that the frequency of C. albicans is higher than the frequencies of C. dubliniensis, C. tropicalis and C. glabrata in diabetic patients with periodontitis. Candida infections were observed at increased frequencies among subjects with high blood sugar levels and PPDs≥5.
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Affiliation(s)
- Sultan Al Mubarak
- King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia.
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Volpato FC, Pires JR, Martinez IDRDC, Orrico SRP, Costa MPD, Spolidório DMP, Gonçalves A. Prevalence of Candida spp. during radiographic examination in Diabetes mellitus patients. REVISTA DE ODONTOLOGIA DA UNESP 2013. [DOI: 10.1590/s1807-25772013000100003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION: It is suggested that individuals with diabetes are more susceptible to Candida infections than healthy people, especially if periodontal infection is associated. OBJECTIVE: This study evaluated the prevalence of colonization by Candida spp. during radiographic examination in diabetic and non-diabetic patients. MATERIAL AND METHODS: Twenty-six patients with type 2 diabetes mellitus and 20 patients without diabetes mellitus, presenting chronic periodontitis and presence of Candida spp. in saliva were evaluated. During radiographic examination, samples of saliva were collected from: oral mucosa, conventional radiographic periapical film, digital x-ray sensor (CDR), and bite block of the receptor-positioning device. Colony forming units (cfu/mL) and identification of Candida yeasts were assessed. RESULT: Oral mucosa from both groups showed the highest colonization with Candida spp. if compared with others surfaces collected (p < 0.05). In diabetic patients, the mucosa of the upper left regions showed higher levels of colonization. In non-diabetic patients, the upper right molar region showed the highest level of colonization during the examination of the receptor-positioning device, the sensor and the non-sensitive film. Candida spp. levels in saliva were similar between diabetics (mean = 3.0 × 10(6)) and non-diabetics (mean = 3.8 × 10(6)). CONCLUSION: No difference in Candida spp. colonization (cfu/mL) in diabetics and non-diabetic patients was observed for the five collected surfaces and the simulated radiographic region. Candida albicans was the prevalent species of Candida spp. found on all the samples.
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Mantri SS, Parkhedkar RD, Mantri SP. Candida colonisation and the efficacy of chlorhexidine gluconate on soft silicone-lined dentures of diabetic and non-diabetic patients. Gerodontology 2012; 30:288-95. [PMID: 23137002 DOI: 10.1111/ger.12012] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/02/2012] [Indexed: 12/01/2022]
Abstract
OBJECTIVES The aim of this study was to evaluate Candida colonisation in the dentures with silicone soft liner in diabetic and non-diabetic patients and to assess the antifungal efficacy of chlorhexidine gluconate on Candida colonies. MATERIALS AND METHODS Thirty patients with resorbed ridges, fifteen each in the diabetic and non-diabetic group, were selected. The mandibular denture of each patient was lined with heat-polymerised silicone resilient liner. Patients were instructed to clean the dentures with soap water and brush. Samples from the fitting surface of mandibular dentures were collected at 15, 21 and 30 days. Subsequently, samples were collected at 15, 21 and 30 days, after cleaning the dentures with a detergent solution of 4% chlorhexidine gluconate, and incubated for the evaluation of Candida growth. These data were subjected to statistical analysis by Mann-Whitney U-test. RESULTS Normal oral flora in diabetics and non-diabetics showed no difference (p > 0.05). The density of colonies increased after 21 and 30 days in diabetic patients (p < 0.05). Number of Candida colonies significantly reduced in both the groups after 21 and 30 days of cleaning the dentures with 4% chlorhexidine gluconate (p < 0.05). CONCLUSION Dentures with silicone resilient liner exhibit increased Candida growth in diabetic patients. Four per cent chlorhexidine gluconate solution effectively disinfects these dentures.
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Affiliation(s)
- Sneha S Mantri
- Departmentt of Prosthodontics, Hitkarini Dental College & Hospital, Jabalpur, India
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Pereira CM, Pires FR, Corrêa MEP, di Hipólito Júnior O, Almeida OPD. Candida in saliva of Brazilian hemophilic patients. J Appl Oral Sci 2012; 12:301-6. [PMID: 20976401 DOI: 10.1590/s1678-77572004000400009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2004] [Accepted: 05/19/2004] [Indexed: 11/22/2022] Open
Abstract
Hemophilia is a common hereditary hemorrhagic disorder, however little is known about the oral microflora of hemophilic patients. The aim of this study was to quantify the Candida and identify its species in non-stimulated saliva of hemophilic patients, and consider its relationship with clinical factors influencing Candida carriage. This study comprised evaluation of 86 hemophilic patients of the Hematology Center/UNICAMP and 43 healthy subjects as controls. All patients were submitted to anamnesis, intraoral examination and unstimulated saliva collection. Candida counts and species identification were performed in salivary samples. Candida was present in 64% of the hemophilic patients and in 44% of the healthy controls. C. albicans represented 65% and 68% of the isolated species, in hemophiliacs and control group respectively, and C. tropicalis was the second most common species in both groups. These results indicate that hemophilic patients carry Candida more frequently and in higher counts than healthy controls, independently of oral clinical parameter considered, as viral infections, complete dentures, transfusions of hemoderivatives, and salivary flow.
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Schulz B, Knobloch M, Moran GP, Weber K, Ruhnke M. Influence of doxorubicin on fluconazole susceptibility and efflux pump gene expression ofCandida dubliniensis. Med Mycol 2012; 50:421-6. [DOI: 10.3109/13693786.2011.608730] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Ellepola ANB, Joseph BK, Khan ZU. Cell surface hydrophobicity of oral Candida dubliniensis isolates following limited exposure to sub-therapeutic concentrations of chlorhexidine gluconate. Mycoses 2012; 56:82-8. [PMID: 22533484 DOI: 10.1111/j.1439-0507.2012.02203.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Candidal adhesion has been implicated as the initial step in the pathogenesis of oral candidiasis and cell surface hydrophobicity (CSH) has been implicated in adhesion to mucosal surfaces. Candida dubliniensis is an opportunistic pathogen associated with recurrent oral candidiasis. Chlorhexidine gluconate is by far the commonest antiseptic mouth wash prescribed in dentistry. At dosage intervals the intraoral concentration of this antiseptic fluctuates considerably and reaches sub-therapeutic levels due to the dynamics of the oral cavity. Hence, the organisms undergo only a limited exposure to the antiseptic during treatment. The impact of this antiseptic following such exposure on CSH of C. dubliniensis isolates has not been investigated. Hence, the main objective of this study was to investigate the effect of brief exposure to sub-therapeutic concentrations of chlorhexidine gluconate on the CSH of C. dubliniensis isolates. Twelve oral isolates of C. dubliniensis were briefly exposed to three sub-therapeutic concentrations of 0.005%, 0.0025% and 0.00125% chlorhexidine gluconate for 30 min. Following subsequent removal of the drug, the CSH of the isolates was determined by a biphasic aqueous-hydrocarbon assay. Compared with the controls, exposure to 0.005% and 0.0025% chlorhexidine gluconate suppressed the relative CSH of the total sample tested by 44.49% (P < 0.001) and 21.82% (P < 0.018), respectively, with all isolates being significantly affected. Although exposure to 0.00125% of chlorhexidine gluconate did not elicit a significant suppression on the total sample tested (7.01%; P > 0.05), four isolates of the group were significantly affected. These findings imply that exposure to sub-therapeutic concentrations of chlorhexidine gluconate may suppress CSH of C. dublinienis isolates, thereby reducing its pathogenicity and highlights further the pharmacodynamics of chlorhexidine gluconate.
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Affiliation(s)
- Arjuna N B Ellepola
- Department of Bioclinical Sciences, Health Sciences Center, Kuwait University, Jabriya, Kuwait.
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Ellepola ANB, Khan ZU. Rapid differentiation of Candida dubliniensis from Candida albicans by early D-xylose assimilation. Med Princ Pract 2012; 21:375-8. [PMID: 22398877 DOI: 10.1159/000336586] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2011] [Accepted: 12/21/2011] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE To determine if D-xylose (XYL) and/or α-methyl-D-glucoside (MDG) assimilation can be used reliably as a rapid test to differentiate Candida dubliniensis from Candida albicans at an earlier time point such as 2 h after inoculation. MATERIALS AND METHODS Thirty isolates of C. albicans and C. dubliniensis recovered from anatomical sites and clinical specimens were used. Isolates were inoculated into the API 20C AUX yeast identification system, and incubated at 30°C. XYL and MDG assimilations were read at 2-hour intervals beginning 2 h after the initial inoculation and up to 24 h of incubation; thereafter, results were read after 48 and 72 h. RESULTS Twenty-nine (97%) C. albicans isolates had assimilated XYL at 16 h and, by 24 h, all isolates were positive for XYL assimilation. None of the C. dubliniensis isolates assimilated XYL. The MDG assimilation revealed that 24, 40, 92 and 100% of C. albicans isolates became positive after 16, 24, 48 and 72 h of incubation, respectively, whereas only 3% of C. dubliniensis isolates assimilated MDG after 72 h. CONCLUSIONS The findings showed that it is possible to rapidly differentiate C. albicans from C. dubliniensis isolates using the API 20C AUX carbohydrate assimilation kits after 16 h of incubation at 30°C based on the XYL assimilation.
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Affiliation(s)
- A N B Ellepola
- Department of Bioclinical Sciences, Faculty of Dentistry, Health Sciences Center, Kuwait University, Jabriya, Kuwait. arjuna @ hsc.edu.kw
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Ge YP, He GX, Lin T, Lu GX, Shen YN, Liu WD. First isolation of Candida dubliniensis from oral cavities of dermatological patients in Nanjing, China. Mycopathologia 2011; 172:465-71. [PMID: 21769632 DOI: 10.1007/s11046-011-9447-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2011] [Accepted: 07/03/2011] [Indexed: 10/18/2022]
Abstract
Candida dubliniensis is an emerging pathogen capable of causing both superficial and systemic infections. Although C. dubliniensis and C. albicans are phenotypically similar, the two species differ in terms of epidemiology and the ability to rapidly develop resistance to fluconazole. C. dubliniensis is primarily associated with oral candidiasis of human immunodeficiency virus (HIV)-infected individuals. In this study, we describe the first recovery of C. dubliniensis from oral cavities of non-HIV-infected patients with dermatological diseases in Nanjing, China. The isolates were phenotypically characterized as C. dubliniensis by their production of brown rough colonies and chlamydospores on tobacco agar and their inability to grow on hypertonic Sabouraud dextrose agar or to assimilate xylose or α-methyl-D-glycoside. The species identification was subsequently confirmed by amplification and sequencing of the internal transcribed spacer region (ITS). Three C. dubliniensis isolates out of 128 (2.3%) presumptive C. albicans/C. dubliniensis ones were finally identified. Further sequence analysis separated the three isolates into two of the four reported ITS genotypes. Antifungal susceptibility testing showed that they were susceptible to fluconazole, itraconazole, voriconazole, micafungin, and amphotericin B. This study adds to the accumulating evidence that C. dubliniensis is widely distributed in non-HIV-infected populations worldwide.
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Affiliation(s)
- Yi P Ge
- Department of Medical Mycology, Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, People's Republic of China
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Sanitá PV, Pavarina AC, Giampaolo ET, Silva MM, Mima EGDO, Ribeiro DG, Vergani CE. Candida spp. prevalence in well controlled type 2 diabetic patients with denture stomatitis. ACTA ACUST UNITED AC 2011; 111:726-33. [DOI: 10.1016/j.tripleo.2011.02.033] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2010] [Revised: 02/14/2011] [Accepted: 02/19/2011] [Indexed: 10/18/2022]
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Ellepola ANB, Khan ZU, Chandy R, Philip L. A comparison of the antifungal activity of herbal toothpastes against other brands of toothpastes on clinical isolates of Candida albicans and Candida dubliniensis. Med Princ Pract 2011; 20:112-7. [PMID: 21252563 DOI: 10.1159/000321199] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2009] [Accepted: 05/26/2010] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES To evaluate the anti-Candida activity on Candida albicans and Candida dubliniensis species of 2 herbal and 7 other brands of toothpastes commonly used in Kuwait. MATERIALS AND METHODS Antifungal activity was determined by agar diffusion test on 65 isolates of C. albicans and 21 isolates of C. dubliniensis for each toothpaste. A uniform quantity of toothpaste was filled into wells punched into Sabouraud dextrose agar medium plates inoculated with the test isolates, incubated at 37°C; inhibition zone diameters were read after 24 h. RESULTS The mean inhibition zone diameters ranged between 12 and 23 mm for C. albicans and between 12 and 27 mm for C. dubliniensis. A herbal toothpaste brand manufactured in the Middle Eastern region (United Arab Emirates) consisting of many herbal ingredients compared to other brands was found to be the most active (p < 0.001) against both Candida species tested, which also demonstrated higher inhibitory activity against C. dubliniensis isolates compared to C. albicans. CONCLUSIONS The herbal toothpaste brand presented significant anticandidal activity over conventional toothpastes and may be useful in reducing the pathogenic potential of Candida species.
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Farah CS, Lynch N, McCullough MJ. Oral fungal infections: an update for the general practitioner. Aust Dent J 2010; 55 Suppl 1:48-54. [PMID: 20553244 DOI: 10.1111/j.1834-7819.2010.01198.x] [Citation(s) in RCA: 99] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Oral candidosis is the most common fungal infection encountered in general dental practice. It manifests in a variety of clinical presentations which may mimic more sinister diseases, and can occasionally be refractory to treatment requiring the attention of an oral medicine specialist. Management of oral candidosis should always include a thorough investigation of underlying predisposing conditions, as the disease often presents when the patient is systemically compromised. This update highlights the pathogenesis, clinical presentation, and management strategies of oral Candidal lesions commonly encountered in dental practice.
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Affiliation(s)
- C S Farah
- School of Dentistry, The University of Queensland, Brisbane.
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Melton JJ, Redding SW, Kirkpatrick WR, Reasner CA, Ocampo GL, Venkatesh A, Mealey BL. Recovery of Candida dubliniensis and other Candida species from the oral cavity of subjects with periodontitis who had well-controlled and poorly controlled type 2 diabetes: a pilot study. SPECIAL CARE IN DENTISTRY 2010; 30:230-4. [PMID: 21044102 DOI: 10.1111/j.1754-4505.2010.00159.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The goal of this study was to determine the prevalence of Candida dubliniensis and other Candida species from saliva samples and from subgingival plaque samples at periodontally healthy and periodontally diseased sites in subjects who had type 2 diabetes and periodontitis. Saliva and subgingival samples were obtained from 30 subjects with periodontitis: 15 with poorly controlled and 15 with well-controlled type 2 diabetes. Samples were analyzed for the presence of C. dubliniensis and other Candida species. Among subjects with poorly controlled diabetes, 53% were positive for C. albicans, 20% for C. glabrata, 6% for C. tropicalis, and 6% for C. parapsilosis. Among well-controlled subjects, 33% were positive for C. albicans and 13% for C. glabrata; none had C. tropicalis or C. parapsilosis. No samples were positive for C. dubliniensis in either group of subjects.
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Ellepola ANB. The effect of brief exposure to sub-therapeutic concentrations of chlorhexidine gluconate on germ tube formation of oral Candida dubliniensis. Mycoses 2010; 54:e330-5. [DOI: 10.1111/j.1439-0507.2010.01915.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Al-Dwairi ZN, Darwazeh AMG, Al-Zwairi AAW. The Relationship between Tobacco Smoking and Oral Colonization with Candida Species. J Contemp Dent Pract 2010; 11:17-24. [DOI: 10.5005/jcdp-11-3-17] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
Abstract
Aim
The aim of this study was to assess and compare the quantitative and qualitative oral colonization of Candida species between a group of healthy tobacco smokers and a comparable group of nonsmokers, and to investigate a possible correlation between oral candidal colonization and the quantity or duration of the smoking habit.
Methods and Materials
Fifty smokers and 50 nonsmokers were included in the study. Candida species were isolated using the concentrated oral rinse (COR) technique and identified using the germ tube test and API 20 C AUX yeast identification system.
Results
Overall candidal transmission was 84 percent. Candida species were isolated from 42 (84 percent) of the smokers and 37 (74 percent) of the nonsmokers (p>0.05). The mean CFU/ml were 333 (SD=358) and 268 (SD=332), respectively (p>0.05).
Conclusion
Tobacco smoking did not appear to increase oral colonization with Candida species in healthy subjects.
Clinical Significance
The effects of smoking on oral tissues and the mechanisms by which Candida proliferate intra-orally as a result of cigarette smoking warrant additional study.
Citation
Darwazeh AM, Al-Dwairi ZN, Al-Zwairi AA. The Relationship between Tobacco Smoking and Oral Colonization with Candida Species. J Contemp Dent Pract [Internet]. 2010 May; 11(3):017-024. Available from: http://www.thejcdp. com/journal/view/volume11-issue3-al_dwairi
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Loreto ES, Scheid LA, Nogueira CW, Zeni G, Santurio JM, Alves SH. Candida dubliniensis: Epidemiology and Phenotypic Methods for Identification. Mycopathologia 2010; 169:431-43. [PMID: 20490751 DOI: 10.1007/s11046-010-9286-5] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2009] [Accepted: 02/04/2010] [Indexed: 11/26/2022]
Affiliation(s)
- Erico Silva Loreto
- Departamento de Química, Centro de Ciências Naturais e Exatas, Universidade Federal de Santa Maria, Santa Maria, RS, Brazil
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Boriollo MFG, Bassi RC, dos Santos Nascimento CMG, Feliciano LM, Francisco SB, Barros LM, Spolidório LC, Palomari Spolidório DM. Distribution and hydrolytic enzyme characteristics of Candida albicans strains isolated from diabetic patients and their non-diabetic consorts. ACTA ACUST UNITED AC 2010; 24:437-50. [PMID: 19832795 DOI: 10.1111/j.1399-302x.2009.00524.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
INTRODUCTION The aim of this study was to investigate the oral colonization profile of Candida albicans strains isolated from diabetic patients and their non-diabetic consorts. In addition hydrolytic enzyme activity of these isolates was analysed. METHODS The genetic diversity of C. albicans oral isolates from 52 couples was established using isoenzyme marker and cluster analysis. Hydrolytic enzyme characteristics, namely secreted aspartyl proteinases (SAPs) and phospholipases (PLs) were also analysed. RESULTS Simultaneous colonization by C. albicans was observed in the consorts of 12 couples (23.1%). Patterns of monoclonal and polyclonal oral colonization by C. albicans strains were identified and the coexistence of identical or highly related strains was observed in both members of eight couples. The genetic diversity observed in the total yeast population revealed four large, genetically distinct groups (A to D) and the coexistence of strains in couples or consorts conjugally unrelated. SAP and PL activity was observed in the majority of C. albicans isolates without any association to particular strain, strain clusters (highly related isolates), or clinical characteristics of the consorts (diabetic, non-diabetic, and gender). CONCLUSION Possible sources of transmission and oral propagation of groups (clusters) of strains of C. albicans can occur between diabetic and non-diabetic consorts. A conjugal genotypic identity exists in most C. albicans-positive couples, that is, both consorts share identical or highly related strains; however, this identity is not couple-specific as seen by the coexistence of clusters in couples and unrelated consorts.
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Affiliation(s)
- M F G Boriollo
- Genetic and Molecular Biology Laboratory, Medicine School of University of Alfenas, Minas Gerais, Brazil.
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Liguori G, Lucariello A, Colella G, De Luca A, Marinelli P. Rapid identification of Candida species in oral rinse solutions by PCR. J Clin Pathol 2007; 60:1035-9. [PMID: 17761740 PMCID: PMC1972426 DOI: 10.1136/jcp.2006.040782] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
AIMS To determine the sensitivity and specificity of a multiplex PCR assay for the contemporary identification of major species involved in oral candidiasis, without extraction and purification of DNA from the samples under investigation; and evaluation of this method in comparison with routine phenotypic culture identification. METHODS 78 oral rinse solutions were collected. The concentrated oral rinse technique was used for a quantitative and qualitative study. Research and identification of Candida spp, with routine phenotypic culture identification (germ-tube test in serum at 37 degrees C for 3 hours and sugar assimilation strip analysis), were performed. Each sample was analysed with multiplex PCR directly on oral rinse solution. Samples giving discrepant results between routine phenotypic and PCR identification methods were resubcultured on CHROMagar Candida plates. The fungus-specific primers ITS1, ITS2, CA3, and CA4 were used. For the identification of other species (C kefyr, C famata and C dubliniensis), ITS1F, ITS1K, and ITS2D primers were designed. RESULTS Multiplex PCR correctly identified all samples, including those with single species, or with mixed species, negative samples and positive samples which appeared to be negative from routine phenotypic methods. CONCLUSION This multiplex PCR assay provides a rapid alternative to the conventional culture based technique for the identification and speciation of the most frequently isolated Candida species. The absence of an extraction method made identification of 10 species possible in a few hours.
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Affiliation(s)
- Giorgio Liguori
- Chair of Hygiene and Epidemiology, Faculty of Movement Sciences, University of Naples Parthenope, Naples, Italy.
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Pires-Gonçalves RH, Miranda ET, Baeza LC, Matsumoto MT, Zaia JE, Mendes-Giannini MJS. Genetic relatedness of commensal strains of Candida albicans carried in the oral cavity of patients' dental prosthesis users in Brazil. Mycopathologia 2007; 164:255-63. [PMID: 17906942 DOI: 10.1007/s11046-007-9052-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2007] [Accepted: 08/29/2007] [Indexed: 10/22/2022]
Abstract
The aim of this study is to describe the degree of yeast-colonization in diabetic and hemodialysed-users of dental prostheses. Individuals (306) were examined using an oral rinse technique in order to evaluate the incidence of yeast-carriage, and genotype of C. albicans. Yeasts were isolated from 68.4% (91/133) individual's dental prostheses users. Dental prostheses were found to be a significant factor for the yeast colonization (P < 0.05). Overall, the intensity of carriage was higher in diabetic patients as compared with health and hemodialysed individuals (P < 0.05). The isolation rates were: C. albicans (51.7%), C. parapsilosis (20.9%), C. tropicalis (14.3%), C. glabrata (6.6%), C. krusei (3.3%), C. rugosa (1.1%), and Pichia (Pichia ohmeri, 2.2%). Ready-To-Go RAPD Analysis Beads were used and primer OPJ 6 distinguished the C. albicans isolates found in prostheses users. All the isolates were grouped into 11 RAPD profiles in four main clusters and, the average S (AB) for the entire collection of 47 C. albicans isolates were 0.779 +/- 0.178. Over 85% of isolates had a similarity level higher than or equal to 0.8 reinforcing the idea that the use of dental prostheses, independently of the host's clinical condition, probably provides the necessary conditions for these strains to gain a growth-specific advantage over others.
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Hintao J, Teanpaisan R, Chongsuvivatwong V, Ratarasan C, Dahlen G. The microbiological profiles of saliva, supragingival and subgingival plaque and dental caries in adults with and without type 2 diabetes mellitus. ACTA ACUST UNITED AC 2007; 22:175-81. [PMID: 17488443 DOI: 10.1111/j.1399-302x.2007.00341.x] [Citation(s) in RCA: 81] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
INTRODUCTION The relationships between suspected bacteria in saliva, yeasts in oral rinse, and supragingival and subgingival plaque versus root surface and coronal caries in adults with type 2 diabetes mellitus and a non-diabetic group were explored. METHODS One-hundred and five patients with type 2 diabetes and 103 non-diabetic subjects were recruited; their periodontal status, plaque index and magnitude of root surface and coronal caries were assessed. Saliva and an oral rinse were cultured for mutans streptococci, lactobacilli and yeasts. Toothbrush samples of supragingival plaque and curette samples of subgingival plaque were assessed for 17 bacterial species using the checkerboard DNA-DNA hybridization method. RESULTS Type 2 diabetes patients had significantly more severe periodontitis, a higher plaque index and a higher prevalence and magnitude of root surface caries than non-diabetic subjects. Significantly more diabetic subjects had higher levels of Treponema denticola, Prevotella nigrescens, Streptococcus sanguinis, Streptococcus oralis and Streptococcus intermedius in their supragingival plaque than non-diabetic subjects. No significant difference was found for the organisms in saliva, oral rinse and subgingival plaque between the two groups. After adjustment for diabetic status, root surface caries was associated with an increased count of mutans streptococci, lactobacilli and yeasts in saliva and of Streptococcus mutans in supragingival plaque samples. Coronal caries was only associated with lactobacilli and yeasts in saliva. CONCLUSION The number of cariogenic organisms in saliva and oral rinse estimated by culture demonstrated a stronger association with both root surface and coronal caries compared to those 17 species assessed with the checkerboard method in supragingival and subgingival plaque.
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Affiliation(s)
- J Hintao
- Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Thailand
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Wang J, Ohshima T, Yasunari U, Namikoshi S, Yoshihara A, Miyazaki H, Maeda N. The carriage of Candida species on the dorsal surface of the tongue: the correlation with the dental, periodontal and prosthetic status in elderly subjects. Gerodontology 2007; 23:157-63. [PMID: 16919096 DOI: 10.1111/j.1741-2358.2006.00130.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To screen the carriage status of Candida species, especially Candida albicans and its genotype in an epidemiological survey and to investigate its correlation with the dental, periodontal and prosthetic status of healthy elderly subjects. MATERIALS AND METHODS Microbiological samples were collected from the dorsum of the tongue of 366 subjects, aged 75, and cultured on CHROMagar medium. The carriage status of Candida spp. and the distribution of C. albicans genotypes by a polymerase chain reaction (PCR) method were analysed and compared with the dental, periodontal and prosthetic status of the subjects. RESULTS A high carriage rate (68.6%) of Candida spp. and the predominant species of C. albicans (72.1%) were found in this study. The prevalence, density and multi-species of Candida spp. were significantly related to the presence of a dental prosthesis. In C. albicans, genotype A predominated (56.4%) and genotype D showed a higher prevalence (12.5%) than previous reports. When comparing Candida spp. carriage with the oral status, significant positive correlations were found with the presence of any dental prosthesis, missing teeth, the number of retained roots and the percentage of sites showing bleeding on probing (BOP), while significant negative correlations were found with the number of teeth present, sound and filled teeth. CONCLUSIONS Candida carriage on the dorsum of the tongue in healthy elderly is significantly associated with the dental, periodontal and prosthetic status, especially the presence of a dental prosthesis. As the complexity of the prosthesis being worn increased, the relative risk of Candida carriage and the numbers and multi-species of Candida increased accordingly.
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Affiliation(s)
- Jing Wang
- Department of Oral Bacteriology, Tsurumi University, School of Dental Medicine, 2-1-3 Tsurumi-ku, Tsurumi City, Yokohama 230-8501, Japan
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Manfredi M, McCullough MJ, Al-Karaawi ZM, Vescovi P, Porter SR. Analysis of the strain relatedness of oral Candida albicans in patients with diabetes mellitus using polymerase chain reaction-fingerprinting. ACTA ACUST UNITED AC 2007; 21:353-9. [PMID: 17064392 DOI: 10.1111/j.1399-302x.2006.00303.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
To increase our understanding of Candida pathogenicity, the identification of those strains most frequently associated with infections is of paramount importance. Polymerase chain reaction (PCR)-based methods are extremely effective in differentiating and determining reproducibility, they require minimum starting material and are rapid and simple to perform. In this study, the genetic relatedness of Candida albicans was assessed for two geographically different patient groups (London, UK and Parma, Italy) affected by diabetes mellitus. C. albicans samples from the oral cavities of non-diabetic healthy subjects were also examined by PCR fingerprinting to evaluate the possible genetic differences among endogenous strains in individuals with and without diabetes mellitus. PCR fingerprinting, with subsequent phylogenetic analysis of C. albicans isolates from the diabetic patients from London and Italy and from the non-diabetic subjects, revealed that there were significant differences (P < 0.0001) between C. albicans isolates indicative of the distinct ecological niches that occur in the oral cavities of these patient cohorts. The most diverse group comprised the isolates from the diabetic patients in the UK, possibly reflecting the antifungal treatment that these patients had received. Further studies that include isolates from patient cohorts with systemic diseases other than diabetes mellitus, and from more diverse geographic localities are required to explain the relatedness of C. albicans isolates in the mouth.
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Affiliation(s)
- M Manfredi
- Oral Medicine, Division of Infection and Immunity, Eastman Dental Institute, UCL, University of London, London, UK.
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Gonçalves RHP, Miranda ET, Zaia JE, Giannini MJSM. Species diversity of yeast in oral colonization of insulin-treated diabetes mellitus patients. Mycopathologia 2006; 162:83-9. [PMID: 16897585 DOI: 10.1007/s11046-006-0038-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2006] [Accepted: 03/28/2006] [Indexed: 10/24/2022]
Abstract
The aim of this study was to investigate oral yeast colonization, antifungal susceptibility and strain diversity in insulin-dependent diabetes mellitus patients (175), as well as to evaluate the influence of dental prostheses. Oral rinse samples were cultured on selective media, in order to isolate, count and identify the yeasts recovered. More than half of the diabetic subjects (53%) carried significant amounts of Candida cells in the buccal cavity and these organisms were recovered at higher densities in diabetics wearing dentures. A total of 93 yeast strains were isolated from these patients, including: Candida spp. (n = 89); Pichia (n = 02); Trichosporon (n = 1), and Geotrichum (n = 1). C. albicans represented 56% of these strains, non-albicans Candida 39.8%, and other genera of yeast 4.3%. C. albicans was prevalent, followed by C. parapsilosis, C. tropicalis, C. glabrata, C. krusei, C. rugosa and C. guilliermondii. Agar disk-diffusion tests of the susceptibility of non-albicans Candida and other genera of yeast to fluconazole showed resistance in 21.9%, mainly in C. rugosa (100%), C. glabrata (57%) and C. krusei (50%). Local oral factors, such as the presence of dentures, in association with diabetes, seemed to have the effect of increasing the amount and variety of Candida species in the oral cavities, mainly those with lower drug susceptibilities.
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