A Study on the Distribution of Oral Candidal Isolates in Diabetics / 대한의진균학회지

ABSTRACT

BACKGROUND: An important constituent of normal human oral microflora has long been recognized. The increase in the incidence of candidal infections has been associated with the increase in the number of patients at risk. Especially, diabetic patients have been increased susceptibility to general and local infections, but it is often equivocal whether or not risk factors such as oral-ambient conditions are related to candidal colonization. OBJECTIVE: The isolates of candidal species were evaluated in the oral cavity of diabetic patients in comparison with non-diabetic, non-immunocompromized subjects. Risk factors that could influence candidal colonization in diabetic patients were also studied. METHOD: Candidal species were isolated from the oral mucosa of 205 diabetics and 62 non-diabetics, using oral swab and smear technique. They were identified by germ tube test, Cornmeal-Tween agar and API 20C system. RESULTS: The frequency of oral candidal isolates was more common in 130 isolates (63.4%) in diabetic patients compared with 23 (37.1%) isolates in controls (p0.05). Germ tubes were formed in the 102 species and chlamydospores in the 105 species in diabetic patients. Candida(C) albicans among the species was the most frequent isolates in both groups (80.8% vs 69.6%). The isolated 130 candidal species, identified by API 20C system, in diabetic patients, showed C. albicans (104), C. tropicalis (16), C. parapsilosis (6), C. krusei (1), C. kefyr (1) and unidentified species (2) compared with C. albicans (16), C. tropicalis (2), C. parapsilosis (2), C. krusei (3), C. kefyr (3) in 23 of controls. These results were almost same in both groups except for the relative high frequency of C. kefyr in controls. As for the risk factors, the isolates were increased in diabetic patients who were smokers (p0.05). Candidal culture rate and diabetic duration were not correlated (p>0.05). The number of colonies in SDA plate was significantly increased in smokers and denture-wearers (p<0.05). CONCLUSION: The frequency of oral candidal isolates in diabetic patients is higher than in that of controls. Oral-ambient factors such as smoking, probably involve in the development of oral candidal colonization, but not being the result of a single factor.