Diversidad de especies de Candida recuperadas de la cavidad bucal de pacientes oncológicos en Barranquilla, Colombia Candida spp bucal y cáncer / Species diversity of the genus Candida in the oral cavity of cancer patients in Barranquilla, Colombia

Resumen Se caracterizaron especies de Candida recuperadas de la cavidad bucal de pacientes oncológicos en una institución prestadora de salud de Barranquilla, Colombia. La investigación tuvo un diseño de corte transversal, mediante un muestreo a conveniencia se seleccionaron 60 pacientes oncológicos con candidiasis oral. Las muestras obtenidas se cultivaron en agar Sabouraud cloranfenicol, CHROMagar® Candida y agar Sabouraud dextrosa. Los microorganismos aislados se identificaron y se estableció el perfil de sensibilidad a los antifúngicos. Se aplicó estadística descriptiva, prueba de X 2 y análisis bivariado utilizando el programa Statgraphics Centurión XVII, con razón de momios (OR) para probabilidad de ocurrencia. Se identificaron un total de 107 cepas de Candida correspondientes a 15 especies, distribuidas del siguiente modo: C. albicans 23%, C. glabrata 18%, C. tropicalis 13%, C. krusei 10%, C. intermedia y C. lipolytica con 1,5%. En 77% de los casos estuvieron implicadas especies diferentes de C. albicans. Se identificó la existencia de relación entre cáncer del sistema reproductor y C. guilliermondii (p = 0,0001, < 0,05; OR 17) y entre C. colliculosa y cánceres respiratorios (p = 0,0003 < 0,05; OR 19,5). El 99% de las especies de Candida identificadas fueron sensibles a los antifúngicos: fluconazol, voriconazol, caspofungina y micafungina. Solo una cepa de C. krusei fue resistente. Se concluye que existió diversidad de especies de Candida en la cavidad bucal de pacientes oncológicos, ya sea como colonizantes únicos o en combinación, de modo que más de una especie de Candida podría ser responsable de la infección micótica en la cavidad bucal de estos enfermos.

Abstract Candida spp. was characterized in the oral cavity of cancer patients in a health care center in Barranquilla, Colombia. This is a cross-sectional investigation including 60 oncological patients with oral candidiasis, selected by convenience sampling, from whom samples were subjected to culture in Sabouraud chloramphenicol agar, CHROMagar® Candida and Sabouraud dextrose agar were taken. The antifungal susceptibility profile was then identified and established. Descriptive statistics, Chi square test, and bivariate analysis were conducted using the Statgraphics Centurion XVII software with odds ratio (OR) for the probability of occurrence. A total of 107 Candida strains were identified belonging to 15 species, C. albicans with 23%, C. glabrata with 18%, C. tropicalis 13%, C. krusei 10%, C intermedia, and C. lipolytica with 1.5%. Species other than C. albicans were identified in 77% of the cases. A relationship between reproductive system cancer and C. guilliermondii was identified (p = 0.0001, <0.05) OR: 17.0. Between C. colliculosa and respiratory cancer (p = 0.0003, <0.05) OR 19.5. With regard to antifungal susceptibility, 99% of the identified Candida species were susceptible to the following antifungals: fluconazole, voriconazole, caspofungin, and micafungin. Only one strain of C. krusei was resistant. It is concluded that there was a diversity of Candida species, either single or mixed in cancer patients, which could determine that only one species is not responsible for fungal infection in the oral cavity.

Antifungal analysis of incorporation of the essential oil of Cymbopogon citratus (D.C.) Stapf into polymethyl methacrylate / Análise antifúngica da incorporação do óleo essencial de Cymbopogon citratus (d.c.) Stapf em polimetacrilato de metila

ABSTRACT Objective: Evaluated the antifungal effect of the incorporation of different concentrations of the essential oil Cymbopogon citratus (capim santo), into polymethylmethacrylate (PMMA) against Candida albicans. Methods: Fifty specimens were fabricated and divided into five groups: Group 1, PMMA + 10% essential oil (n=10); Group 2, PMMA + 15% essential oil (n=10); Group 3, PMMA + 20% essential oil (n=10); Group 4, PMMA + 25% essential oil (n=10); Group 5, PMMA (n=10). PMMA powder was mixed with the monomer and the mixture was placed in disc-shaped cavities measuring 15 mm in diameter, 2 mm thick. To evaluate the antifungal activity of the experimental specimens, the standard strain of Candida albicans was tested. After incubation, the colony count of each plate was performed using a digital colony counter, obtaining the number of colony forming units (CFU) and the Kruskal-Wallis test was applied. Results: There was statistically significant difference in the CFU count of Candida albicans as a consequence of the addition of Cymbopogon citratus essential oil to PMMA (p < 0.001) and values were significantly higher in comparison with those of all the other groups, when the essential oil was incorporated as incorporated into the PMMA in the concentration of 20%. In the other concentrations, no difference in values was observed in comparison with the Control Group without essential oil of Cymbopogon citratus. Conclusion: The acrylic resin with the essential oil incorporated into it in different concentrations provided no effect against development of the genus Candida.

RESUMO Objetivo: Avaliar o efeito antifúngico da incorporação de diferentes concentrações do óleo essencial Cymbopogon citratus (capim santo), em polimetilmetacrilato (PMMA) contra Candida albicans. Métodos: Cinquenta corpos de prova foram confeccionados e divididos em cinco grupos: Grupo 1, PMMA + 10% de óleo essencial (n=10); Grupo 2, PMMA + 15% de óleo essencial (n=10); Grupo 3, PMMA + 20% de óleo essencial (n=10); Grupo 4, PMMA + 25% de óleo essencial (n=10); Grupo 5, PMMA (n=10). O pó de PMMA foi misturado ao monômero e a mistura foi colocada em cavidades em forma de disco medindo 15 mm de diâmetro por 2 mm de espessura. Para avaliar a atividade antifúngica dos espécimes experimentais, foi testada a cepa padrão de Candida albicans. Após a incubação, foi realizada a contagem de colônias de cada placa por meio de um contador digital de colônias, obtendo-se o número de unidades formadoras de colônias (UFC) e para isso foi aplicado o teste de Kruskal-Wallis. Resultados: Houve diferença estatisticamente significativa na contagem de UFC de Candida albicans como consequência da adição do óleo essencial de Cymbopogon citratus ao PMMA (p < 0,001) e os valores foram significativamente maiores em comparação com todos os outros grupos, quando o essencial óleo foi incorporado como incorporado ao PMMA na concentração de 20%. Nas demais concentrações, não houve diferença nos valores em relação ao Grupo Controle sem óleo essencial de Cymbopogon citratus. Conclusão: A resina acrílica com o óleo essencial incorporado a ela em diferentes concentrações não apresentou efeito contra o desenvolvimento do gênero Candida.

Recuento de linfocitos CD4, carga viral y colonización oral por Candida en personas viviendo con VIH/SIDA

Objetivos: determinar la correlación entre el recuento de CD4, carga viral y la colonización oral por Candida en personas viviendo con VIH/SIDA (PVVS) que reciben terapia antirretroviral (TAR). Métodos: se realizó un estudio transversal correlacional con 35 participantes que recibían tratamiento antirretroviral. Mediante citometría de flujo se determinó el recuento de CD4; la carga viral se determinó mediante RT-PCRq y la confirmación de colonización oral se realizó mediante aislamiento de Candida spp. Resultados: el recuento de CD4 se correlacionó significativamente de manera inversa con la carga viral (rho de Spearman = -0,457, p=0,006; Kendall Tau-b= -0,306, p=0,012) y con la colonización oral por Candida (rho de Spearman = -0,442, p=0,008; Kendall Tau-b= -0,366, p=0,010), no se encontró significancia estadística entre la carga viral y colonización (p>0,05). Conclusiones: En las PVVS que reciben TAR, los recuentos bajos de CD4 se relacionan con mayor colonización oral por Candida, no se encontró asociación de dicha colonización con la carga viral.

Objectives: to determine the correlation between CD4 count, viral load, and oral Candida colonization in people living with HIV/AIDS (PLWHA) receiving antiretroviral therapy (ART). Methods: a correlational cross-sectional study was conducted with 35 participants receiving antiretroviral treatment. Using flow cytometry, the CD4 count was determined; the viral load was determined by RT-PCRq and confirmation of oral colonization was made by isolating Candida spp. Results: CD4 count was significantly inversely correlated with viral load (Spearman's rho = -0.457, p=0.006; Kendall Tau-b= -0.306, p=0.012) and with oral Candida colonization (Spearman's rho = -0.442, p=0.008; Kendall Tau-b= -0.366, p=0,010), no statistical significance was found between viral load and colonization (p>0.05). Conclusions: in PLWHA receiving ART, low CD4 counts are associated with greater oral colonization by Candida; no association of said colonization with viral load was found.

Development and evaluation of wafer loaded with sertaconazole solid dispersion for the treatment of oral candidiasis

Abstract Candidiasis is one of the most common fungal infections of oral cavity in humans, causing great oral discomfort, pain and aversion to food. To develop more effective antifungal systems for the treatment of oral candidiasis, an oral mucoadhesive wafer containing sertaconazole solid dispersion (STZ-SD) was developed in this study. Dispersion of STZ in Soluplus® as a solubility enhancement excipient was done by melting, solvent evaporation and freeze drying method at various STZ to Soluplus® ratios. The optimized STZ-SD was then incorporated in the sodium carboxymethyl cellulose (SCMC) gel, xanthan gum gel, or their combination to prepare the lyophilized wafers. The swelling capacity, porosity, and mechanical, release and mucoadhesive properties of the wafers, together with their antifungal activity, were then evaluated. The melting method sample with the ratio of 8:1 showed the best results in terms of saturation solubility and dissolution rate. The STZ-SD-composite wafer exhibited higher hardness and mucoadhesion, as compared to those made of the SCMC polymer. The STZ-SD-wafer also exhibited a greater antifungal effect when compared to the STZ-wafer. The present study, thus, suggested that the STZ-SD-wafer could serve as a novel effective delivery system for oral candidiasis treatment.

Novas estratégias terapêuticas para o controle de biofilmes orais: terapia fotodinâmica e sistema carreador de antimicrobianos / New therapeutic strategics for the control of oral biofilms: photodynamic therapy and drug delivery system

Os biofilmes orais possuem grande relevância clínica por estarem associados com o desenvolvimento de cárie dentária e candidose bucal, que são doenças infecciosas frequentemente encontradas na população. O presente trabalho foi dividido em dois estudos: Estudo 1 que teve como objetivo analisar os efeitos da terapia fotodinâmica antimicrobiana (TFDa), mediada por Fotoenticine (FTC) e Azul de Metileno (AM), sobre biofilmes microcosmos de cárie dentária; e Estudo 2 cujo objetivo foi avaliar o gellan gum como biomaterial para carreador do antifúngico Ester fenetil do ácido caféico (CAPE) contra Candida albicans. No estudo 1, amostras de dentina cariada foram coletadas de diferentes pacientes para formar biofilmes microcosmos in vitro. Os biofilmes foram tratados com FTC ou AM associado à irradiação LED a 660 nm (28,5 J/cm²). Os dados foram analisados pela contagem de Unidades Formadoras de Colônias (UFC/mL). Além disso, a biomassa, estrutura do biofilme e produção de ácidos pelos microrganismos foram determinadas por análises microscópicas ou espectrofotométricas. Os biofilmes de diferentes pacientes apresentaram variações na composição microbiana, sendo formados por estreptococos, lactobacilos e leveduras. No geral, a TFDa diminuiu 3,7 Log10 do total de microrganismos, 2,8 Log10 de estreptococos, 3,2 Log10 de lactobacilos e 3,2 Log10 de leveduras, e atingiu a erradicação de estreptococos do grupo mutans. A TFDa também foi capaz de reduzir a biomassa, desagregar os biofilmes e diminuir a concentração de ácidos em 1,1 a 1,9 mmol de lactato/L. Em relação ao estudo 2, inicialmente, foram preparadas formulações do CAPE em diferentes concentrações de gellan gum (0,6 a 1%). As formulações foram avaliadas em relação ao sistema de liberação e ação antifúngica contra C. albicans. Verificou-se que concentrações mais altas de gellan (0,9 e 1%) levaram a uma liberação mais prolongada do CAPE em relação as concentrações mais baixas. Os valores de concentração inibitória mínima do CAPE sobre C. albicans foram aumentados quando esse composto foi incorporado no gellan. As formulações de CAPE em gellan apresentaram atividade antifúngica tanto em culturas planctônicas como em biofilmes de C. albicans, sendo esses efeitos dependentes do tempo de tratamento. O CAPE e suas formulações em gellan também levaram a uma diminuição da atividade proteolítica de C. albicans. Concluiu-se que a TFDa mediada por Fotoenticine e o sistema carreador de gellan gum podem ser estratégias terapêuticas promissoras para o controle dos biofilmes na cavidade bucal, podendo ser usadas respectivamente no tratamento da cárie e candidose. (AU)

Dental caries and oral candidiasis are infectious diseases frequently found in the population. The present work is divided into two studies, study 1 time as objective: To analyze the effects of antimicrobial photodynamic therapy (aPDT), mediated by Fotoenticine (FTC) and Methylene Blue (MB), on dental caries microcosm biofilms. In study 2, the objective was to evaluate gellan gum as a biomaterial to carry the antifungal caffeic acid phenethyl ester (CAPE) on Candida albicans. To conduct study 1, carious dentin samples were collected from different patients to form in vitro microcosm biofilms. The biofilms were treated with FTC or MB associated with 660 nm red LED irradiation, with energy dose of 28.5 J/cm² and power dose of 40 mW/cm². The data were analyzed by the count of Colony Forming Units (CFU/mL). In addition, the biomass, biofilm structure and acid production of the microorganisms were determined by microscopic or spectrophotometric analysis. The biofilms from different patients showed variations in microbial composition, being formed by streptococci, lactobacilli, and yeasts. Overall, aPDT decreased 3.7 Log10 of total microorganisms, 2.8 Log10 of streptococci, 3.2 Log10 of lactobacilli and 3.2 Log10 of yeasts, and achieved eradication of mutans group streptococci. PDTa was also able to reduce biomass, disaggregate biofilms, and decrease acid concentration by 1.1 to 1.9 mmol lactate/L. For study 2 of this, first the standards of CAPE were determined, such as minimum inhibitory concentration, and absorption peak, then CAPE was incorporated into gellan gum, and then the standard curve test and analysis of CAPE release was performed, finally the formulations were tested on planktonic culture and biofilm of different strains of C. albicans, it was also analyzed the action of this drug on the production of Sap. The MIC found varied from 32 to 64 µg/mL, the release tests showed a gradual release in the higher formulations, finally in the CFU/mL count both in planktonic culture and biofilm the formulations were able to inhibit the fungus. With this it is concluded that both aPDT for oral microcosm and gellan gum as caregiver of CAPE for Candida albicans inhibition are promising. (AU)

Research progress on curcumin-mediated photodynamic therapy for oral infectious diseases / 口腔疾病防治

@#Curcumin is a natural medicine with a wide range of sources and low toxicity. It has antibacterial, antifungal, anti-inflammatory and other pharmacological effects. In recent years, curcumin has attracted much attention in the field of prevention and treatment of oral infectious diseases. Single curcumin is easily degraded during application and has poor water solubility and low bioavailability, but it can be used as a natural photosensitizer to mediate photodynamic treatment of oral infections. Photodynamic therapy has high antibacterial efficiency and can better protect the appearance and function of the affected area. This article reviews the research on curcumin-mediated photodynamic therapy for oral infectious diseases. As a natural photosensitizer, curcumin mediates photodynamic therapy and has shown good therapeutic effects against dental caries, endodontics, periodontitis, oral candidiasis and other oral infectious diseases by enhancing antibacterial ability, increasing the production of reactive oxygen species, and inhibiting the formation of biofilms. In-depth exploration of the mechanism of action of curcumin-mediated photodynamic therapy in different oral infectious diseases can provide new strategies for the prevention and treatment of oral infectious diseases.

Manifestaciones orales y recuento de linfocitos T CD4+ en pacientes adultos con infección por VIH atendidos en el Hospital San Juan de Dios. Santiago, Chile

Resumen Introducción: Las lesiones orales clasificadas como fuertemente asociadas a infección por VIH se presentan en casos de inmunosupresión profunda (recuento de linfocitos T CD4+ ≤ a 200 céls/mm3 de sangre). Objetivo: Asociar la presencia de lesiones orales fuertemente asociadas a infección por VIH con el recuento sérico de linfocitos T (LT) CD4+ al momento del diagnóstico. Métodos: Se realizó un estudio transversal en PVVIH atendidas en el Hospital San Juan de Dios entre 2013 y 2019. Las lesiones orales se diagnosticaron por el criterio de EC-Clearinghouse - OHARA, y la inmunosupresión fue determinada según el recuento de LT CD4+. Resultados: De los 240 pacientes reclutados, 35 pacientes presentaron lesiones fuertemente asociadas a infección por VIH y 26 de ellos presentaron inmunosupresión profunda. La probabilidad de ocurrencia de una lesión fuertemente asociada a infección por VIH fue 12,3 veces mayor en pacientes con inmunosupresión profunda. Conclusión: Existe una asociación estadísticamente significativa entre un estado de inmunosupresión profunda y la presencia de manifestaciones orales fuertemente asociadas a infección por VIH/SIDA, lo cual posee relevancia clínica pues se presenta como una herramienta clínica de diagnóstico inicial, progresión de la enfermedad y monitorización de la terapia antiretroviral.

Abstract Background: Oral lesions classified as strongly associated with HIV infection occur in cases of severe immunosuppression (CD4+ T lymphocyte count ≤ 200 cells/mm3 of blood). Aim: To associate the presence of oral lesions strongly associated with HIV infection with CD4+ T lymphocytes count at the time of diagnosis. Methods: A cross-sectional study was carried out in PLHIV treated at the San Juan de Dios Hospital between 2013 and 2019. Oral lesions were diagnosed by the EC-Clearinghouse - OHARA criteria and immunosuppression was determined according to the CD4+ T lymphocyte count. Results: Of the 240 recruited patients, 35 had lesions strongly associated with HIV infection and 26 of them had severe immunosuppression. The probability of occurrence of a lesion strongly associated with HIV infection is 12.3 times higher in patients with severe immunosuppression. Conclusion: There is a statistically significant association between a severe immunosuppression and the presence of oral manifestations strongly associated with HIV/ AIDS infection, which has clinical relevance since it is presented as a clinical tool for initial diagnosis, disease progression and monitoring of antiretroviral therapy.

Asociación entre los niveles de linfocitos T CD4 y lesiones bucales de portadores del VIH/sida / Association between CD4 T lymphocyte levels and oral lesions in HIV/AIDS patients

Introducción: Las enfermedades de la cavidad bucal en los pacientes con VIH/sida pueden verse agravadas dependiendo de la respuesta inmunitaria del paciente y los niveles de linfocitos. Objetivo: Relacionar los niveles de linfocitos T CD4 y las principales lesiones bucales en pacientes con el VIH/sida del Hospital Nacional Hipólito Unanue (Lima, Perú), durante el 2018. Métodos: Se realizó un estudio analítico y de corte transversal, entre julio y octubre del 2018, en 65 pacientes hospitalizados, a los cuales se realizó un examen clínico de la cavidad bucal. Se evaluó la presencia de manifestaciones bucales asociadas al VIH/sida; también se clasificó el nivel de linfocitos T CD4 en tres categorías (> 500 cel/mm3, entre 200-500 cel/mm3 y < 200 cel/mm3). Resultados: Un 70,8 por ciento de los pacientes no se encontraba con tratamiento antirretroviral al momento del examen. El nivel promedio de linfocitos T CD4 fue 237,65 cel/mm3, con mayor prevalencia en mujeres. El 56,9 por ciento de los pacientes presentaron lesiones bucales, el sexo masculino fue el más afectado (91 por ciento). La lesión más frecuente fue la candidiasis bucal (44,6 por ciento) y la categoría que presentó mayor frecuencia de lesiones bucales fue la < 200 cel/mm3 (38,5 por ciento; p < 0,05). Conclusiones: El sexo masculino presentó la mayor cantidad de lesiones bucales asociadas a bajos niveles de linfocitos T CD4. La mayor parte de lesiones bucales se presentaron en un nivel de linfocitos T CD4 < 200 cel/mm3. La candidiasis bucal fue la lesión que más se evidenció al momento de realizar el examen clínico(AU)

Introduction: Oral diseases may be aggravated in HIV/AIDS patients depending on their immune response and lymphocyte levels. Objective: Describe the relationship between CD4 T lymphocyte levels and the main oral lesions in HIV/AIDS patients from Hipólito Unanue National Hospital in Lima, Peru, during the year 2018. Methods: An analytical cross-sectional study was conducted of 65 hospitalized patients from July to October 2018. The patients underwent oral clinical examination. Evaluation was performed of the presence of HIV/AIDS-related oral manifestations, and CD4 T lymphocyte levels were classified into three categories: > 500 cell/mm3, 200-500 cell/mm3 and < 200 cell/lmm3. Results: Of the total patients studied, 70.8 percent were not under antiretroviral treatment at the moment of the examination. Average CD4 T lymphocyte level was 237.65 cell/mm3, with higher results among women. 56.9 percent of the patients had oral lesions. Males were more commonly affected (91 percent). The most frequent lesion type was oral candidiasis (44.6 percent), whereas the category presenting the highest frequency of oral lesions was < 200 cell/mm3 (38.5 percent; p < 0.05). Conclusions: Male patients presented the largest number of oral lesions associated to low CD4 T lymphocyte levels. Most of the oral lesions were found at a CD4 T lymphocyte level < 200 cell/mm3. Oral candidiasis was the lesion most commonly found by the clinical examination(AU)

Producción de nitrosaminas por Candida albicans y su relación con lesiones de la cavidad oral. Revisión de la literatura / Nitrosamine production by Candida albicans and its relationship with lesions of the oral cavity. A literature review

El objetivo de esta revisión es presentar el estado del conocimiento respecto a la capacidad que tiene Candida albicans de producir nitrosaminas y de cómo estas se relacionan con la posible malignización de lesiones de la cavidad bucal. La candidiasis oral (CO) es una infección frecuente de la mucosa bucal provocada por hongos de la familia Candida spp. Estos hongos son integrantes de la flora bucal habitual, pero, por diferentes factores locales y sistémicos, pueden producir micosis superficiales. Entre las distintas especies, albicans, es la más frecuente en la cavidad bucal.Posee gran variedad de factores de virulencia, uno de ellos la capacidad de nitrosación de nitratos y nitritos presentes en saliva que últimamente se ha considerado relacionada a la malignización de lesiones mucosas de la cavidad bucal y otras como el estómago.

This literature review was carried out to approach the state of knowledge regarding the capacity of Candida Albicans to produce nitrosamines and how these are related to the possible malignancy of lesions in the oral cavity. Oral candidiasis (CO) is a frequent infection of the oral mucosa caused by fungi of the family Candida spp. These fungi are part of the usual oral flora but, due to different local and systemic factors, can produce superficial mycosis. Among the different species, Albicans is the most frequent in the oral cavity. It has a great variety of virulence factors, one of them the nitrosation capacity of nitrates and nitrites present in saliva that lately has been considered related to the malignization of mucosal lesions of the oral cavity and others such as the stomach.

Study of pathogen of oral candidias / Шинэ санаа Шинэ нээлт

Background@#Oral candidiasis, which is one of the most common diseases of the mucous membrane, is carried in the mouth of about 17-75% of healthy population. And 51-74% of this healthy population is asymptomatic. However, oral candidiasis is found in 50-65% of the individuals with dentures, is found in 67% of elders over 75 years old and is found in 85% of the patients with oral cancer. The most common causative organism is C.albicans with 43.7%, less commonly C.glabrata and C.tropicalis. According to some researches, the occurrence of the oral candidiasis has been increasing continuously for last 20-30 years, and has strong tendency to consistently increase for the 21st century. @*Methods@#Total 50 patients were participated in this study, including; the patients with full denture from Department of Prosthodontics of The Dental Center of Ulaanbaatar, and patients with evident symptoms of candidiasis from Department of Neck and Head Surgery and Department of Radiation Therapy of National Cancer Center of Mongolia. The study was carried out by descriptive study type, based on the patients’ questionnaire survey, physical examination and laboratory tests.@*Results@#The oral candidiasis causing pathogen Candida was found in 100% of following patients including; the patients with full denture and the patients having head and neck radiation therapy. For the patients with full denture, Candida albicans was the most commonly implicated organism with 53%, Candida tropicalis 21% and Candida krusei 11%. For the patients with radiation therapy for head and neck cancer, most common pathogen was Candida albicans with 64% and Candida tropicalis with 7%.@*Conclusions@#Main causative pathogens for the patients with full denture are C.albicans (53%), С.tropicalis (21%), and for the patients with radiotherapy for head and neck cancer is C. albicans (64%). 95% of the participants who were diagnosed with oral candidiasis were resistant to Colistin and 100% sensitive to Nystatin and Miconazole.

Acanthus ilicifolius L. Treatment for Oral Candidiasis with Immunosuppressive Conditions Subjected to p38 MAPK Enhancement

ABSTRACT@#Methanolic extract from the leaves of Acanthus ilicifolius L. (A. ilicifolius L.) is a potent inhibitor of Candida albicans (C. albicans) growth and anti-inflammatory. C. albicans causes oral candidiasis in immunosuppressive condition. Mitogen-activated protein kinase (MAPK) signalling via p38 appears to discriminate between yeast and hyphal cells of C. albicans. Activation of p38 MAPK by hyphae results in the upregulation of proinflammatory cytokines. The p38 MAPK activation is known to impair corticosteroid action. The research was conducted to investigate the effect of methanolic extract A. ilicifolius L. treatment of oral candidiasis with the immunosuppressive condition through enhancement of p38 MAPK expression in the epithelial cells. Immunosuppressed conditions were obtained when 16 healthy male Rattus norvergicus (Wistar) was given oral administration of dexamethasone and tetracycline for 14 days and induced with C. albicans (ATCC-10231) 1 McFarland. The subjects were divided into four groups (n = 4/group): immunosuppression (IS), immunosuppression with oral candidiasis without treatment (ISC), immunosuppression with oral candidiasis and nystatin treatment (ISC+N), and immunosuppression with oral candidiasis and A. ilicifolius L. treatment (ISC+AI), and were treated for 14 days. Later, the rats were euthanised, and their tongue were biopsied. The p38 MAPK expression was subjected to immunohistochemical examination, observed under a microscope (400× magnification) and statistically analysed (one-way ANOVA, LSD-test, p < 0.05). The p38 MAPK expression of ISC+AI (36.05 ± 1.54) was higher than IS (26 ± 2.32), ISC (26.4 ± 3.71), IS+N (34.2 ± 0.99). Significant differences existed between ISC+AI and ISC+N to IS and ISC (p < 0.05). No significant differences were present between IS and ISC; ISC+AI and ISC+N (p > 0.05). Therefore, this treatment could enhance p38 MAPK expression in oral candidiasis with the immunosuppressed condition.

Hepatocellular Liver Function of Immunosuppressed Rats with Oral Candidiasis after Hyperbaric Oxygen Treatment: Alanine Transaminase and Aspartate Transaminase Levels

ABSTRACT@#Hepatocellular utility is observed by measuring the hepatocellular enzymes. Changes in its serum levels are related to liver dysfunction. Liver is one of the immunoprotective organs. Continuous use of immunosuppressive drugs can cause oral candidiasis and give effects to liver function. Hyperbaric oxygen treatment (HBOT), while reducing fungal infections, can also repair the liver function. The aim of this study was to investigate the alanine transaminase (ALT) and aspartate transaminase (AST) levels of immunosuppressed rats with oral candidiasis treated with hyperbaric oxygen. Twelve Wistar rats were divided into three groups: K− (normal/ healthy), K+ (oral candidiasis immunosuppressed rats), and P (oral candidiasis immunosuppressed rats treated hyperbaric oxygen). K+ and P groups were immunosuppressed by giving dexamethasone 0.5 mg/day/rat orally for 14 days, added with tetracycline 1 mg/day/rat. HBOT was given in five days successively. Blood serum of rats in all groups were taken to calculate the ALT and AST levels. ALT and AST levels in K+ showed higher value than K− and P groups. The data were analysed with one-way ANOVA test and showed significant difference in ALT levels (p < 0.05), while in AST levels there was no significant difference among the groups (p > 0.05). This study showed that HBOT affected the ALT and AST levels of immunosuppressed rats with oral candidiasis.

Prevalence, antifungal susceptibility and virulence determinants of oral yeast species isolated from immunodeficient patients in Northeastern Brazil / Prevalência, suscetibilidade a antifúngicos e determinantes de virulência de leveduras orais isoladas de pacientes imunodeficientes do Nordeste do Brasil / Prevalencia, susceptibilidad antifúngica y determinantes de virulencia de levaduras orales aisladas de pacientes inmunodeficientes del Noreste de Brasil

Justificativa e Objetivos: A candidíase oral tem uma ocorrência comum em pacientes imunocomprometidos. No entanto, outras infecções emergentes tornaram-se cada vez mais habituais. O objetivo deste estudo foi investigar a prevalência, os determinantes de virulência e a suscetibilidade a antifúngicos de leveduras que colonizam a mucosa de pacientes imunocomprometidos na região Nordeste do Brasil. Métodos: A amostra foi composta por 60 pacientes HIV positivos atendidos no Serviço de Atendimento Especializado/Hospital Dia do Hospital Universitário Prof. Alberto Antunes, vinculado à Universidade Federal de Alagoas. As amostras foram coletadas em regiões subgengivais e semeadas em CHROMagar para confirmação presuntiva de Candida spp., seguido por PCR e sequenciamento. Além disso, testamos os determinantes de virulência fosfolipase e protease e avaliamos in vitro a concentração inibitória mínima dos antifúngicos anfotericina B e fluconazol. Este projeto foi aprovado pelo Comitê de ética em pesquisa do Centro de Estudos Superiores de Maceió. Resultados: Aproximadamente 63% dos pacientes foram colonizados por leveduras. A espécie C. albicans foi predominante, enquanto as espécies de Candida não-albicans representaram 49% dos isolados, sendo C. dubliniensis e C. parapsilosis as mais comuns. Entretanto, C. intermedia, Bullera penniseticola e Naganishia liquefaciens também foram encontrados. Os determinantes da virulência protease e/ou fosfolipase também foram produzidos por Candida spp. e alguns isolados oportunistas incomuns como Kodamaea ohmeri, N. liquefaciens e Saitozyma podzolica. Além disso, a maioria dos isolados de Candida spp. e algumas espécies oportunistas incomuns apresentaram altos valores de concentração inibitória mínima. Conclusão: Os resultados obtidos indicam que C. albicans continua a ser a espécie predominante na cavidade oral de pacientes imunodeficientes e, juntamente com outras espécies incomuns, pode apresentar alta resistência aos antifúngicos testados.(AU)

Background and Objectives: Oral candidiasis has a common occurrence in immunocompromised patients. However, other emergent infections have become increasingly common. The aim of this study was to investigate the prevalence, virulence determinants and the antifungal susceptibility of yeast colonizing the mucosa of immunocompromised patients in Northeastern Brazil. Methods: Samples from sixty HIV-positive patients seen at the Specialized Service / Hospital Dia - Hospital Universitário Prof. Alberto Antunes from the Federal University of Alagoas were collected from subgingival sites and seeded on CHROMagar for presumptive confirmation of Candida spp. followed by PCR and sequencing. In addition, we tested virulence determinants, phospholipase and protease and evaluated in vitro the Minimum Inhibitory Concentration of antifungals amphotericin B and fluconazole. This project was approved by the Research Ethics Committee of the Center for Higher Studies in Maceió. Results: Approximately 63% of the patients were colonized by yeasts, with C. albicans as the predominant species, while non-Candida albicans species accounted for 49% of the isolates, with C. dubliniensis and C. parapsilosis being the commonest, but C. intermedia, Bullera penniseticola and Naganishia liquefaciens were also found. The virulence determinants protease and/or phospholipase were also produced by Candida spp. and some uncommon opportunistic isolates such as Kodamaea ohmeri, N. liquefaciens and Saitozyma podzolica. Furthermore, most of Candida spp. strains and some uncommon opportunistic species showed high values of minimal inhibitory concentration. Conclusion: Results obtained indicate that C. albicans continues to be the predominant species in oral cavity of immunodeficient patients and along with other unusual species may present high resistance to the antifungals tested.(AU)

Justificación y Objetivos: La candidiasis oral acomete con frecuencia a pacientes inmunocomprometidos. Sin embargo, otras infecciones emergentes se han vuelto cada vez más comunes. El objetivo de este estudio fue investigar la prevalencia, la producción de determinantes de virulencia y la susceptibilidad a antifúngicos de levaduras que colonizan la mucosa de pacientes inmunocomprometidos en la región Nordeste de Brasil. Métodos: Se colectaron muestras de sesenta pacientes VIH positivos atendidos en el Servicio de Atención Especializado/Hospital Día del Hospital Universitario Prof. Alberto Antunes, vinculado a la Universidad Federal de Alagoas. Se colectaron las muestras en las regiones subgingivales y las sembraron en CHROMagar para la presunta confirmación de Candida spp. seguido de PCR y secuenciación. Además, analizamos los determinantes de virulencia fosfolipasa y proteasa y evaluamos in vitro la concentración mínima inhibitoria de los antifúngicos anfotericina B y fluconazol. Este proyecto fue aprobado por el Comité de Ética en Investigación del Centro de Estudios Superiores de Maceió. Resultados: Aproximadamente el 63% de los pacientes fueron colonizados por levaduras, y la C. albicans fue la especie predominante, mientras que las especies de Candida no-albicans representaron el 49% de los aislamientos, de las cuales la C. dubliniensis y la C. parapsilosis fueron las más comunes. Sin embargo, también se encontraron C. intermedia, Bullera penniseticola y Naganishia liquefaciens. Los determinantes de virulencia de proteasa y/o fosfolipasa también fueron producidos por Candida spp. y algunos aislados oportunistas inusuales como Kodamaea ohmeri, N. liquefaciens y Saitozyma podzolica. Además, la mayoría de los asilados de Candida spp. y algunas especies oportunistas inusuales mostraron valores altos de concentración mínima inhibitoria. Conclusión: Los resultados obtenidos indican que C. albicans continúa siendo la especie predominante en la cavidad oral de pacientes inmunodeprimidos y, junto con otras especies poco comunes, puede presentar una alta resistencia a los antifúngicos evaluados.(AU)

Effect of probiotic bacteria on oral Candida in head- and neck-radiotherapy patients: A randomized clinical trial

Objective: The aim of the study is to assess the effect of probiotic bacteria on oral Candida counts in cancer patients who are undergoing head- and neck-radiotherapy in a tertiary care center. Study Design: The study was a randomized clinical trial including 90 patients who just completed head- and neck-radiotherapy. Materials and Methods: Participants were randomly allocated into three equal sized groups, i.e., probiotics group, candid group, and combination groups. Oral rinse samples of the patients were collected before and after the intervention for the identification of Candida. The samples were incubated on Sabouraud's Dextrose Agar with Chloramphenicol at 37°C for 48 h, to assess the counts of colony-forming units/milliliter (CFU/ml) of Candida in saliva, and further on chrome agar plates to identify the Candida spp. Data were analyzed using mixed ANOVA to compare mean CFU/ml of Candida among three groups before and after the intervention. Results: A total of 86 patients were included in the final analysis and there was a statistically significant reduction in mean Candida spp. Counts (CFU/ml) after intervention in all the three groups (P = 0.000) and significant reductions identified in both probiotic and combination therapy groups. Apart from reduction in Candida albicans, significant decrease in Candida glabrata and Candida tropicalis was observed after probiotics usage compared to other groups. Conclusions: The present study suggests that probiotic bacteria were effective in reducing oral Candida spp which can be recommended alone or in combination with traditional antifungal agents for effective reduction in oral Candida in head- and neck-radiotherapy patients

Candidiasis bucal en pacientes con cáncer sometidos a quimioterapia / Oral candidiasis in patients undergoing cancer chemotherapy

RESUMEN Introducción: Algunos tipos de cáncer suelen ser tratados con fármacos quimioterapéuticos que afectan de forma indirecta la cavidad bucal, los cuales susceptibilizan al paciente a contraer infecciones bucales como candidiasis bucal. Se ha evidenciado que una condición oncológica facilita una infección bucal por Candida albicans, sin embargo, otras especies de Candida se les relaciona poco. Objetivo: Identificar especies de Candida spp. en cavidad bucal de pacientes sometidos a quimioterapia. Métodos: Estudio descriptivo de corte transversal. Se tomaron 60 muestras de igual número de pacientes por conveniencia de un Instituto Oncológico en Barranquilla, Colombia. Previo a un examen clínico de diagnóstico de candidiasis bucal. Se tomaron hisopados en las superficies infectadas para realizar un examen directo -tinción de Gram y cultivo en agar dextrosa Sabouraud con cloranfenicol incubadas a 37 ºC durante 48 h y posteriormente cultivadas en medio CHROMagar® Candida- para identificación de diferentes especies. Se aplicó estadística descriptiva y de correlación. Resultados. El 55 por ciento de los pacientes correspondió al sexo femenino, con edades mayores a 60 años. El cáncer de mama fue el más frecuente en el 30 por ciento. La quimioterapia aplicada a todos fue el 5-fluorouracilo combinado con ciclofosfamida. El tipo clínico de candidiasis atrófica en lengua fue más frecuente en el 37 por ciento, seguida de candidiasis pseudomembranosa en lengua en el 33 por ciento. El 90 por ciento de muestras presentó algún tipo de Candida, crecimiento de una única especie y cultivos mixtos con más de una especie de Candida. Se evidenció el 13,3 por ciento de C. albicans y otro 13,3 por ciento de Candida spp. no albicans. Ninguno de los diagnósticos oncológicos tuvo una asociación estadísticamente significativa con las especies de Candida. Conclusiones: Se evidencia que la especie de C. albicans en candidiasis bucal en pacientes con cáncer, fue la más frecuente, con predominio en mayor proporción cultivos mixtos de Candida no albicans (C. glabrata, C. tropicalis) poco relacionados con este tipo de enfermedad(AU)

ABSTRACT Introduction: Some types of cancer are often treated with chemotherapeutic drugs which indirectly affect the oral cavity, thus making the patient vulnerable to infections such as oral candidiasis. Oral infection by Candida albicans has been found to be fostered by oncological conditions, but other Candida species have not been sufficiently analyzed in such a context. Objective: Identify Candida spp. in the oral cavity of patients undergoing cancer chemotherapy. Methods: A descriptive cross-sectional study was conducted of 60 samples of an equal number of patients selected by convenience sampling at an Oncological Institute in Barranquilla, Colombia, following diagnostic clinical examination for oral candidiasis. Swab samples were taken from the infected surfaces to perform direct examination - Gram staining and Sabouraud dextrose agar culture with chloramphenicol incubated at 37ºC for 48 h and then cultured in CHROMagar® Candida medium - for identification of various species. Analysis was based on correlation and descriptive statistics. Results: Of the total patients evaluated 55 percent were female and aged over 60 years. Breast cancer prevailed with 30%. The chemotherapy applied in all cases was 5-fluorouracil combined with cyclophosphamide. Atrophic candidiasis of the tongue was the most common clinical type with 37 percent, followed by pseudomembranous candidiasis of the tongue with 33 percent. Of the samples examined, 90 percent contained some sort of Candida, growth of a single species and mixed cultures with more than one Candida species. C. albicans represented 13.3 percent and non-albicans spp. another 13.3 percent. None of the oncological diagnostic analyses had a statistically significant association to Candida species. Conclusions: The species C. albicans was the most commonly found in oral candidiasis among cancer patients, with a predominance of non-albicans Candida spp. (C. glabrata, C. tropicalis) mixed cultures, a fact not generally related to this condition(AU)

In vitro antifungal activity and phytochemical characterization of Eugenia uniflora, Libidibia ferrea and Psidium guajava

The aim of this study was evaluate the in vitro antifungal activity of crude extracts from Eugenia uniflora, Libidibia ferrea and Psidium guajava. The extracts were obtained by turbo-extraction using water (AQ) or acetone-water (AC-W) (7:3, v/v) as solvents and lyophilized to obtain the crude extracts (CE). The CE were characterized by UV-Vis, TLC and HPLC. The activity of CEs was investigated against clinical isolates of Candida spp. and the Minimum Inhibitory Concentration (MIC), MIC50 and MIC90 were determinated. The analysis by TLC showed that all CEs presented polyphenols (flavonoids and tannins). The CEs from E. uniflora showed higher amount of polyphenols (30.35 ± 2.15%, AC-W) and the HPLC analysis revealed the tannins in all extracts. The CEs of E. uniflora showed MIC range from 1.9 to 500.0 µg/mL, and lower values of MIC50 and MIC90 against non-albicans Candida isolates. Regarding L. ferrea and P. guajava, the results showing MIC from 3.9 to 1000.0 µg/mL (CE-AQ) against C. albicans. The results demonstrate antifungal performance from CE against various species of Candida spp., suggesting that the herbal species may be use as new potential antifungal agents. Additionally, the polyphenol content can play a pivotal role in the antifungal properties of CE.

Oral Candidiasis in Immunosuppressed Wistar Rats (Rattus norvegicus) Post Dexamethasone Injection at 7. 2 mg/kg and 16 mg/kg Doses / Candidíase oral em ratos Wistar imunossuprimidos (Rattus norvegicus) pós-injeção de dexametasona com doses de 7, 2 mg / kg e 16 mg / kg

Objective: Oral candidiasis is an infection that occurs in the oral cavity and is caused by candida species, often Candida albicans. This infection commonly occurs in a condition of immunosuppression caused by dexamethasone. Due to the side effects of antifungal therapy, developing a standardized immunosuppressed animal model to induce oral candidiasis for new therapies is required. The aim of this study is to observe oral candidiasis in immunosuppressed Wistar rats post dexamethasone injection at 7.2 mg/kg and 16 mg/kg doses. Material and Methods: Twenty-one Wistar rats were divided into three groups: control group, treatment group 1 (injected with dexamethasone at a concentration of 7.2 mg/kg), and treatment group 2 (at a concentration of 16 mg/kg) for five days. Immunosuppression status was observed by leukocyte count and all the subjects' palates were inoculated with C. albicans 0.1 ml of 15x108 UFC/ml 24 hours later. The subjects' tongues were observed and confirmed by laboratory examination on day 10. A statistical analysis was performed using one way ANOVA, Kruskal­Wallis, Tukey HSD, and Mann-Whitney U tests. Results: A significant clinical appearance of the subjects' tongues was observed only between C and T1 (p=0.023; p<0.05). Significant hyphal formation was observed between C and T1 (p= 0.037; p<0.05) and between C and T2 (p=0.007; p<0.05), and no significant difference was observed between T1 and T2. A significant increase in the colony count was also observed in similar results. Conclusion: Dexamethasone injection at doses of 7.2 mg/kg and 16 mg/kg is effective in triggering immunosuppression to induce oral candidiasis in immunosuppressed Wistar rats. (AU)

Candidíase oral é uma infecção que ocorre na cavidade oral e é causada por espécies de Candida, freqüentemente Candida albicans. Esta infecção geralmente ocorre em uma condição de imunossupressão causada por dexametasona. Devido aos efeitos colaterais de terapia antifúngica, o desenvolvimento de um padrão de modelo animal imunossuprimido para induzir candidíase oral para testar novas terapias se faz necessário. O objetivo deste estudo é observar candidíase oral em ratos Wistar imunossuprimidos pós-injeção de dexametasona utilizando doses de 7,2 mg /kg e 16 mg / kg. Material e métodos: Vinte e um ratos Wistar foram divididos em três grupos: grupo controle, tratamento grupo 1 (injetado com dexametasona na concentração de 7,2 mg / kg), e tratamento grupo 2 (concentração de 16 mg / kg) por cinco dias. A imunossupressão foi observada pela contagem de leucócitos e todos os palatos dos animais foram inoculados com C. albicans 0,1 ml de 15x108 UFC / ml após 24horas. As línguas dos animais foram observadas e confirmadas por exame laboratorial após 10 dias. A análise estatística foi realizada usando os testes de ANOVA um fator, kruskal ­ Wallis, Tukey HSD e de Mann-Whitney. Resultados: Significante diferença na aparência clínica da língua dos animais foi observada apenas entre C e T1 (p = 0,023; p <0,05). Significativa diferença na formação de hifas foi observada entre C e T1(p = 0,037; p <0,05) e entre C e T2 (p = 0,007; p <0,05), e nenhuma diferença significativa foi observada entre T1 e T2. Um aumento significativo na contagem de colônias foi também observado com resultados semelhantes. Conclusão: Injeção de dexametasona utilizando doses de 7,2 mg / kg e 16 mg / kg é eficaz no desencadeamento da imunossupressão para induzir candidíase oral em ratos Wistar imunossuprimidos. (AU)

Eficácia antimicrobiana da terapia fotodinâmica no tratamento da candidíase oral em pessoas vivendo com HIV/Aids / Antimicrobial efficacy of photodynamic therapy on the treatment of oral candidiasis in people living with HIV/Aids / Eficacia antimicrobiana de la terapia fotodinámica en el tratamiento de la candidiasis bucal en personas viviendo con VIH/Sida

Objetivo: avaliar a eficácia antimicrobiana da terapia fotodinâmica no tratamento da candidíase oral em pessoas vivendo com HIV/aids. Método: estudo experimental, qualitativo e descritivo com 18 pessoas vivendo com HIV/aids que manifestavam a candidíase oral, maiores de 18 anos, que estavam em tratamento no Hospital Universitário Gaffrée e Guinle. Este grupo subdividiu-se em um grupo controle, composto por sete pessoas, que recebeu tratamento com a terapia fotodinâmica e antifúngicos, e um grupo experimental, com 11, que recebeu apenas a terapia fotodinâmica. A evolução do tratamento de cada participante foi acompanhada por registros fotográficos em duas consultas, inicial e final. Esta pesquisa foi aprovada pelo Comitê de Ética em Pesquisa do hospital, parecer número 2.431.107. Resultados: a maioria dos participantes apresentou melhora clínica, ainda que discreta, e em apenas um houve piora clínica. Conclusão: a terapia fotodinâmica antimicrobiana pode ser eficaz no tratamento da candidíase oral em pessoas vivendo com HIV/Aids

Objective: evaluate the antimicrobial efficacy of photodynamic therapy in the treatment of oral candidiasis in people living with HIV/ aids. Method: experimental, qualitative and descriptive study with 18 people living with HIV/aids who presented oral candidiasis, over 18 years of age, who were being treated at the Gaffrée and Guinle University Hospital. This group was subdivided into a control group, composed of seven people, who received treatment with photodynamic and antifungal therapy, and an experimental group, with 11, who received only the photodynamic therapy. The evolution of the treatment of each participant was followed by photographic registers in two appointments, initial and final. This research was approved by the Research Ethics Committee from the hospital, dictum number 2.431.107. Results: most of the participants showed clinical improvement, albeit discrete, and in only one there was clinical worsening. Conclusion: antimicrobial photodynamic therapy may be effective in the treatment of oral candidiasis in people living with HIV/Aids

Objetivo: evaluar la eficacia antimicrobiana de la terapia fotodinámica en el tratamiento de la candidiasis bucal en personas que viven con VIH/sida. Método: estudio experimental, cualitativo y descriptivo con 18 personas viviendo con VIH/sida que manifestaban la candidiasis bucal, mayores de 18 años, que estaban en tratamiento en el Hospital Universitario Gaffrée y Guinle. Este grupo se subdividió en grupo control, compuesto por siete personas, que recibió tratamiento con la terapia fotodinámica y antifúngicos, y un grupo experimental, con 11, que recibió sólo la terapia fotodinámica. La evolución del tratamiento de cada participante fue acompañada por registros fotográficos en dos consultas, inicial y final. La investigación fue aprobada por el Comité de Ética en Investigación del lugar, dictamen número 2.431.107. Resultados: la mayoría de los participantes presentó mejoría clínica, aunque discreta, y en apenas uno hubo empeoramiento clínico. Conclusión: la terapia fotodinámica antimicrobiana puede ser eficaz en el tratamiento de la candidiasis bucal en personas que viven con el VIH/Sida

Multicenter study of Candida species in oral mucosa of different patients: analysis of 711 strains and literature review

This study aimed to identify Candida spp. collected from oral mucosa and maintained in culture collections, correlating the findings with the medical history of patients and comparing with data from the literature over the past five years. Seven hundred and eleven oral Candida spp. isolates, collected between 2013 and 2017, were selected and identified using traditional and molecular methods. In addition, a literature review was performed with the key words: "Oral", "Candida" and "Yeast". Seven species of the genus Candida: were identified C. albicans(73.3%); C. tropicalis (9.3%); C. parapsilosis (8.2%); C. glabrata (3.9%); C. guilliermondii(2.8%); C. krusei (1.7%) and C. lusitaniae (0.3%). The strains identified as C. albicans were submitted to molecular methods using specific primers and of these, 5.8% were identified as C. dubliniensis strains. The greatest diversity of strains was found in patients presenting no systemic diseases or HIV +, while the highest percentage of strains of Candidanon-albicanswere observed in cancer patients. This study reports a representative distribution of Candidaspecies among individuals exhibiting distinct clinical conditions, in order to contribute to the design of future research on details of aspects involved in the infections caused by these microorganisms. The correct identification of oral Candida strains contributes to a realistic epidemiological approach and future clinical protocols against these pathogens

Presença de Candida sp na saliva de pacientes usuários de prótese total e próteses parciais removíveis atendidos em uma Faculdade de Odontologia de Goiás / Presence of Candida sp in the saliva of patients with complete dentures and partial removable dentures of a Goiás Dental School

Objetivos ­ À vista disso, conhecendo como a principal condição exógena para que ocorra a proliferação de Candida e introdução de Candidose em cavidade oral é a prótese dentária com tempo de uso de mais de 5 anos, propomos nesse estudo avaliar a quantificação de Candida na saliva pacientes usuários de prótese parcial e total removíveis, correlacionando com idade avançada e o fluxo salivar e fatores que possam agir influenciando sua quantificação. As espécies do gênero Candida são normalmente encontradas na microbiota de pacientes saudáveis, sendo a C. Albicans a mais comum. Já a patogenicidade da espécie só ocorre caso haja condições propicias para o seu desenvolvimento, como comprometimento do sistema imune, hiposalivação e uso incorreto de próteses. As próteses totais, em especial, estão associadas ao aumento de UFC e presença de candidose na cavidade oral. Métodos ­ Foram avaliados 121 indivíduos sendo 31 do grupo controle e 90 usuários de próteses dentárias. Foram realizada uma coleta de saliva de cada paciente no momento da primeira consulta odontológica e os pacientes foram classificados quanto ao fluxo salivar em reduzido, normal e aumentados. A análise microbiológica foi realizada com a mesma saliva utilizada na avaliação do fluxo salivar, sendo estas semeadas e a as colônias de Candida foram quantificadas e os pacientes serão categorizados em negativos, portadores e positivos. Resultados ­ Foi possível uma relação forte no que se refere a diminuição do fluxo salivar associado a idade avançada e em decorrência disto, com a quantidade de UFC de Candida na saliva dos pacientes estudados. Conclusão ­ Posto isso, fica comprovado que os pacientes que utilizam próteses removíveis são os com maior quantidade de UFC, seguidos pelos pacientes que utilizam próteses totais

Objectives ­ In view of this, knowing as the main exogenous condition for the occurrence of Candida proliferation and introduction of Candidosis in oral cavity is the dental prosthesis with time of use of more than 5 years, we propose in this study to carry out a evaluation the quantification of the presence of Candida in saliva in patients using partial and total removable prosthesis, correlating at the found with advanced age and the salivar flow and factors that may influence its quantification. Species of the genus Candida are usually found in the microbiota of healthy patients, with C. Albicans being the most universal. The pathogenicity of the species occurs only if there are propitious conditions to its development, such as impairment of the immune system, hyposalivation and incorrect use of prostheses. Total prostheses, in particular, are associated with increased CFU and the presence of candidosis in the oral cavity. Methods ­ A total of 121 individuals were evaluated, 31 from the control group and 90 users of dental prostheses. Saliva collection was performed from each patient at the time of the first dental appointment and the patients were classified as reduced, normal and increased salivary flow. Microbiological analysis was performed with the same saliva used for salivary flow evaluation. These were sown and Candida colonies were quantified and patients were categorized as negative, carrier and positive. Results ­ It was possible to have a strong relationship regarding the decrease in salivary flow associated with advanced age and, as a result, with the amount of Candida CFU in the saliva of the studied patients. Conclusion ­ Thus, it is proven that patients using removable prostheses are the ones with the highest amount of CFU, followed by patients using total prosthesis