Prevalence of oral Candidiasis and Risk Factors in Diabetic Pateints

Document Type : Original Article

Authors

1 1Botany Department Faculty of Women for Arts, Science and Education, Ain Shams University, Cairo, Egypt

2 Microbiology and Internal medicine Departments, Faculty of Medicine for Girls Al-Azhar University, Cairo, Egypt

3 Botany Department Faculty of Women for Arts, Science and Education, Ain Shams University, Cairo, Egypt

Abstract

Oral candidiasis has a strong association with diabetes. This study investigated the prevalence of candidiasis, effects of age and denture wearing on the isolation rate of Candida, virulence factors such as (germ tube (GT), gelatinase assay, phospholipase (PL) activities, biofilm (BF) formation) of different Candida species isolated from 40 confirmed diabetic patients with oral candidiasis and susceptibility of Candida isolates to antifungal agents.  The prevalence of candidiasis was (67%) which is more prevalent in middle age (40-60) years (65%) and among females (65%). Sixty Candida isolates were identified among which Candida albicans represented (53.3%), followed by C. glabrata (31.7%), C. tropicalis (10%) and C. krusei (5%). In denture wearers, the isolation rate of all Candida species was 94.7% while in non denture wearers was 53.7%. The minimun inhibitory concentrations (MICs) of ketoconazle as the lowest concentration of antifungal that inhibited 100% of C. krusei while MIC for flucytosine that inhibited 90.6% and 84.2% of C. albicans and C. glabrata respectively, also the MIC for itraconazole and voriconazole that inhibited 93.5% and 81.2% of C. albicans. The MIC of amphotericin B was defined as the lowest drug concentration causing 100% inhibition of all Candida species. Candida albicans and C. tropicalis isolates were positive for all the virulence factors while C. glabrata and C. krusei were negative for GT, gelatinase and PL activities. C. krusei were positive only for BF formation. InConclusion, Candida spp. in the oral cavity of diabetic patients are potentially pathogenic and can participate in infectious and inflammatory processes since they exhibit most of the virulence factors and resistance to most antifungals. Denture wearing, female sex and middle age are among the risk factors. Controlling serum glucose level and oral hygiene are essential in diabetics.
 

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