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Dadgal KV, Mohod S. A Case Report With Dual Diagnosis of Candidiasis in a Patient With Uncontrolled Diabetes Mellitus. Cureus 2024; 16:e65908. [PMID: 39219866 PMCID: PMC11364957 DOI: 10.7759/cureus.65908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2024] [Accepted: 07/31/2024] [Indexed: 09/04/2024] Open
Abstract
Chronic hyperglycemia is a hallmark of diabetes mellitus (DM), one of the most common endocrine illnesses affecting millions of people globally. A key issue for diabetes patients is a compromised immune system, which impairs their capacity to fight off invading microbes and increases their susceptibility to infections. Compared to the healthy population, those with DM experience noticeably longer recovery from illnesses or injuries. Individuals suffering from DM are more susceptible to Candida albicans colonizing their oral and/or vaginal mucosa and urinary system. The present article presented a case of a 52-year-old female patient who reported recurrent multiple plaque-like lesions with the underlying condition of hyperglycemia. The oral lesions were treated using the local application of clotrimazole gel and the discomfort subsided with Aceclofenac. The underlying condition was treated by a general physician who prescribed the tablet metformin 500mg. The patient was educated about the predisposing condition, and motivated to make some lifestyle changes and to maintain a proper diet.
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Affiliation(s)
- Komal V Dadgal
- Oral Medicine and Radiology, Sharad Pawar Dental College and Hospital, Datta Meghe Institue of Higher Education and Research, Wardha, IND
| | - Swapnil Mohod
- Oral Medicine and Radiology, Sharad Pawar Dental College and Hospital, Datta Meghe Institue of Higher Education and Research, Wardha, IND
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Zhang X, Zhao Z, Zhang R, Liu J, Guo Z, Hu Q, Liu N, Liu Q. Photoactivated disinfection procedure for denture stomatitis in diabetic rats. PeerJ 2024; 12:e17268. [PMID: 38708351 PMCID: PMC11067891 DOI: 10.7717/peerj.17268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 03/29/2024] [Indexed: 05/07/2024] Open
Abstract
Objective To study the efficacy of PADTM Plus-based photoactivated disinfection (PAD) for treating denture stomatitis (DS) in diabetic rats by establishing a diabetic rat DS model. Methods The diabetic rat DS model was developed by randomly selecting 2-month-old male Sprague-Dawley rats and dividing them into four groups. The palate and denture surfaces of rats in the PAD groups were incubated with 1 mg/mL toluidine blue O for 1 min each, followed by a 1-min exposure to 750-mW light-emitting diode light. The PAD-1 group received one radiation treatment, and the PAD-2 group received three radiation treatments over 5 days with a 1-day interval. The nystatin (NYS) group received treatment for 5 days with a suspension of NYS of 100,000 IU. The infection group did not receive any treatment. In each group, assessments included an inflammation score of the palate, tests for fungal load, histological evaluation, and immunohistochemical detection of interleukin-17 (IL-17) and tumor necrosis factor (TNF-α) conducted 1 and 7 days following the conclusion of treatment. Results One day after treatment, the fungal load on the palate and dentures, as well as the mean optical density values of IL-17 and TNF-α, were found to be greater in the infection group than in the other three treatment groups (P < 0.05). On the 7th day after treatment, these values were significantly higher in the infection group than in the PAD-2 and NYS groups (P < 0.05). Importantly, there were no differences between the infection and PAD-1 groups nor between the PAD-2 and NYS groups (P > 0.05). Conclusions PAD effectively reduced the fungal load and the expressions of IL-17 and TNF-α in the palate and denture of diabetic DS rats. The efficacy of multiple-light treatments was superior to that of single-light treatments and similar to that of NYS.
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Affiliation(s)
- Xiao Zhang
- Hebei Key Laboratory of Stomatology, Hebei Clinical Research Center for Oral Diseases, School and Hospital of Stomatology, Hebei Medical University, Hebei, China
| | - Zirui Zhao
- Hebei Key Laboratory of Stomatology, Hebei Clinical Research Center for Oral Diseases, School and Hospital of Stomatology, Hebei Medical University, Hebei, China
| | - Ruiqi Zhang
- Hebei Key Laboratory of Stomatology, Hebei Clinical Research Center for Oral Diseases, School and Hospital of Stomatology, Hebei Medical University, Hebei, China
| | - Juan Liu
- Hebei Key Laboratory of Stomatology, Hebei Clinical Research Center for Oral Diseases, School and Hospital of Stomatology, Hebei Medical University, Hebei, China
| | - Zhijiao Guo
- Hebei Key Laboratory of Stomatology, Hebei Clinical Research Center for Oral Diseases, School and Hospital of Stomatology, Hebei Medical University, Hebei, China
| | - Qiaoyu Hu
- Hebei Key Laboratory of Stomatology, Hebei Clinical Research Center for Oral Diseases, School and Hospital of Stomatology, Hebei Medical University, Hebei, China
| | - Na Liu
- Department of Preventive Dentistry, School and Hospital of Stomatology, Hebei Medical University, Hebei, China
| | - Qing Liu
- Hebei Key Laboratory of Stomatology, Hebei Clinical Research Center for Oral Diseases, School and Hospital of Stomatology, Hebei Medical University, Hebei, China
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Ouchi C, Hasebe A, Sakata KI, Sato J, Yamazaki Y, Ohga N, Kitagawa Y. Genotypes and virulence-related activities of Candida albicans derived from oral cavity of patients in Hokkaido. Arch Oral Biol 2024; 157:105827. [PMID: 37918303 DOI: 10.1016/j.archoralbio.2023.105827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 10/10/2023] [Accepted: 10/16/2023] [Indexed: 11/04/2023]
Abstract
OBJECTIVE This study aimed to elucidate the difference in virulence of Candida albicans derived from oral candidiasis and non-oral candidiasis patients, and its genotype differences in Hokkaido to obtain a clue of a platform to develop new approaches for diagnosis and treatment. DESIGN C. albicans strains were collected from patients who visited the Hokkaido University Hospital Dental Center. Each strain was examined to i) identify the Candida albicans genotype by PCR, ii) measure the strain's extracellular secretory enzyme activity, iii) determine the strain's ability to induce the production of interleukin-8, and iv) determine the strain's ability to induce cell death. RESULTS Certain virulence-related protease activities and cytotoxicity were higher in strains derived from patients with oral candidiasis compared with strains derived from patients without oral candidiasis. This is the first report on genotypes and the virulence-related activities, such as some protease secretion, IL-8 induction and cytotoxicity of C. albicans in Hokkaido. CONCLUSIONS The virulence-related activities of the fungal strain may influence the pathogenesis of oral candidiasis, such as production of secreted aspartyl protease and cytotoxicity. In addition, C. albicans genotype C may be important for pathogenicity in Hokkaido, because the ratio of genotype C was increased in strains derived from oral candidiasis patients.
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Affiliation(s)
- Chisato Ouchi
- Oral Diagnosis and Medicine, Faculty of Dental Medicine, Hokkaido University, Sapporo, Japan; Department of Oral Molecular Microbiology, Faculty of Dental Medicine and Graduate School of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Akira Hasebe
- Department of Oral Molecular Microbiology, Faculty of Dental Medicine and Graduate School of Dental Medicine, Hokkaido University, Sapporo, Japan.
| | - Ken-Ichiro Sakata
- Oral Diagnosis and Medicine, Faculty of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Jun Sato
- Oral Diagnosis and Medicine, Faculty of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Yutaka Yamazaki
- Gerodontology, Department of Oral Health Science, Faculty of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Noritaka Ohga
- Oral Diagnosis and Medicine, Faculty of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Yoshimasa Kitagawa
- Oral Diagnosis and Medicine, Faculty of Dental Medicine, Hokkaido University, Sapporo, Japan
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Araiza J, Sánchez-Pedraza V, Carrillo AK, Fernández-Samar D, Tejeda J, Bonifaz A. Mixed oral candidiasis in type 2 diabetic patients: Identification and spectrum of sensitivity. BIOMEDICA : REVISTA DEL INSTITUTO NACIONAL DE SALUD 2023; 43:97-108. [PMID: 37721911 PMCID: PMC10586404 DOI: 10.7705/biomedica.6878] [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: 01/30/2023] [Accepted: 04/12/2023] [Indexed: 09/20/2023]
Abstract
Introduction Patients with type 2 diabetes mellitus are susceptible to acquire Candida spp. infections, sometimes involving more than one species. The resistance of some species to antimycotic agents can cause treatment failure. Objectives To determine the frequency and clinical varieties of mixed oral candidiasis in patients with type 2 diabetes mellitus, the involved species, and its sensitivity spectra when exposed to antifungals used as candidiasis treatment. Material and methods We developed an analytical cross-sectional study with 72 patients with type 2 diabetes mellitus with hyperglycemia (HbA1C ≥ 7%) and an oral candidiasis diagnosis. The causal species of oral candidiasis were identified through microbiological techniques, and sensitivity tests were carried out using the diffusion method in a plate with strips (E-test ®). Results We included 72 patients in the study, 32 (44%) males and 40 (56%) females. Patients were divided into three age groups: young adults (17%), adults (74%), and older adults (9%). The mean age of the patients was 51 years. No significant differences were found between mixed oral candidiasis and groups (sex and age), or between mixed oral candidiasis and gender, glycosylated hemoglobin level (HbA1C), antihyperglycemic treatment, or type 2 diabetes mellitus time of diagnosis. We found a correlation between the adult group and development of mixed or simple oral candidiasis. The results showed eight (13%) cases of mixed oral candidiasis: seven with a coinfection of two species and one with a coinfection of three species. The identified species were Candida albicans, C. glabrata, C. dubliniensis, C. kefyr, C. tropicalis, and C. krusei. Most of these species presented sensitivity against ketoconazole and fluconazole, and higher resistance to itraconazole. Conclusions Mixed oral candidiasis occurs in approximately 10% of the patients with type 2 diabetes mellitus and its treatment can be ineffective when the etiological agent is not identified.
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Affiliation(s)
- Javier Araiza
- Laboratorio de Micología, Servicio de Dermatología, Hospital General de México "Dr. Eduardo Liceaga", Ciudad de México, México.
| | - Valentín Sánchez-Pedraza
- Servicio de Endocrinología, Hospital General de México "Dr. Eduardo Liceaga", Ciudad de México, México.
| | - Ana Karen Carrillo
- Laboratorio de Micología, Servicio de Dermatología, Hospital General de México "Dr. Eduardo Liceaga", Ciudad de México, México.
| | - Denise Fernández-Samar
- Laboratorio de Micología, Servicio de Dermatología, Hospital General de México "Dr. Eduardo Liceaga", Ciudad de México, México.
| | - Jazmín Tejeda
- Laboratorio de Micología, Servicio de Dermatología, Hospital General de México "Dr. Eduardo Liceaga", Ciudad de México, México.
| | - Alexandro Bonifaz
- Laboratorio de Micología, Servicio de Dermatología, Hospital General de México "Dr. Eduardo Liceaga", Ciudad de México, México.
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Management of Invasive Infections in Diabetes Mellitus: A Comprehensive Review. BIOLOGICS 2023. [DOI: 10.3390/biologics3010004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/08/2023]
Abstract
Patients with diabetes often have more invasive infections, which may lead to an increase in morbidity. The hyperglycaemic environment promotes immune dysfunction (such as the deterioration of neutrophil activity, antioxidant system suppression, and compromised innate immunity), micro- and microangiopathies, and neuropathy. A greater number of medical interventions leads to a higher frequency of infections in diabetic patients. Diabetic individuals are susceptible to certain conditions, such as rhino-cerebral mucormycosis or aspergillosis infection. Infections may either be the primary symptom of diabetes mellitus or act as triggers in the intrinsic effects of the disease, such as diabetic ketoacidosis and hypoglycaemia, in addition to increasing morbidity. A thorough diagnosis of the severity and origin of the infection is necessary for effective treatment, which often entails surgery and extensive antibiotic use. Examining the significant issue of infection in individuals with diabetes is crucial. Comprehensive research should examine why infections are more common amongst diabetics and what the preventive treatment strategies could be.
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Oral Cavity and Candida albicans: Colonisation to the Development of Infection. Pathogens 2022; 11:pathogens11030335. [PMID: 35335659 PMCID: PMC8953496 DOI: 10.3390/pathogens11030335] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 03/07/2022] [Accepted: 03/08/2022] [Indexed: 02/01/2023] Open
Abstract
Candida colonisation of the oral cavity increases in immunocompromised individuals which leads to the development of oral candidiasis. In addition, host factors such as xerostomia, smoking, oral prostheses, dental caries, diabetes and cancer treatment accelerate the disease process. Candida albicans is the primary causative agent of this infection, owing to its ability to form biofilm and hyphae and to produce hydrolytic enzymes and candialysin. Although mucosal immunity is activated, from the time hyphae-associated toxin is formed by the colonising C. albicans cells, an increased number and virulence of this pathogenic organism collectively leads to infection. Prevention of the development of infection can be achieved by addressing the host physiological factors and habits. For maintenance of oral health, conventional oral hygiene products containing antimicrobial compounds, essential oils and phytochemicals can be considered, these products can maintain the low number of Candida in the oral cavity and reduce their virulence. Vulnerable patients should be educated in order to increase compliance.
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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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Muscogiuri G, Pugliese G, Laudisio D, Castellucci B, Barrea L, Savastano S, Colao A. The impact of obesity on immune response to infection: Plausible mechanisms and outcomes. Obes Rev 2021; 22:e13216. [PMID: 33719175 DOI: 10.1111/obr.13216] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 10/19/2020] [Accepted: 10/19/2020] [Indexed: 12/22/2022]
Abstract
Emerging data suggest an association between obesity and infectious diseases. Although the mechanisms underlying this link are not well established, a number of potential factors may be involved. Indeed, the obesity-related vulnerability to infectious diseases could be due to chronic low-grade inflammation, hyperglycemia, hyperinsulinemia, and hyperleptinemia, which lead to a weakening of both the innate and adaptive immune responses. In addition, obesity results in anatomical-functional changes by the mechanical obstacle of excessive adipose tissue that blunt the respiratory mechanisms and predisposing to respiratory infections. Subjects with obesity are also at risk of skin folds and sweat more profusely due to the thick layers of subcutaneous fat, favoring the proliferation of microorganisms and slowing the repair of wounds down. All these factors make subjects with obesity more prone to develop nosocomial infections, surgical site, skin and soft tissue infections, bacteremia, urinary tract infections, and mycosis. Furthermore, infections in subjects with obesity have a worse prognosis, frequently prolonging hospitalization time as demonstrated for several flu viruses and recently for COVID-19. Thus, the aim of this manuscript is to provide an overview of the current clinical evidence on the associations between obesity and infectious diseases highlighting physio pathological insights involved in this link.
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Affiliation(s)
- Giovanna Muscogiuri
- Dipartimento di Medicina Clinica e Chirurgia, Unità di Endocrinologia, Università Federico II di Napoli, Napoli, Italy.,Centro Italiano per la cura e il Benessere del paziente con Obesità (C.I.B.O), Dipartimento di Medicina Clinica e Chirurgia, Unità di Endocrinologia, Università Federico II di Napoli, Napoli, Italy
| | - Gabriella Pugliese
- Dipartimento di Medicina Clinica e Chirurgia, Unità di Endocrinologia, Università Federico II di Napoli, Napoli, Italy.,Centro Italiano per la cura e il Benessere del paziente con Obesità (C.I.B.O), Dipartimento di Medicina Clinica e Chirurgia, Unità di Endocrinologia, Università Federico II di Napoli, Napoli, Italy
| | - Daniela Laudisio
- Dipartimento di Medicina Clinica e Chirurgia, Unità di Endocrinologia, Università Federico II di Napoli, Napoli, Italy.,Centro Italiano per la cura e il Benessere del paziente con Obesità (C.I.B.O), Dipartimento di Medicina Clinica e Chirurgia, Unità di Endocrinologia, Università Federico II di Napoli, Napoli, Italy
| | - Bianca Castellucci
- Dipartimento di Medicina Clinica e Chirurgia, Unità di Endocrinologia, Università Federico II di Napoli, Napoli, Italy.,Centro Italiano per la cura e il Benessere del paziente con Obesità (C.I.B.O), Dipartimento di Medicina Clinica e Chirurgia, Unità di Endocrinologia, Università Federico II di Napoli, Napoli, Italy
| | - Luigi Barrea
- Dipartimento di Medicina Clinica e Chirurgia, Unità di Endocrinologia, Università Federico II di Napoli, Napoli, Italy.,Centro Italiano per la cura e il Benessere del paziente con Obesità (C.I.B.O), Dipartimento di Medicina Clinica e Chirurgia, Unità di Endocrinologia, Università Federico II di Napoli, Napoli, Italy
| | - Silvia Savastano
- Dipartimento di Medicina Clinica e Chirurgia, Unità di Endocrinologia, Università Federico II di Napoli, Napoli, Italy.,Centro Italiano per la cura e il Benessere del paziente con Obesità (C.I.B.O), Dipartimento di Medicina Clinica e Chirurgia, Unità di Endocrinologia, Università Federico II di Napoli, Napoli, Italy
| | - Annamaria Colao
- Dipartimento di Medicina Clinica e Chirurgia, Unità di Endocrinologia, Università Federico II di Napoli, Napoli, Italy.,Centro Italiano per la cura e il Benessere del paziente con Obesità (C.I.B.O), Dipartimento di Medicina Clinica e Chirurgia, Unità di Endocrinologia, Università Federico II di Napoli, Napoli, Italy.,Cattedra Unesco "Educazione alla salute e allo sviluppo sostenibile", Università Federico II di Napoli, Napoli, Italy
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Hegde SS, Sattur AP, Bargale AB, Rao GS, Shetty RS, Kulkarni RD, Ajantha GS. Estimation and correlation of serum and salivary glucose and immunoglobulin A levels and salivary candidal carriage in diabetic and non-diabetic patients. J Dent Res Dent Clin Dent Prospects 2020; 14:206-213. [PMID: 33575008 PMCID: PMC7867688 DOI: 10.34172/joddd.2020.041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Accepted: 06/12/2020] [Indexed: 01/15/2023] Open
Abstract
Background. A correlation has been noted between diabetes mellitus (DM) and changes in the oral cavity. The present study aimed to estimate, compare, and correlate serum and salivary glucose and IgA levels and salivary candidal carriage in diabetic and non-diabetic individuals. Methods. Eighty-eight subjects were categorized into three groups: group 1 (controlled DM; n=27), group 2 (uncontrolled DM; n=32) and group 3 (non-diabetics; n=29). Serum and salivary glucose levels were estimated by glucose oxidase/peroxidase method, serum and salivary IgA by a diagnostic kit, and candidal colonization by inoculating samples into Sabouraud dextrose agar plate. Statistical analyses were carried out by one-way ANOVA, post hoc Tukey tests, and Pearson's correlation coefficient. Results. Significant elevation of serum IgA levels was observed in group 2 compared to group 3 and significant decreases in salivary IgA levels in groups 1 and 2. The candidal carriage was significantly higher in group 2 compared to group 3. Serum glucose and salivary IgA levels showed a significant correlation in group 1. There was a positive correlation between serum/ salivary glucose and serum/salivary IgA levels in group 2. In addition, there was a significant correlation between serum glucose and serum IgA levels in group 3. Conclusion. Saliva could be a potential, non-invasive diagnostic tool to estimate glucose levels. The evaluation of salivary components, like IgA, might be useful in diagnosing and managing oral manifestations in diabetic individuals. Elevated salivary glucose levels contribute to elevated candidal carriage, making individuals susceptible to oral candidiasis.
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Affiliation(s)
- Shruthi S Hegde
- Department of Oral Medicine and Radiology, Srinivas Institute of Dental Sciences, Mukka, Surathkal, Mangalore, Karnataka, India
| | - Atul P Sattur
- Department of Oral Medicine and Radiology, SDM College of Dental Sciences and Hospital, Dharwad, India
| | - Anil Bapu Bargale
- Department of Biochemistry, SDM College of Medical Sciences and Hospital, Dharwad, Karnataka, India
| | - Gayathri S Rao
- Department of Oral Medicine and Radiology, Srinivas Institute of Dental Sciences, Mukka, Surathkal, Mangalore, Karnataka, India
| | - Rajeeth S Shetty
- Department of Oral and Maxillofacial Surgery, Srinivas Institute of Dental Sciences, Mukka, Surathkal, Mangalore, India
| | - Raghavendra D Kulkarni
- Department of Microbiology, SDM College of Medical Sciences and Hospital, Dharwad, India
| | - Ganavalli S Ajantha
- Department of Microbiology, SDM College of Medical Sciences and Hospital, Dharwad, India
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Bai W, Wang Q, Deng Z, Li T, Xiao H, Wu Z. TRAF1 suppresses antifungal immunity through CXCL1-mediated neutrophil recruitment during Candida albicans intradermal infection. Cell Commun Signal 2020; 18:30. [PMID: 32093731 PMCID: PMC7038620 DOI: 10.1186/s12964-020-00532-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Accepted: 02/13/2020] [Indexed: 02/07/2023] Open
Abstract
Background Candida albicans is the most common opportunistic human fungal pathogen. The chemokine ligand CXCL1 plays a protective role in fungal infection through the recruitment of neutrophils. TRAF1 (tumor necrosis factor-associated factor 1) can be highly induced by proinflammatory stimuli such as LPS and TNF and has been implicated in septic shock. However, the role of TRAF1 in infection, especially fungal infection, remains elusive. Herein, we reveal that TRAF1 suppresses the antifungal immune response to Candida albicans intradermal infection through the regulation of CXCL1 induction and neutrophil recruitment. Methods A mouse model of C. albicans intradermal infection was established. The Traf1−/− mice and Traf1−/− immortalized human keratinocytes were generated. The p65 inhibitor triptolide, STAT1 inhibitor fludarabine, neutrophil-depletion antibody Ly6G, and neutralizing antibody for CXCL1 were utilized. The expression of proinflammatory cytokines and chemokines was assessed by real-time PCR and ELISA, and the activation of signaling molecules was analyzed by Western blotting. Hematoxylin and eosin staining and periodic acid Schiff staining were used for histology or fungal detection, respectively. The immunofluorescence and flow cytometry analyses were employed in the assessment of immune cell infiltration. Bone marrow transplantation and adoptive transfer experiments were conducted to establish a role for TRAF1 in the macrophage compartment in fungal skin infection. Results TRAF1-deficient mice demonstrated improved control of Candida albicans intradermal infection, and concomitant increase in neutrophil recruitment and reduction in fungal burden. The chemokine CXCL1 was upregulated in the TRAF1-deficient macrophages treated with heat-killed C. albicans. Mechanistically, TRAF1-deficient macrophages showed increased activation of transcription factor NFκB p65. The human CXCL8 was also highly induced in the TRAF1-deficient human keratinocytes upon TNF stimulation through decreasing the activation of transcription factor STAT1. TRAF1-deficient macrophages played a critical role in containing the C. albicans skin infection in vivo. Conclusion TRAF1-deficient mice can better control fungal infection in the skin, a process attributable to the CXCL-neutrophil axis. Mechanistically, TRAF1 likely regulates CXCL1 expression in both macrophages and keratinocytes through the transcriptional factor NFκB and STAT1, respectively. Our finding offers new insight into the understanding of the immune regulatory mechanisms in host defense against C. albicans infection. Graphical abstract ![]()
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Affiliation(s)
- Wenjuan Bai
- Pediatric Intensive Care Unit, Guangzhou Women and Children's Medical Center,
- Guangzhou Medical University, 9 Jinsui Road, Guangzhou, Guangdong, 510120, People's Republic of China.,Key Laboratory of Molecular Virology and Immunology, Institut Pasteur of Shanghai, Chinese Academy of Sciences, Shanghai, 200031, People's Republic of China
| | - Qingqing Wang
- Key Laboratory of Molecular Virology and Immunology, Institut Pasteur of Shanghai, Chinese Academy of Sciences, Shanghai, 200031, People's Republic of China
| | - Zihou Deng
- Key Laboratory of Molecular Virology and Immunology, Institut Pasteur of Shanghai, Chinese Academy of Sciences, Shanghai, 200031, People's Republic of China
| | - Tiantian Li
- Key Laboratory of Molecular Virology and Immunology, Institut Pasteur of Shanghai, Chinese Academy of Sciences, Shanghai, 200031, People's Republic of China
| | - Hui Xiao
- Key Laboratory of Molecular Virology and Immunology, Institut Pasteur of Shanghai, Chinese Academy of Sciences, Shanghai, 200031, People's Republic of China
| | - Zhiyuan Wu
- Pediatric Intensive Care Unit, Guangzhou Women and Children's Medical Center,
- Guangzhou Medical University, 9 Jinsui Road, Guangzhou, Guangdong, 510120, People's Republic of China.
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Sampath A, Weerasekera M, Dilhari A, Gunasekara C, Bulugahapitiya U, Fernando N, Samaranayake L. Type 2 diabetes mellitus and oral Candida colonization: Analysis of risk factors in a Sri Lankan cohort. Acta Odontol Scand 2019; 77:508-516. [PMID: 31145647 DOI: 10.1080/00016357.2019.1607547] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Aims: Oral candidiasis is a major oral manifestation of uncontrolled diabetes mellitus, and a number of cofactors are associated with the pathogenesis of this infection. Here, we describe the prevalence of oral Candida in a Sri Lankan cohort of type 2 diabetes mellitus and risk factors that predispose them to this common fungal infection. Methods: A case-control study was conducted in 250 diabetics with type 2 diabetes and 81 nondiabetic controls. Clinical and demographic data were collected using an interviewer administered questionnaire, and patient records. Oral rinse samples were collected to determine the candidal carriage, and the resultant yeast growth was quantified and speciated using multiplex-PCR and phenotypic analyses. Chi-square test (χ2 test) and Fisher exact test were used for the determination of the significant relationships between risk factors and oral candidiasis. Results: The oral prevalence of Candida species among both groups was similar (81%) although a significantly higher proportion of diabetics (32.8%) yielded >2000 CFU/mL of yeasts compared with only 12.3% of the healthy controls (p < .05). Significant associations were noted between oral candidal carriage amongst diabetics, and (i) denture wearing, (ii) female gender and (iii) cigarette smoking (all, p < .05). Amongst both groups, C.albicans was the most common Candida species isolated followed by C. parapsilosis, C. tropicalis and C. glabrata. Conclusions: The oral infestation of Candida in our Sri Lankan cohort of diabetics is significantly higher than their healthy counterparts, and co-carriage of multiple yeast species is a common finding in the study population. As there are no previous such reports of the latter phenomenon particularly from the Asian region it is noteworthy, mainly in view of the recent data on the emergence of drug-resistant yeast species the world over.
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Affiliation(s)
- Asanga Sampath
- Department of Microbiology, Faculty of Medical Sciences, University of Sri Jayewardenepura, Nugegoda, Sri Lanka
| | - Manjula Weerasekera
- Department of Microbiology, Faculty of Medical Sciences, University of Sri Jayewardenepura, Nugegoda, Sri Lanka
| | - Ayomi Dilhari
- Department of Microbiology, Faculty of Medical Sciences, University of Sri Jayewardenepura, Nugegoda, Sri Lanka
| | - Chinthika Gunasekara
- Department of Microbiology, Faculty of Medical Sciences, University of Sri Jayewardenepura, Nugegoda, Sri Lanka
| | | | - Neluka Fernando
- Department of Microbiology, Faculty of Medical Sciences, University of Sri Jayewardenepura, Nugegoda, Sri Lanka
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De la Torre-Luna R, Domínguez-Pérez RA, Guillén-Nepita AL, Ayala-Herrera JL, Martínez-Martínez RE, Romero-Ayala ME, Pérez-Serrano RM, Vázquez-Garcidueñas MS. Prevalence of Candida albicans in primary endodontic infections associated with a higher frequency of apical periodontitis in type two diabetes mellitus patients. Eur J Clin Microbiol Infect Dis 2019; 39:131-138. [PMID: 31529305 DOI: 10.1007/s10096-019-03702-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Accepted: 09/03/2019] [Indexed: 12/18/2022]
Abstract
To identify the prevalence of C. albicans in primary endodontic infections of type two diabetes mellitus (T2DM) patients and compare their clinical and radiographical characteristics with a non-diabetic control group, establishing the possible relationship between primary endodontic infection, T2DM, and C. albicans, since diabetes mellitus (DM), influences the development, course, and response to the treatment of apical periodontitis, but the presence of Candida albicans (C. albicans) has not been considered before. A total of 120 patients were selected and divided into two groups: 60 T2DM diagnosed patients and 60 non-diabetic controls. A clinical examination and radiographic analysis were performed to establish a periapical index score (PAI). Root canal samples were taken. Deoxyribonucleic acid (DNA) was extracted, and specific primers were used to identify C. albicans by polymerase chain reaction (PCR). A twofold increase in the prevalence of C. albicans in T2DM patients was observed in contrast to control patients (p = 0.0251). Sixty-five percent of T2DM patients with positive C. albicans scored a ≥ 3 PAI, while only 27% of the patients without C. albicans had a ≥ 3 PAI score (p = 0.0065). Long-term DM patients presented C. albicans more frequently (p < 0.0001). In this study, long-term T2DM patients carried C. albicans in their root canals more frequently when having a primary endodontic infection. Furthermore, this C. albicans presence seems to be related to a higher frequency of apical periodontitis.
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Affiliation(s)
- Rocio De la Torre-Luna
- Laboratorio de Investigación Odontológica Multidisciplinaria. Facultad de Medicina, Universidad Autónoma de Querétaro, Clavel #200, Prados de La Capilla, 76176, Santiago de Queretaro, QRO, México.,Endodontic Specialization Program, Facultad de Medicina, Universidad Autónoma de Querétaro, Santiago de Queretaro, México
| | - Rubén Abraham Domínguez-Pérez
- Laboratorio de Investigación Odontológica Multidisciplinaria. Facultad de Medicina, Universidad Autónoma de Querétaro, Clavel #200, Prados de La Capilla, 76176, Santiago de Queretaro, QRO, México. .,Endodontic Specialization Program, Facultad de Medicina, Universidad Autónoma de Querétaro, Santiago de Queretaro, México.
| | - Ana Laura Guillén-Nepita
- División de Estudios de Posgrado de la Facultad de Ciencias Médicas y Biológicas "Dr. Ignacio Chávez", Universidad Michoacana de San Nicolás de Hidalgo, Morelia, Michoacán, México
| | | | - Rita Elizabeth Martínez-Martínez
- Departamento de Investigación de la Maestría en Ciencias Odontológicas, Universidad Autónoma de San Luis Potosí, San Luis Potosi, México
| | - Ma Esther Romero-Ayala
- Centro Universitario de Estudios de Posgrado e Investigación, Facultad de Odontología, Universidad Michoacana de San Nicolás de Hidalgo, Morelia, México
| | - Rosa Martha Pérez-Serrano
- Laboratorio de Investigación Odontológica Multidisciplinaria. Facultad de Medicina, Universidad Autónoma de Querétaro, Clavel #200, Prados de La Capilla, 76176, Santiago de Queretaro, QRO, México.,Endodontic Specialization Program, Facultad de Medicina, Universidad Autónoma de Querétaro, Santiago de Queretaro, México
| | - Ma Soledad Vázquez-Garcidueñas
- División de Estudios de Posgrado de la Facultad de Ciencias Médicas y Biológicas "Dr. Ignacio Chávez", Universidad Michoacana de San Nicolás de Hidalgo, Morelia, Michoacán, México
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14
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Karasuno T, Sata H, Noda Y, Imakita M, Yasumi M. Invasive candidiasis leading to gastric perforation in an immunocompromised patient. IDCases 2019; 18:e00627. [PMID: 31516828 PMCID: PMC6727104 DOI: 10.1016/j.idcr.2019.e00627] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 08/18/2019] [Accepted: 08/18/2019] [Indexed: 01/05/2023] Open
Abstract
Invasive candidiasis remains an important cause of mortality and morbidity in patients with underlying diseases. Here, we report a case of gastric perforation due to Candia glabrata infection in a 74-year-old-male with Paroxysmal nocturnal hemoglobinuria (PNH) who received long-term corticosteroid treatment of hemophagocytic syndrome associated with acute cholecystitis. Total gastrectomy was performed, and he was treated liposomal amphotericin B. The patient was extubated successfully on the 2nd postoperative day, but the patient died of Pneumocystis jirovecii pneumonia (PJP). An autopsy revealed that there was a small amount of the cystic form of Pneumocystic jirovecii, but there was not the presence of Candida spp. Concerning the prophylaxis of invasive candidiasis, there is no strong evidence-based data in clinical practice in immunocompromised patients, such as those receiving long-term immunomodulatory therapy or corticosteroids. Our present case suggests the importance of fungal management and may indicate the need for a new approach to the fungal prophylaxis in such patients.
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Affiliation(s)
| | - Hiroshi Sata
- Department of Hematology, Rinku General Medical Center, Japan
| | - Yuri Noda
- Department of Pathology, Kaizuka City Hospital, Japan
| | - Masami Imakita
- Department of Pathology, Rinku General Medical Center, Japan
| | - Masato Yasumi
- Department of Hematology, Rinku General Medical Center, Japan
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15
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Cohen Atsmoni S, Brener A, Roth Y. Diabetes in the practice of otolaryngology. Diabetes Metab Syndr 2019; 13:1141-1150. [PMID: 31336457 DOI: 10.1016/j.dsx.2019.01.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Accepted: 01/14/2019] [Indexed: 02/07/2023]
Abstract
Diabetes mellitus is the most common endocrine disease, characterized by chronic hyperglycemia. The hyperglycemic milieu leads to endothelial injury in blood vessels of variant size, which results in microangiopathy and macroangiopathy (atherosclerosis). Consequential ischemia of nerves and hyperglycemia by itself lead to nerve degeneration and generalized neuropathy, affecting most often the sensory peripheral nerves and the autonomic nervous system. Auditory, vestibular and olfactory sensorium may be compromised by DM. People with DM have an increased susceptibility to infection, as a result of neutrophil dysfunction and impaired humoral immunity. Therefore DM predisposes to certain infectious diseases, such as fungal sinusitis or malignant otitis externa, which are rare in general population. Recovery from infections or from injuries may be compromised by coexisting DM. In this review we discuss complications of DM in the head and neck region. Otolaryngologists and general practitioners should be alert to specific conditions related to DM and be minded of the relevant complications and consequences.
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Affiliation(s)
- Smadar Cohen Atsmoni
- Department of Otolaryngology-Head and Neck Surgery, The Edith Wolsfon Medical Center, Holon, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Avivit Brener
- Pediatric Endocrinology & Diabetes Unit, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yehudah Roth
- Department of Otolaryngology-Head and Neck Surgery, The Edith Wolsfon Medical Center, Holon, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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16
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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: 131] [Impact Index Per Article: 26.2] [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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17
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Verhulst MJL, Loos BG, Gerdes VEA, Teeuw WJ. Evaluating All Potential Oral Complications of Diabetes Mellitus. Front Endocrinol (Lausanne) 2019; 10:56. [PMID: 30962800 PMCID: PMC6439528 DOI: 10.3389/fendo.2019.00056] [Citation(s) in RCA: 127] [Impact Index Per Article: 25.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Accepted: 01/22/2019] [Indexed: 12/13/2022] Open
Abstract
Diabetes mellitus (DM) is associated with several microvascular and macrovascular complications, such as retinopathy, nephropathy, neuropathy, and cardiovascular diseases. The pathogenesis of these complications is complex, and involves metabolic and hemodynamic disturbances, including hyperglycemia, insulin resistance, dyslipidemia, hypertension, and immune dysfunction. These disturbances initiate several damaging processes, such as increased reactive oxygen species (ROS) production, inflammation, and ischemia. These processes mainly exert their damaging effect on endothelial and nerve cells, hence the susceptibility of densely vascularized and innervated sites, such as the eyes, kidneys, and nerves. Since the oral cavity is also highly vascularized and innervated, oral complications can be expected as well. The relationship between DM and oral diseases has received considerable attention in the past few decades. However, most studies only focus on periodontitis, and still approach DM from the limited perspective of elevated blood glucose levels only. In this review, we will assess other potential oral complications as well, including: dental caries, dry mouth, oral mucosal lesions, oral cancer, taste disturbances, temporomandibular disorders, burning mouth syndrome, apical periodontitis, and peri-implant diseases. Each oral complication will be briefly introduced, followed by an assessment of the literature studying epidemiological associations with DM. We will also elaborate on pathogenic mechanisms that might explain associations between DM and oral complications. To do so, we aim to expand our perspective of DM by not only considering elevated blood glucose levels, but also including literature about the other important pathogenic mechanisms, such as insulin resistance, dyslipidemia, hypertension, and immune dysfunction.
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Affiliation(s)
- Martijn J. L. Verhulst
- Department of Periodontology, Academic Centre for Dentistry Amsterdam, University of Amsterdam and Vrije Universiteit, Amsterdam, Netherlands
- *Correspondence: Martijn J. L. Verhulst
| | - Bruno G. Loos
- Department of Periodontology, Academic Centre for Dentistry Amsterdam, University of Amsterdam and Vrije Universiteit, Amsterdam, Netherlands
| | - Victor E. A. Gerdes
- Department of Vascular Medicine, Amsterdam UMC, Amsterdam, Netherlands
- Department of Internal Medicine, Spaarne Gasthuis, Hoofddorp, Netherlands
| | - Wijnand J. Teeuw
- Department of Periodontology, Academic Centre for Dentistry Amsterdam, University of Amsterdam and Vrije Universiteit, Amsterdam, Netherlands
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18
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Aitken-Saavedra J, Lund RG, González J, Huenchunao R, Perez-Vallespir I, Morales-Bozo I, Urzúa B, Tarquinio SC, Maturana-Ramírez A, Martos J, Fernandez-Ramires R, Molina-Berríos A. Diversity, frequency and antifungal resistance of Candida species in patients with type 2 diabetes mellitus. Acta Odontol Scand 2018; 76:580-586. [PMID: 30045641 DOI: 10.1080/00016357.2018.1484154] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To determine number, species of Candida and Candida resistance to antifungal therapy according to the metabolic control state and the associated salivary changes in patients with type 2 diabetes mellitus (DM2). MATERIALS AND METHODS Samples of non-stimulated saliva were collected from 52 patients with DM2. Salivary pH was measured and cultured on Sabouraud glucose agar and the values of CFU/ml were calculated. The species were presumptively identified using CHROMagar Candida® plates, and identification was confirmed by polymerase chain reaction (PCR). C. albicans isolates were cultured on SGA tetracycline agar with nystatin and fluconazole diffusion disks to measure susceptibility. RESULTS Sixty six percent of the yeasts isolated were Candida albicans, followed by C. glabrata (20.7%). In patients with decompensated DM2, there was an inverse association between HbA1c value and salivary pH. At higher levels of salivary acidification, a greater diversity and quantity of yeasts of the genus Candida were observed. With nystatin, higher inhibition was observed at lower pH. CONCLUSIONS The antifungal therapies could be more effective if it consider, qualitative salivary characteristics as pH, that could determine the susceptibility of species of Candida to at least to nystatin, which is the most used antifungal for treatment to oral candidiasis in patients with DM2.
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Affiliation(s)
- Juan Aitken-Saavedra
- Department of Oral Pathology and Medicine, School of Dentistry, University of Chile, Santiago, Chile
- Post Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, Brazil
| | - Rafael G. Lund
- Post Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, Brazil
| | - Jaime González
- Department of Oral Pathology and Medicine, School of Dentistry, University of Chile, Santiago, Chile
| | - Romina Huenchunao
- Department of Oral Pathology and Medicine, School of Dentistry, University of Chile, Santiago, Chile
| | - Ilia Perez-Vallespir
- Department of Oral Pathology and Medicine, School of Dentistry, University of Chile, Santiago, Chile
| | - Irene Morales-Bozo
- Faculty of Dentistry, Institute for Research in Dental Sciences, University of Chile, Santiago, Chile
| | - Blanca Urzúa
- Faculty of Dentistry, Institute for Research in Dental Sciences, University of Chile, Santiago, Chile
| | | | - Andrea Maturana-Ramírez
- Department of Oral Pathology and Medicine, School of Dentistry, University of Chile, Santiago, Chile
| | - Josué Martos
- Post Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, Brazil
| | - Ricardo Fernandez-Ramires
- Department of Oral Pathology and Medicine, School of Dentistry, University of Chile, Santiago, Chile
| | - Alfredo Molina-Berríos
- Faculty of Dentistry, Institute for Research in Dental Sciences, University of Chile, Santiago, Chile
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19
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Tranberg A, Thorarinsdottir HR, Holmberg A, Schött U, Klarin B. Proton pump inhibitor medication is associated with colonisation of gut flora in the oropharynx. Acta Anaesthesiol Scand 2018. [PMID: 29520757 DOI: 10.1111/aas.13094] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND The normal body exists in mutualistic balance with a large range of microbiota. The primary goal of this study was to establish whether there is an imbalance in the oropharyngeal flora early after hospital or ICU admittance, and whether flora differs between control, ward and critically ill patients. The secondary goal was to explore whether there are patient characteristics that can be associated with a disturbed oropharyngeal flora. METHODS Oropharyngeal cultures were obtained from three different study groups: (1) controls from the community, (2) ward patients and (3) critically ill patients, the two latter within 24 h after admittance. RESULTS Cultures were obtained from 487 individuals: 77 controls, 193 ward patients and 217 critically ill patients. Abnormal pharyngeal flora was more frequent in critically ill and ward patients compared with controls (62.2% and 10.4% vs. 1.3%, P < 0.001 and P = 0.010, respectively). Colonisation of gut flora in the oropharynx was more frequent in critically ill patients compared with ward patients or controls (26.3% vs. 4.7% and 1.3%, P < 0.001 and P < 0.001, respectively). Proton pump inhibitor medication was the strongest independent factor associated with the presence of gut flora in the oropharynx in both ward and critically ill patients (P = 0.030 and P = 0.044, respectively). CONCLUSION This study indicates that abnormal oropharyngeal flora is an early and frequent event in hospitalised patients and more so in the critically ill, compared to controls. Proton pump inhibitor medication is associated with colonisation of gut flora in the oropharynx.
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Affiliation(s)
- A. Tranberg
- Division of Intensive and Perioperative Care; Skåne University Hospital; Lund Sweden
| | - H. R. Thorarinsdottir
- Division of Intensive and Perioperative Care; Skåne University Hospital; Lund Sweden
| | - A. Holmberg
- Division of Infection Medicine; Department of Clinical Sciences; Lund University; Lund Sweden
| | - U. Schött
- Division of Intensive and Perioperative Care; Skåne University Hospital; Lund Sweden
| | - B. Klarin
- Division of Intensive and Perioperative Care; Skåne University Hospital; Lund Sweden
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20
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Tomooka K, Saito I, Furukawa S, Maruyama K, Eguchi E, Iso H, Tanigawa T. Yellow Tongue Coating is Associated With Diabetes Mellitus Among Japanese Non-smoking Men and Women: The Toon Health Study. J Epidemiol 2018; 28:287-291. [PMID: 29311441 PMCID: PMC5976872 DOI: 10.2188/jea.je20160169] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2016] [Accepted: 05/25/2017] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Yellow tongue coating is one of the clinical signs for diabetes mellitus according to traditional East Asian medicine. Few reports have been available on the association between yellow tongue coating and the prevalence of type 2 diabetes in the general population. We examined that association among population samples of non-smoking men and women. METHODS The study subjects were Japanese non-smoking men (n = 315) and women (n = 654) aged 30-79 years who resided in Toon city and participated in the Toon Health Study from July 2011 through November 2014. Tongue coating was assessed by a nationally licensed acupuncturist and classified into three categories of white (normal), light yellow, and yellow. We performed an oral glucose tolerance test to confirm the presence of diabetes mellitus and prediabetes. The associations between yellow tongue coating and the prevalence of diabetes mellitus and prediabetes were examined using multivariable logistic regression analyses, adjusting for age, sex, body mass index, drinking status, and physical activity. RESULTS The multivariable odds ratios of diabetes mellitus were 1.39 (95% confidence interval [CI], 0.72-2.67) for light yellow tongue coating and 2.23 (95% CI, 1.16-4.30) for yellow tongue coating compared with white tongue coating. The respective multivariable odds ratios of prediabetes were 1.13 (95% CI, 0.80-1.61) and 1.43 (95% CI, 0.96-2.12). CONCLUSIONS Yellow tongue coating was associated with higher prevalence of diabetes mellitus and tended to be associated with that of prediabetes among Japanese non-smoking men and women.
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Affiliation(s)
- Kiyohide Tomooka
- Department of Public Health, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Isao Saito
- Department of Community Health Systems Nursing, Ehime University Graduate School of Medicine, Ehime, Japan
| | - Shinya Furukawa
- Department of Epidemiology and Preventive Medicine, Ehime University Graduate School of Medicine, Ehime, Japan
| | - Koutatsu Maruyama
- Department of Public Health, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Eri Eguchi
- Department of Public Health, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Hiroyasu Iso
- Department of Public Health, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Takeshi Tanigawa
- Department of Public Health, Juntendo University Graduate School of Medicine, Tokyo, Japan
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21
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Presence of different Candida species at denture wearers with type 2 diabetes and clinically healthy oral mucosa: Pilot study. BALKAN JOURNAL OF DENTAL MEDICINE 2018. [DOI: 10.2478/bjdm-2018-0003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background/Aim: The aim of this study was to examine prevalence of different Candida spp. at diabetics and nondiabetics wearing dentures without clinical signs of Denture Stomatitis (DS) and to study if some local and systematic factors are confounders for harboring Candida at these subjects. Material and Methods: Total of 60 subjects wearing partial or complete upper acrylic denture having at least half of palatal mucosa covered by denture were selected and stratified into three experimental groups: systematically health subjects; patients with diagnosed Type 2 Diabetes (T2D) and good glycoregulation; and T2D subjects with poorly regulated blood sugar level. Cotton swab samples were obtained from each patient from hard palate mucosa and denture surface. Swab cultures were made on Sabouraud dextrose agar and ChromAgar Media for distinciton of various Candida spp. Density growth was also measured. Results: Frequency of Candida spp. findings were similar between groups. At healthy subjects, only C.albicans was detected. At diabetics, C.albicans was the most common isolated species, followed by C.glabrata and C.tropicalis. Negative finding of yeasts on palatal mucosa, but positive on denture surface were detected at all groups, with the highest frequency (33.4%) at diabetics with poor glycoregulation. Denture surface was heavier colonized than hard palate mucosa. Duration of diabetes in years were only independent predictors for harboring Candida spp. at denture surface (Exp B=1.186, CI=1.047-1.344, p=0.007). Conclusions: Prosthesis of denture wearers without DS may serve as reservoir of Candida spp. Presence of more pathogenic and resistant non-albicans species are related to diabetics, even without clinical signs of DS.
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22
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Abstract
Removable dentures are worn by 20% of the UK population and two thirds of these individuals have denture stomatitis. Poor oral hygiene is commonplace among this group, as is smoking and xerostomia, which also contribute to the development of denture stomatitis. A complex polymicrobial biofilm is able to proliferate on the surface of denture materials and matures to form visible denture plaque. This denture plaque biofilm stimulates a local inflammatory process that is detectable clinically as erythema, and hyperplasia. Systemically, denture plaque represents a potential risk factor for systemic disease, in particular aspiration pneumonia. Respiratory pathogens have been detected in the denture plaque and overnight denture wear has been linked to an increased risk of aspiration pneumonia. There is a general lack of evidence on the adequate management of denture stomatitis and we present a protocol for use in the primary care setting.
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23
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Man A, Ciurea CN, Pasaroiu D, Savin AI, Toma F, Sular F, Santacroce L, Mare A. New perspectives on the nutritional factors influencing growth rate of Candida albicans in diabetics. An in vitro study. Mem Inst Oswaldo Cruz 2017; 112:587-592. [PMID: 28902283 PMCID: PMC5572443 DOI: 10.1590/0074-02760170098] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2017] [Accepted: 04/15/2017] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND The link between Candida albicans and diabetes mellitus is well-acknowledged, but incompletely elucidated. OBJECTIVES The purpose of this study is to assess the growth rate of C. albicans (CA) in the presence of different concentrations of glucose and fructose, two of the main pathophysiologic and nutritionally relevant sugars in diabetic patients, in order to obtain a better understanding of the nutrient acquisition strategy and its possible relation to the hyperglycemic status of diabetic patients. METHODS The effects of different concentrations of glucose and fructose (1000 mg%, 500 mg%, 250 mg% and 100 mg% w/v) on the growth rate of CA have been studied by flow-cytometry. FINDINGS We found that glucose concentration is directly related to CA growth, which may be linked to the frequent yeast infections that occur in non-controlled diabetic patients; we also show that fructose inhibits CA growth rate. MAIN CONCLUSIONS As a consequence of our hypothesis, the study demonstrates that fructose-containing food may prevent the development of candidiasis, at least in oral sites.
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Affiliation(s)
- Adrian Man
- University of Medicine and Pharmacy, Department of Microbiology, Tîrgu Mures, Romania
| | | | - Dan Pasaroiu
- University of Medicine and Pharmacy, Tîrgu Mures, Romania
| | | | - Felicia Toma
- University of Medicine and Pharmacy, Department of Microbiology, Tîrgu Mures, Romania.,Emergency Clinical County Hospital, Tîrgu Mures, Romania
| | - Floredana Sular
- University of Medicine and Pharmacy, Department of Laboratory Medicine, Tîrgu Mures, Romania.,Emergency Clinical County Hospital, Tîrgu Mures, Romania
| | - Luigi Santacroce
- University of Bari Aldo Moro, Policlinico University Hospital, Ionian Department and Microbiology and Virology Service, Bari, Italy
| | - Anca Mare
- University of Medicine and Pharmacy, Department of Microbiology, Tîrgu Mures, Romania
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24
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Dilhari A, Weerasekera MM, Siriwardhana A, Maheshika O, Gunasekara C, Karunathilaka S, Nagahawatte A, Fernando N. Candida infection in oral leukoplakia: an unperceived public health problem. Acta Odontol Scand 2016; 74:565-569. [PMID: 27538681 DOI: 10.1080/00016357.2016.1220018] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVES The study aimed to determine the proportion, known risk factors and etiology for Candida infection in leukoplakia lesions among patients with oral leukoplakia attending the Oral and Maxillofacial Clinic at a Tertiary Care Hospital in Sri Lanka. MATERIALS AND METHODS Eighty clinically suspected oral leukoplakia patients were included. Two oral swabs each, from leukoplakia patients: one swab from the lesion and the other one from the contralateral unaffected corresponding area (as a control) were collected. Direct microscopy and culture followed by colony count and phenotypic identification were performed to identify pathogenic Candida species. RESULTS Candida infection was seen in 47% of patients with oral leukoplakia. Candida albicans (94.7%) was the most common Candida species followed by Candida tropicalis (5.3%). Majority of Candida-infected lesions were seen in the buccal mucosa region. Alteration of taste (p = 0.021), having other oral lesions (p = 0.008), angular cheilitis (p = 0.024) and periodontitis (p = 0.041) showed a significant association with Candida-associated leukoplakia. Increasing age showed a significant tendency for Candida infection (p = 0.020). Smoking (p = 0.026) and betel-quid chewing (p = 0.006) were also found to be significantly associated, although alcohol consumption alone did not show a significant association. Oral leukoplakia patients who had all three habits: alcohol consumption, smoking and betel-quid chewing had a significant association with Candida infection (p = 0.004). CONCLUSIONS Patients who had a combination of risk factors: smoking, betel-quid chewing and alcohol consumption were seen to have a significant association with Candida infection. Further betel-quid chewing alone and smoking singly was also significantly associated with Candida infection in oral leukoplakia.
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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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Ellepola AN, Khajah R, Jayatilake S, Samaranayake L, Sharma P, Khan Z. Impact of brief exposure to antifungal agents on the post-antifungal effect and hemolysin activity of oral Candida albicans. J Appl Oral Sci 2016; 23:412-8. [PMID: 26398514 PMCID: PMC4560502 DOI: 10.1590/1678-775720150100] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Post-antifungal effect (PAFE) of Candida and its production of hemolysin are determinants of candidal pathogenicity. Candida albicans is the foremost aetiological agent of oral candidosis, which can be treated with polyene, azole, and echinocandin antifungals. However, once administered, the intraoral concentrations of these drugs tend to be subtherapeutic and transient due to the diluent effect of saliva and cleansing effect of the oral musculature. Hence, intra-orally, Candida may undergo a brief exposure to antifungal drugs.
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Affiliation(s)
| | - Rana Khajah
- Health Sciences Center, Faculty of Dentistry, Kuwait University, KW
| | | | | | - Prem Sharma
- Health Sciences Center, Faculty of Medicine, Kuwait University, KW
| | - Zia Khan
- Health Sciences Center, Faculty of Medicine, Kuwait University, KW
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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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Arslan S, Koç AN, Şekerci AE, Tanriverdi F, Sav H, Aydemir G, Diri H. Genotypes and virulence factors of Candida species isolated from oralcavities of patients with type 2 diabetes mellitus. Turk J Med Sci 2016; 46:18-27. [PMID: 27511328 DOI: 10.3906/sag-1405-73] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2014] [Accepted: 01/27/2015] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND/AIM This study compared the genotypes and virulence factors of Candida species isolated from oral cavities of healthy individuals and patients with diabetes mellitus (DM). MATERIALS AND METHODS A total of 142 healthy individuals and 73 diabetic patients participated in this study. Study populations were classified into 4 groups as follows: Group I - Healthy, without caries; Group II - Healthy, with caries; Group III - DM, with caries; Group IV - DM, without caries. Diabetic patients' blood glucose and hemoglobin A1c concentrations were determined. Identification of Candida species was performed with conventional methods. Biofilm production, proteinase, phospholipase, and esterase were analyzed. The genetic diversity of Candida species was established using rep-PCR. RESULTS The most isolated species was Candida albicans. There were statistical differences in terms of isolated Candida frequency between healthy subjects and diabetic patients. There was no statistical difference between the virulence factors of groups. Twelve genotypes were determined. While there were statistical differences in aerobe biofilm production, proteinase, and phospholipase activity between genotypes, there were no statistical differences in anaerobe biofilm production and esterase activity between genotypes. CONCLUSION Diabetes has no effect on the activities of virulence factors of Candida species. Different genotypes of Candida albicans exhibited different virulence activities.
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Affiliation(s)
- Soley Arslan
- Department of Restorative Dentistry, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
| | - Ayşe Nedret Koç
- Department of Microbiology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Ahmet Ercan Şekerci
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
| | - Fatih Tanriverdi
- Department of Endocrinology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Hafize Sav
- Department of Microbiology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Gonca Aydemir
- Department of Microbiology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Halit Diri
- Department of Endocrinology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
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Tooyama H, Matsumoto T, Hayashi K, Kurashina K, Kurita H, Uchida M, Kasuga E, Honda T. Candida concentrations determined following concentrated oral rinse culture reflect clinical oral signs. BMC Oral Health 2015; 15:150. [PMID: 26597294 PMCID: PMC4657271 DOI: 10.1186/s12903-015-0138-z] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2015] [Accepted: 11/18/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Oral candidiasis is an infection caused by a yeast-like fungus called Candida. Various methods can be used to isolate Candida from the oral cavity. However, it is difficult to correctly and satisfactorily diagnose oral candidiasis because currently no microbiological or laboratory standards based on samples from the oral cavity are available. The aim of this study is to establish a reliable laboratory test for diagnosing oral candidiasis. METHODS Oral swab, rinse and concentrated rinse samples were obtained from 200 consecutive outpatients (103 male patients and 97 female patients; mean age, 47.2 years; age range, 9-89 years). Candida colonies from cultured samples were enumerated to compare the sensitivities and specificities of the above sampling methods, and the associations between Candida detection or concentration and the clinical oral signs were examined. RESULTS The mean colony numbers were 263 ± 590 CFU/swab for the swab method, 2894 ± 6705 CFU/100 μL for the rinse method, and 9245 ± 19,030 CFU/100 μL for the concentrated rinse method. The median numbers were 23 CFU/swab for the swab method, 56 CFU/100 μL for the rinse method, and 485 CFU/100 μL for the concentrated rinse method. Candida was detected in the oral cavity of 33.5 % and 52.0 % of the outpatients by the swab method and concentrated rinse, respectively. Candida concentrations determined by the concentrated rinse were closely related to the severity of the clinical oral signs. The positive predictive values of residual root, redness of the oral mucosa, denture, glossalgia, dry mouth, and taste disorder were useful predictors of oral candidiasis. CONCLUSIONS Concentrated rinse sampling is suitable for evaluating oral candidiasis, and Candida concentrations examined using this method strongly associated with the oral signs associated with Candida infection.
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Affiliation(s)
- Hiroaki Tooyama
- Department of Dentistry and Oral Surgery, Shinshu University School of Medicine, Shinshu University Hospital, 3-1-1 Asahi, Matsumoto, 390-8621, Japan.
| | - Takehisa Matsumoto
- Department of Laboratory Medicine, Shinshu University School of Medicine, Shinshu University Hospital, 3-1-1 Asahi, Matsumoto, 390-8621, Japan.
| | - Kiyonori Hayashi
- Department of Dentistry and Oral Surgery, Aizawa Hospital, 2-5-1 Honjo, Matsumoto, 390-8510, Japan.
| | - Kenji Kurashina
- Department of Dentistry and Oral Surgery, Aizawa Hospital, 2-5-1 Honjo, Matsumoto, 390-8510, Japan.
| | - Hiroshi Kurita
- Department of Dentistry and Oral Surgery, Shinshu University School of Medicine, Shinshu University Hospital, 3-1-1 Asahi, Matsumoto, 390-8621, Japan.
| | - Mitsuo Uchida
- Center for Health, Safety and Environmental Management, Shinshu University, 3-1-1 Asahi, Matsumoto, 390-8621, Japan.
| | - Eriko Kasuga
- Department of Laboratory Medicine, Shinshu University School of Medicine, Shinshu University Hospital, 3-1-1 Asahi, Matsumoto, 390-8621, Japan.
| | - Takayuki Honda
- Department of Laboratory Medicine, Shinshu University School of Medicine, Shinshu University Hospital, 3-1-1 Asahi, Matsumoto, 390-8621, Japan.
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Local, systemic, demographic, and health-related factors influencing pathogenic yeast spectrum and antifungal drug administration frequency in oral candidiasis: a retrospective study. Clin Oral Investig 2015; 20:1477-86. [PMID: 26481235 DOI: 10.1007/s00784-015-1631-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Accepted: 10/12/2015] [Indexed: 10/22/2022]
Abstract
OBJECTIVES In order to identify oral candidiasis patients being at risk of carrying potentially drug-resistant Candida, the aim of the study was to detect local, systemic, demographic, and health-related factors influencing (I) yeast spectrum composition and (II) antifungal administration frequency. Additionally, the aim was to investigate (III) species shift occurrence. MATERIALS AND METHODS Data from 798 patients (496 females, 302 males; mean age 59.7) with oral candidiasis diagnosed based on positive clinical and microbial findings (species identification and CFU count) between 2006 and 2011 were retrospectively analyzed using Pearson's chi(2) test and regression analysis. RESULTS Among 958 isolates, Candida albicans was the most frequently detected (76.8 %). Also, species intrinsically resistant to azoles were frequently isolated (15.8 and 17.7 % of isolates and patients). (I) Infections only caused by C. albicans were significantly associated with the use of inhalation steroids (p = 0.001) and antibiotics (p = 0.04), super-infection of lichen planus (p = 0.002), and the absence of removable dentures (p < 0.001). (II) Anti-mycotics were significantly more frequently administered in patients using inhalation steroids (p = 0.001), suffering from asthma/COPD, or smoking heavily (p = 0.003) and if C. albicans and non-albicans species were detected together (p = 0.001). (III) Pathogen composition did not change over time within the examined period (p = 0.239). CONCLUSIONS Different variables enhance the presence of certain Candida and the antifungal prescription frequency. No species shift was evident. CLINICAL RELEVANCE The major pathogen in oral candidiasis remains C. albicans. Nevertheless, therapeutic problems may be caused by the frequent presence of species intrinsically resistant to azoles, especially in patients wearing dentures.
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Aitken-Saavedra J, Rojas-Alcayaga G, Maturana-Ramírez A, Escobar-Álvarez A, Cortes-Coloma A, Reyes-Rojas M, Viera-Sapiain V, Villablanca-Martínez C, Morales-Bozo I. Salivary gland dysfunction markers in type 2 diabetes mellitus patients. J Clin Exp Dent 2015; 7:e501-5. [PMID: 26535097 PMCID: PMC4628805 DOI: 10.4317/jced.52329] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2015] [Accepted: 08/22/2015] [Indexed: 12/01/2022] Open
Abstract
Background Diabetes mellitus (DM) is a chronic disease of the carbohydrate metabolism that, when not rigorously controlled, compromises systemic and organ integrity, thereby causing renal diseases, blindness, neuropathy, arteriosclerosis, infections, and glandular dysfunction, including the salivary glands. The aim of this study was to determine the relationship between the qualitative and quantitative parameters of salivary alteration, which are indicators of salivary gland dysfunction, and the level of metabolic control of type 2 diabetes patients. Material and Methods A convenience sample of 74 voluntary patients with type 2 DM was selected, each of whom donated a sample of unstimulated saliva. Salivary parameters such as salivary flow rate, protein concentration, pH, and xerostomia were studied. Results There is a positive relationship between the level of metabolic control measured with HbA1 and the protein concentration in saliva (Spearman rho = 0.329 and p = 0.004). The same assay showed an inverse correlation between HbA1 and pH (Spearman rho = -0.225 and p = 0.05). Conclusions The protein concentration in saliva and, to a lesser extent, the pH may be useful as glandular dysfunction indicators in DM2 patients. Key words:Saliva, type 2 diabetes mellitus, pH, protein concentration, xerostomia.
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Affiliation(s)
- Juan Aitken-Saavedra
- Departamento de Patología y Medicina Oral. Facultad de Odontología. Universidad de Chile
| | - Gonzalo Rojas-Alcayaga
- Departamento de Patología y Medicina Oral. Facultad de Odontología. Universidad de Chile
| | | | | | - Andrea Cortes-Coloma
- Instituto de Investigación en Ciencias Odontológicas. Facultad de Odontología. Universidad de Chile
| | - Montserrat Reyes-Rojas
- Departamento de Patología y Medicina Oral. Facultad de Odontología. Universidad de Chile
| | | | | | - Irene Morales-Bozo
- Instituto de Investigación en Ciencias Odontológicas. Facultad de Odontología. Universidad de Chile
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O'Donnell LE, Millhouse E, Sherry L, Kean R, Malcolm J, Nile CJ, Ramage G. PolymicrobialCandidabiofilms: friends and foe in the oral cavity. FEMS Yeast Res 2015; 15:fov077. [DOI: 10.1093/femsyr/fov077] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/14/2015] [Indexed: 12/26/2022] Open
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GHENO JN, MARTINS MAT, MUNERATO MC, HUGO FN, SANT’ANA FILHO M, WEISSHEIMER C, CARRARD VC, MARTINS MD. Oral mucosal lesions and their association with sociodemographic, behavioral, and health status factors. Braz Oral Res 2015; 29:S1806-83242015000100289. [DOI: 10.1590/1807-3107bor-2015.vol29.0093] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2014] [Accepted: 03/30/2015] [Indexed: 02/20/2023] Open
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Olczak-Kowalczyk D, Pyrżak B, Dąbkowska M, Pańczyk-Tomaszewska M, Miszkurka G, Rogozińska I, Swoboda-Kopeć E, Gozdowski D, Kalińska A, Piróg A, Mizerska-Wasiak M, Roszkowska-Blaim M. Candida spp. and gingivitis in children with nephrotic syndrome or type 1 diabetes. BMC Oral Health 2015; 15:57. [PMID: 25952029 PMCID: PMC4425863 DOI: 10.1186/s12903-015-0042-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2014] [Accepted: 04/28/2015] [Indexed: 01/12/2023] Open
Abstract
Background Diabetes and Nephrotic syndrome (NS) promote plaque-related gingivitis and yeast-like fungal infections. The study assesses the impact of Candida spp. and general disease- or treatment-related factors on plaque-related gingivitis severity in children and adolescents with Nephrotic syndrome /diabetes. Methods Body mass index (BMI), BMI standard deviation score, and oral cavity (Plaque Index – PLI, Gingival Index – GI, mucosa status, presence and Candida enzymatic activity) were assessed in 96 patients (32 with NS: 30- immunosuppressive treatment, 35 - type 1 diabetes, and 29 generally healthy), aged; 3–18 years. Laboratory included cholesterol and triglyceride measurements; in diabetic subjects– glycated haemoglobin, in NS: total protein, albumin, creatinine, haemoglobin, haematocrit, white cell count, urinary protein excretion. Medical records supplied information on disease duration and treatment. A statistical analysis was performed; Kendall Tau coefficient, chi-square test, t-test, and multiple regression analysis ( P < 0.05). Results Candida spp. often occurred in healthy patients, but oral candidiasis was found only in the NS and diabetes groups (9.37% and 11.43%). Gingivitis occurred more frequently in patients with NS/diabetes. Gingivitis severity was correlated with PLI, age, and yeast enzyme activity in NS – to with immunosuppressive treatment with >1 drug, drug doses, treatment duration, lipid disorders, and BMI; in diabetes, with blood glucose and glycated haemoglobin >8%. Conclusion Poor hygiene control is the main cause of gingivitis. Gingivitis severity is most likely related to age, lipid disorders and increase in body mass. Candida spp., in uncompensated diabetes and in those using immunosuppressive treatment, might intensify plaque-related gingivitis.
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Affiliation(s)
- Dorota Olczak-Kowalczyk
- Department of Paediatric Dentistry, Medical University of Warsaw, 18 Miodowa St, 00-246, Warszawa, Poland.
| | - Beata Pyrżak
- Department of Paediatric Endocrinology, Medical University of Warsaw, Warszawa, Poland.
| | - Maria Dąbkowska
- Department of Dental Medical Microbiology, Medical University of Warsaw, Warszawa, Poland.
| | | | - Grażyna Miszkurka
- Department of Paediatric Endocrinology, Medical University of Warsaw, Warszawa, Poland.
| | - Izabela Rogozińska
- Department of Paediatric Endocrinology, Medical University of Warsaw, Warszawa, Poland.
| | - Ewa Swoboda-Kopeć
- Department of Dental Medical Microbiology, Medical University of Warsaw, Warszawa, Poland.
| | - Dariusz Gozdowski
- Department of Experimental Statistics and Bioinformatics, Warsaw University of Life Sciences, Warsaw, Poland.
| | - Angelika Kalińska
- Department of Paediatric Dentistry, Medical University of Warsaw, 18 Miodowa St, 00-246, Warszawa, Poland.
| | - Anna Piróg
- Department of Paediatric Dentistry, Medical University of Warsaw, 18 Miodowa St, 00-246, Warszawa, Poland.
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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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Shenoy MP, Puranik RS, Vanaki SS, Puranik SR, Shetty P, Shenoy R. A comparative study of oral candidal species carriage in patients with type1 and type2 diabetes mellitus. J Oral Maxillofac Pathol 2014; 18:S60-5. [PMID: 25364182 PMCID: PMC4211241 DOI: 10.4103/0973-029x.141361] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2014] [Accepted: 09/01/2014] [Indexed: 11/18/2022] Open
Abstract
Context: Diabetes mellitus can have profound effects upon the oral tissues especially in patients with poor glycemic control being prone to severe and/or recurrent infections particularly candidiasis. The main aim was to study the association between Type 1 and Type 2 diabetes mellitus and candidal carriage. Materials and Methods: The study design comprised of previously diagnosed 30 patients each with type 1 diabetes mellitus (Group A) and type 2 diabetes mellitus (Group B) and 30 age-, sex- and dental status-matched healthy non-diabetic individuals as controls (Group C). The saliva samples were collected and inoculated onto Sabouraud dextrose agar (SDA) and chromogenic agar culture medium. Candidal colony forming units per ml (CFU/ml) values were determined. Statistical Analysis: Data were analyzed by χ2 test, Mann-Whitney U-test, Spearman's rank correlation and Karl Pearson's correlation coefficient. Results: Data analysis showed statistically significant higher positive candidal growth in Group A and Group B when compared to Group C. The CFU/ml values were significantly higher in Groups A and B as compared with Group C. Significant positive correlation of CFU/ml with fasting blood sugar level and HbA1c% in both Groups A and B was seen. Oral signs and symptoms observed in diabetics were dry mouth, burning sensation, fissuring and atrophic changes of tongue and erythematous areas, which positively correlated with candidal load. Conclusion: The glycemic control status of the diabetic patients may directly influence candidal colonization. The quantitative and biochemical characterization allows better insight into the study of association of diabetes mellitus and candida.
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Affiliation(s)
- Mangesh P Shenoy
- Department of Oral Pathology and Microbiology, Attavara Balakrishna Shetty Memorial Institute of Dental Sciences, Deralakatte, Mangalore, Karnataka, India
| | - Rudrayya S Puranik
- Department of Oral Pathology and Microbiology, Parvathagouda Mallannagouda Nadagouda Memorial Dental College and Hospital, Bagalkot Karnataka, India
| | - Shrinivas S Vanaki
- Department of Oral Pathology and Microbiology, Parvathagouda Mallannagouda Nadagouda Memorial Dental College and Hospital, Bagalkot Karnataka, India
| | - Surekha R Puranik
- Department of Oral Medicine and Radiology, Parvathagouda Mallannagouda Nadagouda Memorial Dental College and Hospital, Bagalkot, Karnataka, India
| | - Pushparaja Shetty
- Department of Oral Pathology and Microbiology, Attavara Balakrishna Shetty Memorial Institute of Dental Sciences, Deralakatte, Mangalore, Karnataka, India
| | - Radhika Shenoy
- Department of Biochemistry, Srinivas Institute of Medical Sciences and Research Centre, Srinivas Nagar, Mukka, Mangalore, Karnataka, India
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Peker E, Zor F, Toprak ME, Bariş E. Facial Candidal Abscess in a Patient with Unknown Type 2 Diabetes Mellitus. J Maxillofac Oral Surg 2014; 14:995-8. [PMID: 26604475 DOI: 10.1007/s12663-014-0680-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2013] [Accepted: 07/30/2014] [Indexed: 01/21/2023] Open
Abstract
INTRODUCTION Facial candidal abscess is an infection with a fungal cause which was presented in this case such a rarity. We report a rare case of facial abscess due to Candida species in a patient with unknown diabetes. MATERIALS AND METHODS The patient presented with a longstanding firm swelling which occurred 2 weeks ago and did not show any improvement of healing process in spite of surgical and medical treatments. MRI examinations were conclusive and compatible with abscess, so she underwent surgical intervention. Facial candidal abscess was the final diagnosis. CONCLUSIONS We concluded that, in persistent abscesses, invasive candidiasis should be considered in the differential diagnosis of bacterial infections as it generally affects individuals with diabetes or general defects in the immune system, or those who use widespread antibiotics and steroids.
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Affiliation(s)
- Elif Peker
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Gazi University, Ankara, Turkey
| | - Fatma Zor
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Gazi University, Ankara, Turkey
| | - Mehmet Emin Toprak
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Gazi University, Ankara, Turkey
| | - Emre Bariş
- Department of Oral Pathology, Faculty of Dentistry, Gazi University, Ankara, Turkey
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Kumar S, Padmashree S, Jayalekshmi R. Correlation of salivary glucose, blood glucose and oral candidal carriage in the saliva of type 2 diabetics: A case-control study. Contemp Clin Dent 2014; 5:312-7. [PMID: 25191065 PMCID: PMC4147805 DOI: 10.4103/0976-237x.137925] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES To study the correlation between blood glucose levels and salivary glucose levels in type 2 diabetic patients, to study the relationship between salivary glucose levels and oral candidal carriage in type 2 diabetic patients and to determine whether salivary glucose levels could be used as a noninvasive tool for the measurement of glycemic control in type 2 diabetics. STUDY DESIGN THE STUDY POPULATION CONSISTED OF THREE GROUPS: Group 1 consisted of 30 controlled diabetics and Group 2 consisted of 30 uncontrolled diabetics based on their random nonfasting plasma glucose levels. Group 3 consisted of 30 healthy controls. Two milliliters of peripheral blood was collected for the estimation of random nonfasting plasma glucose levels and glycosylated hemoglobin (HbA1c). Unstimulated saliva was collected for the estimation of salivary glucose. Saliva was collected by the oral rinse technique for the estimation of candidal counts. RESULTS The salivary glucose levels were significantly higher in controlled and uncontrolled diabetics when compared with controls. The salivary candidal carriage was also significantly higher in uncontrolled diabetics when compared with controlled diabetics and nondiabetic controls. The salivary glucose levels showed a significant correlation with blood glucose levels, suggesting that salivary glucose levels can be used as a monitoring tool for predicting glycemic control in diabetic patients. CONCLUSION The present study found that estimation of salivary glucose levels can be used as a noninvasive, painless technique for the measurement of diabetic status of a patient in a dental set up. Increased salivary glucose levels leads to increased oral candidal carriage; therefore, oral diagnosticians are advised to screen the diabetic patients for any oral fungal infections and further management.
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Affiliation(s)
- Satish Kumar
- Department of Oral Medicine and Radiology, Vananchal Dental College and Hospital, Ranchi, Jharkhand, India
| | - S Padmashree
- Department of Oral Medicine and Radiology, Vydehi Institute of Dental Sciences, Bangalore, Karnataka, India
| | - Rema Jayalekshmi
- Department of Oral Medicine and Radiology, Vydehi Institute of Dental Sciences, Bangalore, Karnataka, India
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Takeuchi S, Motohashi J, Kimori H, Nakagawa Y, Tsurumoto A. Effects of oral moisturising gel containing egg yolk antibodies against Candida albicans in older people. Gerodontology 2014; 33:128-34. [PMID: 25059332 DOI: 10.1111/ger.12139] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/18/2014] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the inhibitory effects of oral moisturising gel containing egg yolk antibody against Candida albicans (anti-CA IgY) in older people. Therefore, we measured the number of Candia CFU present on oral swabs at baseline and after using the gel. METHODS A randomised, double-blind, placebo-controlled trial was conducted among volunteers living in a nursing home in Japan. The participants were divided into two groups. The group 1 participants received oral care using an experimental oral moisturising gel with anti-CA IgY, and those in group 2 received oral care using a placebo oral moisturising gel without anti-CA IgY. The oral care was performed by care workers three times a day for 4 weeks. The participants' tongues were sampled using a swab method at baseline and after 2 and 4 weeks of using the oral gel, and the number of C. albicans, Candida tropicalis and Candida krusei colonies was counted. RESULTS The baseline oral condition of the participants in the two groups did not differ significantly. The experimental gel significantly reduced the number of C. albicans colonies from baseline to after 4 weeks of using the oral gel; however, no significant reductions were observed in the number of C. tropicalis or C. krusei colonies. CONCLUSION The use of oral moisturising gel containing anti-CA IgY for 1 month significantly reduces the number of C. albicans CFU present on swabs in older people.
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Affiliation(s)
- Susumu Takeuchi
- Department of Community Dentistry, Tsurumi University School of Dental Medicine, Yokohama, Japan
| | - Jun Motohashi
- Department of Community Dentistry, Tsurumi University School of Dental Medicine, Yokohama, Japan
| | - Hisato Kimori
- Department of Geriatric Dentistry, Tsurumi University School of Dental Medicine, Yokohama, Japan
| | - Yoichi Nakagawa
- Department of Clinical Pathophysiology, Tsurumi University Dental Hospital, Yokohama, Japan
| | - Akihisa Tsurumoto
- Department of Community Dentistry, Tsurumi University School of Dental Medicine, Yokohama, Japan
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Boros-Majewska J, Salewska N, Borowski E, Milewski S, Malic S, Wei XQ, Hayes AJ, Wilson MJ, Williams DW. Novel Nystatin A₁ derivatives exhibiting low host cell toxicity and antifungal activity in an in vitro model of oral candidosis. Med Microbiol Immunol 2014; 203:341-55. [PMID: 24924305 DOI: 10.1007/s00430-014-0343-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2013] [Accepted: 05/21/2014] [Indexed: 12/21/2022]
Abstract
Opportunistic oral infections caused by Candida albicans are frequent problems in immunocompromised patients. Management of such infections is limited due to the low number of antifungal drugs available, their relatively high toxicity and the emergence of antifungal resistance. Given these issues, our investigations have focused on novel derivatives of the antifungal antibiotic Nystatin A1, generated by modifications at the amino group of this molecule. The aims of this study were to evaluate the antifungal effectiveness and host cell toxicity of these new compounds using an in vitro model of oral candidosis based on a reconstituted human oral epithelium (RHOE). Initial studies employing broth microdilution, revealed that against planktonic C. albicans, Nystatin A1 had lower minimal inhibitory concentration than novel derivatives. However, Nystatin A1 was also markedly more toxic against human keratinocyte cells. Interestingly, using live/dead staining to assess C. albicans and tissue cell viability after RHOE infection, Nystatin A1 derivatives were more active against Candida with lower toxicity to epithelial cells than the parent drug. Lactate dehydrogenase activity released by the RHOE indicated a fourfold reduction in tissue damage when certain Nystatin derivatives were used compared with Nystatin A1. Furthermore, compared with Nystatin A1, colonisation of the oral epithelium by C. albicans was notably reduced by the new polyenes. In the absence of antifungal agents, confocal laser scanning microscopy showed that C. albicans extensively invaded the RHOE. However, the presence of the novel derivatives greatly reduced or totally prevented this fungal invasion.
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Affiliation(s)
- Joanna Boros-Majewska
- Department of Pharmaceutical Technology and Biochemistry, Gdańsk University of Technology (GUT), 11/12 Narutowicza Street, 80-233, Gdańsk, Poland
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Premkumar J, Ramani P, Chandrasekar T, Natesan A, Premkumar P. Detection of species diversity in oral candida colonization and anti-fungal susceptibility among non-oral habit adult diabetic patients. J Nat Sci Biol Med 2014; 5:148-54. [PMID: 24678215 PMCID: PMC3961921 DOI: 10.4103/0976-9668.127315] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background and Objectives: Patients with diabetes mellitus are prone to secondary infections. In this study we aim to determine the prevalence of one such secondary infection (oral Candida colonization) and evaluate the influence of local and systemic factors on the oral candidal colonization in patients with diabetes mellitus. Materials and Methods: Forty non-insulin-dependent diabetic patients and 40 healthy individuals were included in this study. Samples were collected by using the oral rinse method. The candidal species were isolated and identified through phenotypic methods. An in vitro antifungal susceptibility profile was evaluated. Glycemic control, as determined by the glycosylated hemoglobin concentrations (HbA1c) of the study subjects, was correlated with the candidal colonization. Results: Patients with diabetes showed a significantly higher prevalence of candidal colonization. The rate of carriage and density (P = 0.001) was higher. Candida albicans was the most predominantly isolated species, however, C. dubliniensis, C. tropicalis, and C. parapsilosis were also observed. Variable resistance toward the antifungal drugs (amphotericin B and fluconazole) was observed in the Candida isolated from diabetics, but not from healthy patients. Interestingly, a positive correlation was observed between glycemic control and candidal colonization. Conclusion: Diabetic patients had a higher candidal carriage rate, with a variety of candidal strains, which significantly varied in their resistance to routinely used anti-fungal agents. Interestingly the higher oral candidal colonization in diabetic patients is related to local and systemic factors, independent of their oral habits.
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Affiliation(s)
- Jeyanthi Premkumar
- Department of Oral and Maxillofacial Pathology, College of Dental Sciences and Hospital, Rau, Indore, India
| | - Pratibha Ramani
- Department of Oral and Maxillofacial Pathology, Saveetha Dental College, Chennai, India
| | | | - Anuja Natesan
- Department of Oral and Maxillofacial Pathology, Saveetha Dental College, Chennai, India
| | - Priya Premkumar
- Department of Oral and Maxillofacial Pathology, Saveetha Dental College, Chennai, India
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Ellepola ANB, Joseph BK, Khan ZU. The postantifungal effect and phospholipase production of oralCandida albicansfrom smokers, diabetics, asthmatics, denture wearers and healthy individuals following brief exposure to subtherapeutic concentrations of chlorhexidine gluconate. Mycoses 2014; 57:553-9. [DOI: 10.1111/myc.12194] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2013] [Revised: 03/02/2014] [Accepted: 03/04/2014] [Indexed: 11/29/2022]
Affiliation(s)
- Arjuna N. B. Ellepola
- Department of Bioclinical Sciences; Faculty of Dentistry; Health Sciences Center; Kuwait University; Safat Kuwait
| | - Bobby K. Joseph
- Department of Diagnostic Sciences; Faculty of Dentistry; Health Sciences Center; Kuwait University; Safat Kuwait
| | - Z. U. Khan
- Department of Microbiology; Faculty of Medicine; Health Sciences Center; Kuwait University; Safat Kuwait
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van Boven JFM, de Jong-van den Berg LTW, Vegter S. Inhaled corticosteroids and the occurrence of oral candidiasis: a prescription sequence symmetry analysis. Drug Saf 2013; 36:231-6. [PMID: 23516006 DOI: 10.1007/s40264-013-0029-7] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The primary aim of the study was to gain insight into the relative risk of clinically relevant oral candidiasis following inhaled corticosteroid (ICS) initiation over time. A secondary aim was to analyse the influence of patient characteristics and co-medication on the occurrence of this adverse effect. METHODS Drug prescription data from 1994 to 2011 were retrieved from the IADB.nl database. To study the influence of ICS use on occurrence of oral candidiasis, a prescription symmetry analysis was used, including patients using medication for oral candidiasis up to 1 year before or after ICS initiation. The relative risk was calculated by dividing the number of patients receiving medication for oral candidiasis after ICS initiation by the number of patients receiving the same medication before ICS initiation. Sub-analyses were conducted to compare the relative risks at several time points after ICS initiation and to account for therapy persistence by only including chronic users of ICS. A multivariate logistic regression model was used to identify predictive factors. RESULTS A total of 52,279 incident users of ICS therapy were identified, of which 1,081 received medication for oral candidiasis up to 1 year before or after ICS initiation. A total of 701 patients received medication for oral candidiasis after ICS initiation, while 361 received these medications in the reversed sequence, resulting in a sequence ratio (SR) of 1.94 (95 % CI 1.71-2.21). In the first 3 months after ICS initiation, the SR was 2.72 (95 % CI 2.19-3.38) and then decreased to 1.47 (95 % CI 1.11-1.95) 9-12 months after ICS initiation. Predictive factors were higher daily dose of ICS and concomitant use of oral corticosteroids. CONCLUSIONS This study found a significant and clinically relevant increased number of patients receiving medication for oral candidiasis in the first year after therapy initiation with ICS. Relative risk is highest in the first 3 months, but remains increased up to at least 1 year after ICS initiation. This study stresses the need for patient education and inhalation instruction.
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Affiliation(s)
- Job F M van Boven
- Unit of PharmacoEpidemiology and PharmacoEconomics, Department of Pharmacy, University of Groningen, Groningen, The Netherlands.
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Costa ACBP, Pereira CA, Junqueira JC, Jorge AOC. Recent mouse and rat methods for the study of experimental oral candidiasis. Virulence 2013; 4:391-9. [PMID: 23715031 PMCID: PMC3714131 DOI: 10.4161/viru.25199] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
The Candida genus expresses virulence factors that, when combined with immunosuppression and other risk factors, can cause different manifestations of oral candidiasis. The treatment of mucosal infections caused by Candida and the elucidation of the disease process have proven challenging. Therefore, the study of experimentally induced oral candidiasis in rats and mice is useful to clarify the etiopathology of this condition, improve diagnosis, and search for new therapeutic options because the disease process in these animals is similar to that of human candidiasis lesions. Here, we describe and discuss new studies involving rat and mouse models of oral candidiasis with respect to methods for inducing experimental infection, methods for evaluating the development of experimental candidiasis, and new treatment strategies for oral candidiasis.
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Affiliation(s)
- Anna C B P Costa
- Department of Microbial Pathogenicity Mechanisms; Hans-Knoell-Institute; Jena, Germany
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López-Pintor RM, Hernández G, de Arriba L, de Andrés A. Oral candidiasis in patients with renal transplants. Med Oral Patol Oral Cir Bucal 2013; 18:e381-7. [PMID: 23385511 PMCID: PMC3668861 DOI: 10.4317/medoral.18658] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2012] [Accepted: 10/16/2012] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES Oral candidiasis (OC) is a frequent oral lesion in renal transplant patients (RTPs). Despite the increased prevalence of OC in RTPs, no study has examined related risk factors. The aims of this study were to analyze the prevalence of and risk factors for OC in RTPs compared with age- and gender-matched healthy control group (HC) as well as determine the incidence of OC after transplantation. STUDY DESIGN [corrected] We analyzed the prevalence and risk factors of OC in a group of 500 RTPs (307 men, 193 women, mean age 53.63 years) and 501 HC subjects (314 men, 187 women, mean age 52.25 years). Demographic and pharmacological data were recorded for all subjects. Incident cases of OC were ascertained retrospectively from outpatient clinical records only in the RTP group. RESULTS The prevalence of OC was 7.4% in RTPs compared with 4.19% in HC (P<0.03). The most frequent type of OC in the two groups was denture stomatitis. Statistical association was found between OC and age, mycophenolate mofetil dose and blood levels, dentures and tobacco. The multiple logistic regression model only chose for denture variable. According to the outpatient clinical records, 24 RTPs suffered OC during the first moth post-transplant. Severe lesions affecting the oral cavity and pharynx appeared in 79% of the OC cases. CONCLUSIONS This study shows a lower prevalence of OC in RTPs than previous reports. Denture stomatitis was the most frequent OC prevalence form described in RTPs. Severe candidiasis is more frequent in the immediate posttransplant period. The presence of denture is an important risk factor of OC. These results emphasise the importance of adequate pre- and post-transplant oral health and denture cleaning and adjustment is recommended for these subjects to prevent this infection.
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Affiliation(s)
- Rosa-María López-Pintor
- Department of Oral Medicine and Orofacial Surgery, Faculty of Odontology, Complutense University, Madrid, Spain.
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46
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Abstract
The impact of dietary behaviors and food consumption and their relation to oral health are significant public health issues. Women and men exhibit different dietary behaviors. Understanding the influences of dietary behaviors on oral health from the perspective of gender disparities, however, is limited. This article provides the intersections of dietary factors and oral-systemic health for which women are at greater risk than men. Topics include the effect of dietary choices on oral health disparities seen in female patients. Interventional strategies at the local and community level that are designed to influence the balance between dietary habits and oral-systemic health are discussed.
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Affiliation(s)
- Juhee Kim
- Department of Public Health, Center for Health Disparities, Brody School of Medicine, East Carolina University, Greenville, NC 27834, USA.
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47
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Ellepola ANB, Joseph BK, Khan ZU. Changes in the cell surface hydrophobicity of oral Candida albicans from smokers, diabetics, asthmatics, and healthy individuals following limited exposure to chlorhexidine gluconate. Med Princ Pract 2013; 22:250-4. [PMID: 23258226 PMCID: PMC5586741 DOI: 10.1159/000345641] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2012] [Accepted: 11/05/2012] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE The objective of this study was to determine the cell surface hydrophobicity of 40 oral Candida albicans isolates obtained from smokers, diabetics, asthmatics using steroid inhalers, and healthy individuals, following brief exposure to subtherapeutic concentrations of chlorhexidine gluconate. MATERIALS AND METHODS Forty C. albicans oral isolates (10 isolates each from smokers, diabetics, asthmatics using steroid inhalers, and healthy individuals) were exposed to 3 subtherapeutic concentrations of chlorhexidine gluconate (0.00125, 0.0025, and 0.005%) for 30 min. Thereafter, the antiseptic was removed and the cell surface hydrophobicity was measured by a biphasic aqueous-hydrocarbon assay. RESULTS Compared to the unexposed controls, the cell surface hydrophobicity of C. albicans isolates was suppressed by 5.40% (p > 0.05), 21.17% (p < 0.05), and 44.67% (p < 0.05) following exposure to 0.00125, 0.0025, and 0.005% chlorhexidine gluconate, respectively. CONCLUSIONS A brief period of transient exposure to subtherapeutic concentrations of chlorhexidine gluconate may modulate the cell surface hydrophobicity of C. albicans isolates and thereby may reduce candidal pathogenicity.
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Affiliation(s)
- Arjuna N B Ellepola
- Department of Bioclinical Sciences, Faculty of Dentistry, Health Sciences Center, Kuwait University, Jabriya, Kuwait.
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Weerasekera MM, Sissons CH, Wong L, Anderson S, Holmes AR, Cannon RD. Use of denaturing gradient gel electrophoresis for the identification of mixed oral yeasts in human saliva. J Med Microbiol 2012; 62:319-330. [PMID: 23065546 DOI: 10.1099/jmm.0.050237-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
A PCR-denaturing gradient gel electrophoresis (DGGE) method was established for the simultaneous presumptive identification of multiple yeast species commonly present in the oral cavity. Published primer sets targeting different regions of the Saccharomyces cerevisiae 26-28S rRNA gene (denoted primer sets N and U) and the 18S rRNA gene (primer set E) were evaluated with ten Candida and four non-Candida yeast species, and twenty Candida albicans isolates. Optimized PCR-DGGE conditions using primer set N were applied to presumptively identify, by band matching, yeasts in the saliva of 25 individuals. Identities were confirmed by DNA sequencing and compared with those using CHROMagar Candida culture. All primer sets yielded detectable DGGE bands for all species tested. Primer set N yielded mainly single bands and could distinguish all species examined, including differentiating Candida dubliniensis from C. albicans. Primer set U was less discriminatory among species but yielded multiple bands that distinguished subspecies groups within C. albicans. Primer set E gave poor yeast discrimination. DGGE analysis identified yeasts in 17 of the 25 saliva samples. Six saliva samples contained two yeast species: three contained C. albicans and three C. dubliniensis. C. dubliniensis was present alone in one saliva sample (total prevalence 16 %). CHROMagar culture detected yeasts in 16 of the yeast-containing saliva samples and did not enable identification of 7 yeast species identified by DGGE. In conclusion, DGGE identification of oral yeast species with primer set N is a relatively fast and reliable method for the simultaneous presumptive identification of mixed yeasts in oral saliva samples.
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Affiliation(s)
- Manjula M Weerasekera
- Department of Microbiology, Faculty of Medical Sciences, University of Sri Jayewardenepura, Nugegoda 10250, Sri Lanka.,Dental Research Group, School of Medicine and Health Sciences, University of Otago, Wellington 6242, New Zealand
| | - Chris H Sissons
- Dental Research Group, School of Medicine and Health Sciences, University of Otago, Wellington 6242, New Zealand
| | - Lisa Wong
- Dental Research Group, School of Medicine and Health Sciences, University of Otago, Wellington 6242, New Zealand
| | - Sally Anderson
- Dental Research Group, School of Medicine and Health Sciences, University of Otago, Wellington 6242, New Zealand
| | - Ann R Holmes
- Department of Oral Sciences, Faculty of Dentistry, University of Otago, Dunedin 9016, New Zealand
| | - Richard D Cannon
- Department of Oral Sciences, Faculty of Dentistry, University of Otago, Dunedin 9016, New Zealand
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Ellepola ANB, Joseph BJ, Khan ZU. Effects of subtherapeutic concentrations of chlorhexidine gluconate on germ tube formation of oral Candida. Med Princ Pract 2012; 21:120-4. [PMID: 22024644 DOI: 10.1159/000332569] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2011] [Accepted: 08/15/2011] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE The main objective of this study was to investigate the effect of brief exposure to subtherapeutic concentrations of chlorhexidine gluconate on germ tube formation of Candida albicans isolates obtained from smokers, diabetics, asthmatics using steroid inhalers and healthy individuals. MATERIALS AND METHODS Forty isolates of C. albicans were used in this study. All these isolates were quantified for germ tube formation without exposure to the drug and were used as the control group for data analysis. Isolates were also exposed to three subtherapeutic concentrations of chlorhexidine gluconate (0.00125, 0.0025 and 0.005%) for 30 min (limited exposure); the antiseptic was then removed and germ tube formation of these isolates was quantified microscopically following incubation in a germ tube-inducing medium. RESULTS Compared with the unexposed controls, brief exposure to all concentrations of chlorhexidine gluconate suppressed the ability of the C. albicans isolates to form germ tubes in increasing order by 13.72% (p < 0.001 to p = 0.02), 46.16% (p < 0.001) and 72.46% (p <0.001). CONCLUSIONS These findings show that brief exposure to subtherapeutic concentrations of chlorhexidine gluconate may modulate germ tube formation of C. albicans isolates, thereby suppressing their pathogenicity, and further elucidate the pharmacodynamic mechanisms by which chlorhexidine gluconate may operate in vivo.
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Affiliation(s)
- Arjuna N B Ellepola
- Department of Bioclinical Sciences, Faculty of Dentistry, Kuwait University, Jabriya, Kuwait.
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Sardi JCO, Duque C, Höfling JF, Gonçalves RB. Genetic and phenotypic evaluation of Candida albicans strains isolated from subgingival biofilm of diabetic patients with chronic periodontitis. Med Mycol 2011; 50:467-75. [PMID: 22114891 DOI: 10.3109/13693786.2011.633233] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Candida spp. are commensal microorganisms that are part of the microflora of different sites within the oral cavity. In healthy subjects, who have an unaltered immunological status, these yeasts do not cause disease. However, in immunosuppressed individuals whose condition may have been caused by diabetes mellitus, Candida spp. can express different virulence factors and may consequently become pathogenic. Studies have detected the presence of Candida spp. in periodontal sites of patients with chronic periodontitis, especially those that are immunologically compromised. However, the role of these microorganisms in the pathogenesis of periodontal disease is still unknown. The objectives of this study were: (1) to isolate and identify Candida albicans strains from subgingival sites of diabetic patients with chronic periodontitis; (2) to evaluate the following virulence factors; colony morphology, proteinase, phospholipase and hemolysin activities and cell surface hydrophobicity (CSH) under different atmospheric conditions; and (3) to determine the genetic patterns of these C. albicans isolates. Microbial samples were collected from subgingival sites and seeded on CHROMagar for subsequent identification of C. albicans by polymerase chain reaction (PCR). For the phenotypic tests, all strains of C. albicans were grown under reduced oxygen (RO) and anaerobiosis (ANA) conditions. Genotypes were defined by the identification through PCR of the transposable introns in the 25S rDNA. The results obtained relative to virulence factors were analyzed according to the atmospheric condition or genetic group, using Chi-square and Wilcoxon non-parametric tests. In this study, 128 strains were identified as C. albicans and of these, 51.6% were genotype B, 48.4% were genotype A and Genotype C was not found. Most of the strains were alpha-hemolytic in both atmospheric conditions, without a statistical difference. However, when comparing the genotypes, 46.1% of the genotype A strains were beta-hemolytic. In relation to colony morphology, 100% of the strains under ANA showed rough colonies, which were especially prevalent in genotype A isolates. In contrast, most of the colonies were smooth under RO. C. albicans strains did not produce proteinase and phospholipase activity in the total absence of oxygen. In RO, most strains had high proteinase activity and were positive by phospholipase tests (P < 0.05). Hydrophobicity was higher in anaerobiosis and was noted mainly for genotype A isolates. In conclusion, environmental oxygen concentration influenced the virulence factors of C. albicans strains isolated from subgingival sites of diabetic and periodontal patients. In addition, genotype A seems to be more virulent based on the phenotypic tests evaluated in this study.
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Affiliation(s)
- Janaina C O Sardi
- Department of Oral Diagnosis, Microbiology and Immunology, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil.
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