RESUMEN
The purpose of this study was to determine the prevalence, species distribution and antifungal susceptibility profile among oral cavity isolates of Candida species from diabetic and non-diabetic subjects. The contribution of smoking and dental status to the prevalence and distribution of Candida species was also evaluated. Retrospective study of oral cadidiasis in diabetic patients between January and October 2003 was undertaken. Three private clinics in Amman, Jordan and Department of Biological Sciences at Hashemite University. A total of 262 individuals were enrolled in the study, 132 were diabetics and 130 healthy controls. None of the non-diabetic controls had any clinical evidence of oral candidiasis, 8.3% of diabetics had clinical evidence of oral candidiasis, of which, 36% were overnight denture wearers and tobacco smokers. An imprint culture method was used to determine the frequency of isolation and density of Candida species at up to nine intra-oral sites. Yeast-like colonies were identified by classical methods and CHROMagar Candida medium. Broth macrodilution technique was used to determine the antifungal susceptibility pattern of Candida isolates. Positive yeast was detected in 58.3% of diabetics compared with 30% in healthy controls [P<0.001]. C. albicans was the most prevalent species in both diabetics [81.8%] and controls [76.9%] followed by C. tropicalis, C. parapsilosis and C. glabrata. C. kefyr and C. krusei were isolated only from diabetics at a combined rate of 1.3%. Candida was detected more frequently in diabetic denture wearers than in control counterparts in all anatomic sampled sites [P<0.05]. The frequency of Candida isolation was significantly higher in smokers than in the non-smokers in both diabetics and controls [P<0.001]. All C. albicans recovered from diabetics and controls were susceptible to amphotericin B, ketoconazole, itraconazole and fluconazole. Non-albicans Candida isolates were shown to have higher azole MIC values than C. albicans isolates. Our findings show that smoking and continuously worn dentures, promote oral candidal colonization in diabetics