Background: Candida, and especially Candida albicans, colonizes the oral mucosa and becomes invasive when the immune system weakens. Therefore, frequently, oral and maxillofacial pathology can be associated with Candida. Objective: The qualitative and quantitative assessment of Candida colonization of the oral cavity in patients with oro-maxillo-facial conditions; to establish an association between the different contributing factors and colonization. Material and methods: Samples were collected from 70 patients hospitalized in the Clinic of Oral and Maxillo-Facial Surgery, by rinsing the mouth with sterile saline; historical data were also collected. The samples were analyzed at the Microbiology Laboratory of the University of Medicine and Pharmacy of Tîrgu Mureș, using Sabouraud agar medium. For each isolate, the antifungigram for Fluconazole and Voriconazole was performed following the CLSI standards. Results: From the 70 samples 45.7% were positive for 11 different yeast species. Regarding predisposing factors, most importantly, smoking was significantly associated with Candida colonization (OR = 2.34; 95% CI = 1.42-3.84; p <0.05). Other factors, such as radiotherapy, oral hygiene or antibiotics, are related, but not statistically significant in our study. Candida albicans was the predominant species (38.8%). The testing of Candida albicans and non-albicans to Fluconazole showed an increased resistance (52.4%) in both cases, while the resistance to Voriconazole was 50% and 12.5%, respectively. Conclusions: Colonization of the oral cavity with Candida is present in about half of the patients with OMF conditions, and this is probably not only due to classical predisposing factors, but also due to chronic oral pathology and to several risk factors like smoking or radiotherapy.
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1. Dongari-Bagtzoglou A Kashleva H Dwivedi P Diaz P Vasilakos J. Characterization of Mucosal Candida albicans Biofilms. PLoS ONE. 2009;4:e7967.
2. Rozkiewicz D1 Daniluk T Zaremba ML et al. Oral Candida albicans carriage in healthy preschool and school children. Adv Med Sci. 2006;51:187-190.
3. Yamamoto T. Oral candidiasis: clinical features and control. Rinsho Byori. 2010;58:1027-1034.
4. Țovaru Ș. Patologie Medicală Stomatologică. Bucharest: Editura Cerma 1999; p. 186-191.
5. Constantinescu EM. Factori de risc asociați infecțiilor produse de specia Candida albicans. Teză de doctorat Tîrgu Mureș 2009. p. 5-40.
6. Thaweboon S Thaweboon B Srithavaj T Choonharuangdej S. Oral colonization of Candida species in patients receiving radiotherapy in the head and neck area. Quintessence Int. 2008;39:e52-e57.
7. Oltean G. Tratamentul în candidoze cutaneo-mucoase. Acta Medica Transilvanica. 2009;2:63-65.
8. Akpan A Morgan R. Oral candidiasis. Postgrad Med J. 2002;78:455-459.
9. Pfaller MA Diekema DJ Gibbs DL et al. Results from the ARTEMIS DISK Global Antifungal Surveillance study 1997 to 2005: an 8.5-year analysis of susceptibilities of Candida species and other yeast species to fluconazole and voriconazole determined by CLSI standardized disk diffusion testing. J Clin Microbiol. 2007;45:1735-1745.
10. Abu-Elteen KH Hamad MA. Prevalence of Oral Candida Infections in Diabetic Patients. Bahrain Medical Bulletin. 2006;28:4-5.
11. Arendorf TM Walker DM. The prevalence and intra-oral distribution of Candida albicans in man. Arch Oral Biol. 1980;25:1-10.
12. Dutt P Chaudhary S Kumar P. Oral Health and Menopause: A Comprehensive Review on Current Knowledge and Associated Dental Management. Ann Med Health Sci Res. 2013;3:320-323.
13. Javed F Klingspor L Sundin U Altamash M Klinge B Engström PE. Periodontal conditions oral Candida albicans and salivary proteins in type 2 diabetic subjects with emphasis on gender. BMC Oral Health. 2009;9:12.
14. Kleinegger CL Lockhart SR Vargas K Soll DR. Frequency intensity species and strains of oral Candida vary as a function of host age. J Clin Microbiol. 1996;34:2246-2254
15. Samonis G Gikas A Anaissie EJ et al. Prospective evaluation of effects of broad-spectrum antibiotics on gastrointestinal yeast colonization of humans. Antimicrob Agents Chemother. 1993;37:51-53.
16. Samonis G Maraki S Anatoliotakis N et al. Effect of erythromycin clarithromycin roxithromycin and azithromycin on murine gut colonization by Candida albicans. Med Mycol. 2002;40:139-142.
17. Bucur A Navarro Vila C Lowry J. Compendiu de chirurgie oro-maxilofacială. Bucharest: Med Publishing 2009; p. 546.
18. Epstein JB Freilich MM Le ND. Risk factors for oropharynheal candidiasis in patients who receive radiation therapy for malignant conditions of the head and neck. Oral Surg Oral Med Oral Pathol. 1993;76:169-174.
19. Darwazeh AM Hammad MM Al-Jamaei AA. The relationship between oral hygiene and oral colonization with Candida species in healthy adult subjects. Int J Dent Hyg. 2010;8:128-133.
20. Budtz-Jłrgensen E Mojon P Banon-Clément JM Baehni P. Oral candidosis in long-term hospital care: comparison of edentulous and dentate subjects. Oral Dis. 1996;2:285-290.
21. Grimoud AM Lodter JP Marty N et al. Improved oral hygiene and Candida species colonization level in geriatric patients. Oral Dis. 2005;11:163-169.
22. Karbach J Walter C Al-Nawas B. Evaluation of saliva flow rates Candida colonization and susceptibility of Candida strains after head and neck radiation. Clin Oral Investig. 2012;16:1305-1312.
23. Muzurović S Hukić M Babajić E Smajić R. The relationship between cigarette smoking and oral colonization with Candida species in healthy adult subjects. Med Glas (Zenica). 2013;10:397-399.
24. Darwazeh AM Al-Dwairi ZN Al-Zwairi AA. The relationship between tobacco smoking and oral colonization with Candida species. J Contemp Dent Pract. 2010;11:017-24.
25. Mandras N Tullio V Allizond V et al. In Vitro Activities of Fluconazole and Voriconazole against Clinical Isolates of Candida spp. Determined by Disk Diffusion Testing in Turin Italy. Antimicrob Agents Chemother. 2009;53:1657-1659.
26. Urai M Kaneko Y Niki M et al. Potent drugs that attenuate anti-Candida albicans activity of Fluconazole and their possible mechanism of action. J Infect Chemother. 2014;20:612-615