The relationship of Candida colonization of the oral and vaginal mucosae of mothers and oral mucosae of their newborns at birth.

OBJECTIVE: Vaginal Candida colonization is common during pregnancy. Vaginal Candida may transmit vertically to the mouth of newborns during labor. The aim of this study was to assess and compare oral Candida colonization between vaginally born newborns and cesarean-born newborns and to investigate the association of the mother's vaginal and oral Candida colonization and the newborn's oral colonization at the time of delivery. STUDY DESIGN: Culture swabs were collected from the oral and vaginal mucosae of 100 pregnant women and from the oral mucosa of their 100 full-term newborns. Fifty (50%) of the mothers gave birth vaginally and the other 50 (50%) by cesarean section. RESULTS: The prevalence of oral and vaginal Candida in pregnant mothers was 49% and 40%, respectively. Oral Candida colonization in newborns was 7%. Oral Candida was isolated from 5 of 50 (10%) in the vaginally born group and from 2 of 50 (4%) in the cesarean-born group (P = .44). In vaginally born group, oral Candida was isolated from 5 of 20 (25%) in those born to mothers with vaginal colonization of Candida, and 0 of 30 (0.0%) in mothers without vaginal colonization of Candida (P = .007). CONCLUSIONS: The mother's vaginal Candida may constitute an important source of oral Candida in the newborns, particularly in those delivered vaginally.

Admission to the Intensive Care Unit is Associated With Changes in the Oral Mycobiome.

A prospective exploratory study was conducted to characterize the oral mycobiome at baseline and determine whether changes occur after admission to the intensive care unit (ICU). We found that ICU admission is associated with alterations in the oral mycobiome, including an overall increase in Candida albicans.

Distribution and hydrolytic enzyme characteristics of Candida albicans strains isolated from diabetic patients and their non-diabetic consorts.

INTRODUCTION: The aim of this study was to investigate the oral colonization profile of Candida albicans strains isolated from diabetic patients and their non-diabetic consorts. In addition hydrolytic enzyme activity of these isolates was analysed. METHODS: The genetic diversity of C. albicans oral isolates from 52 couples was established using isoenzyme marker and cluster analysis. Hydrolytic enzyme characteristics, namely secreted aspartyl proteinases (SAPs) and phospholipases (PLs) were also analysed. RESULTS: Simultaneous colonization by C. albicans was observed in the consorts of 12 couples (23.1%). Patterns of monoclonal and polyclonal oral colonization by C. albicans strains were identified and the coexistence of identical or highly related strains was observed in both members of eight couples. The genetic diversity observed in the total yeast population revealed four large, genetically distinct groups (A to D) and the coexistence of strains in couples or consorts conjugally unrelated. SAP and PL activity was observed in the majority of C. albicans isolates without any association to particular strain, strain clusters (highly related isolates), or clinical characteristics of the consorts (diabetic, non-diabetic, and gender). CONCLUSION: Possible sources of transmission and oral propagation of groups (clusters) of strains of C. albicans can occur between diabetic and non-diabetic consorts. A conjugal genotypic identity exists in most C. albicans-positive couples, that is, both consorts share identical or highly related strains; however, this identity is not couple-specific as seen by the coexistence of clusters in couples and unrelated consorts.

Predictive value of oral colonization by Candida yeasts for the onset of a nosocomial infection in elderly hospitalized patients.

The incidence of nosocomial yeast infections has increased markedly in recent decades, especially among the elderly. The present study was therefore initiated not only to determine the predictive value of oral colonization by yeasts for the onset of a nosocomial Candida infection in elderly hospitalized patients (> 65 years), but also to clarify the factors that promote infection and to establish a relationship between the intensity of oral carriage and the onset of yeast infection. During this prospective cohort study, 256 patients (156 women and 100 men with a mean age of 83 +/- 8 years) were surveyed for yeast colonization or infection. Samples were collected every 4 days from day 0 to day 16 from four sites in the mouth, and intrinsic and extrinsic factors that might promote infection were recorded for each patient. Pulsed field gel electrophoresis was performed on Candida albicans isolates from all infected patients. Poor nutritional status was observed in 81 % of the patients and hyposalivation in 41 %. The colonization level was 67 % on day 0 (59 % C. albicans) and a heavy carriage of yeasts (> 50 c.f.u.) was observed for 51 % of the patients. The incidence of nosocomial colonization reached 6.9 % on day 4 (6.1 % on day 8 and 2.7 % on day 12), and that of nosocomial infection was 3.7 % on day 4 (6.8 % on day 8, 11.3 % on day 12 and 19.2 % on day 16). Of the 35 patients infected, 57 % were suffering from oral candidiasis. The principal risk factors for colonization were a dental prosthesis, poor oral hygiene and the use of antibiotics. The risk factors for infection, in addition to those already mentioned for colonization, were endocrine disease, poor nutritional status, prolonged hospitalization and high colony counts. Genotyping revealed person-to-person transmission in two patients. Thus, this study demonstrates a significant association between oral colonization and the onset of yeast infections in elderly hospitalized patients. Therefore, oral samples should be collected at admission and antifungal treatment should be administered in cases of colonization, especially in patients presenting a heavy carriage of yeasts. Genotyping of the strains confirmed the possibility of person-to-person transmission.

Oral colonization by Candida spp. among AIDS household contacts.

This study was designed to investigate the oral yeast colonization rate of household contacts of AIDS patients. Sixty-four AIDS household contacts were sequentially enrolled along with 103 HIV-negative blood bank donors (control group). Samples were obtained by swabbing the oral mucosa. Yeast isolates were identified by classical methods and antifungal susceptibility testing was performed according to NCCLS microbroth assay. Candida spp. was recovered from the oral cavity of 33% of the AIDS household contacts, in contrast with 14% of the control group (P = 0.003 or P = 0.04 after adjusting for oral prosthesis use). Candida albicans was the most frequently isolated species in both groups. All of the isolates were susceptible to fluconazole, itraconazole and ketoconazole. In conclusion, we were able to demonstrate a higher colonization rate in the AIDS household contacts group compared with the control group. No resistant isolates to antifungal drugs was observed. We suggest that the contact with AIDS patients may play a role as a risk factor for developing oral colonization by Candida spp.

[Environment of school as potential place of interindividual transmissions]. / Srodowisko szkolne jako potencjalne miejsce transmisji miedzyosobniczych.

The purpose of examinations was defined role of environment of school in interindyvidual transmisions. The yeast and yeast--like fungi isolated from the oral cavity, troat and nose from 270 healthy children, at the age of 6 to 15 years, from country and municipal schools. The frequency of occurrence of fungi in country was higher than in minicipal schools by the resambling biodifferentiation. Totally 13 species belonging to 5 genera were detected in the examined material: Candida, Rhodotorula, Saccharomyces, Saccharomycopsis i Trichosporon. Increasing part of S. capsularis was noted in ontocenoses of healthy children. The qualitative and quantitative changes testify about changes of environment. Simultaneously, they inform about timely condition of mycoflora of the examined ontocenosis and surroundings.

Influência da xerostomia na transmissibilidade de Candida albicans na cavidade bucal de ratos / Effects of xerostomia in the transmissibility of Candida albicans in the oral cavity of rats

A xerostomia produzida pela sialoadenectomia em ratos aumenta a colonizaçäo, permanência e patogenicidade da Candida albicans na cavidade bucal destes animais. O objetivo deste trabalho foi verificar se ratos xerostômicos transmitem Candida albicans para ratos normais com maior intensidade. Foram usados 10 ratos normais e 12 sialoadenectomizados que receberam 12 inoculaçöes semanais contendo 10(8) células de Candida albicans desde 10 até sessenta dias de idade. Após as inoculaçöes, os ratos foram emparelhados com 10 (grupo controle) e 12 (grupo experimental) ratos normais de mesma idade respectivamente. A quantidade de ratos que passaram a apresentar Candida foi maior no grupo experimental três a vinte e oito dias após o emparelhamento, apresentado 83,3 por cento de recuperaçäo após 10,75 por cento após quatorze e dezoito dias, e 100 por cento após vinte e um dias. A transmissibilidade de C. albicans foi mais rápida e acentuada portanto, a partir dos animais sialoadenectomizados

Transmission of an azole-resistant isogenic strain of Candida albicans among human immunodeficiency virus-infected family members with oropharyngeal candidiasis.

We report transmission of an azole-resistant, isogenic strain of Candida albicans in a human immunodeficiency virus (HIV)-infected family of two children with symptomatic oropharyngeal candidiasis and a mother with asymptomatic colonization over a 5-year period. These findings were confirmed by three different molecular epidemiology methods: interrepeat PCR, Southern hybridization with a C. albicans repetitive element 2 probe, and electrophoretic karyotyping. This study contributes to an evolving understanding of the mode of transmission of C. albicans, particularly in children, and underscores the importance of monitoring specimens from family members of HIV-infected patients.

Oropharyngeal candidosis in AIDS patients: an epidemiological study using restriction analysis of Candida albicans total genomic DNA.

This study investigates the epidemiology of Candida albicans strains isolated from oral and rectal swabs obtained before and after treatment with antifungal drugs in hospitalized AIDS patients. Twenty-one health care workers from the hospital unit were also studied. Samples were obtained from the oral cavity and hands. The molecular fingerprinting restriction endonuclease-digested genomic DNA technique was used. A total of 94 C. albicans strains were isolated: 76 from patients and 18 from the health care workers. Each sample was digested independently with EcoRI and HinfI restriction enzymes, electrophoresed on 0.8% agarose gels and stained with ethidium bromide. The strains were sorted into groups according to patterns. Analysis of the different restriction patterns suggests that most of the infective strains had an endogenous source, whereas the recurrences of candidosis, after antifungal therapy, could be considered as persistence or reinfection by a different strain. Our data show that horizontal transmission by strains carried by health care workers does not play an important role in the overall epidemiology of candidosis.

NAPWA sends thrush alert. National Association of People with AIDS.

AIDS: The National Association of People with AIDS (NAPWA) is warning people that drug-resistant strains of oral candidiasis (thrush) can be transmitted. The group recommends that people with greater than 200 T4 cell counts discontinue prophylactic treatment, and that people with thrush receive treatment as needed to minimize the chance of developing resistant strains.^ieng

Oral transmission of Candida albicans between partners in HIV-infected couples could contribute to dissemination of fluconazole-resistant isolates.

BACKGROUND: Fluconazole resistance has emerged among Candida albicans isolates and has been associated with the prolonged or repeated use of the drug. This study was designed to discover whether transmission of oral isolates could occur between sexual partners and thereby explain fluconazole resistance in patients never treated with the drug. MATERIALS AND METHODS: The oral flora of 10 HIV-infected couples (five heterosexual and five homosexual) were studied. In vitro susceptibility testing and genotyping (restriction fragment length polymorphism with EcoRI and HinfI) were used to delineate strain relatedness for 230 clones (five clones per sample, one to four samples per patient). RESULTS: The genetic diversity of the clones with one DNA subtype was specific to a given patient or a given couple, except in one case in which unrelated patients shared clones of the same genotype. The persistence of clones between partners was stable over time in six out of 10 couples and only transient in one couple. Fluconazole resistance in isolates from patients who had never been treated with azoles was associated in three patients with the first episode of oropharyngeal candidiasis and treatment failure. CONCLUSION: The observation that couples tended to share genetically indistinguishable clones was highly suggestive of transmission between partners. This phenomenon may, in part, explain the pathogenesis of oropharyngeal candidiasis and the increased frequency of fluconazole resistance both in vitro and in vivo.

Candida: the hidden deterrent to breastfeeding.

The '80s and '90s have been characterized by an increase in the number of breastfeeding mothers. The added health benefits of breastfeeding for both mother and child, the father's influence, maternal age, family practices and education all may contribute to a mother's decision to breastfeed. Although the incidence of mothers choosing to breastfeed their infants has increased, both research and practice indicate that a significant number of mothers stop breastfeeding long before their target date. Among the many reasons given for the early cessation of breastfeeding is the complaint of persistently sore and red nipples. Such a complaint should raise a red flag to the hospital or community nurse. The pain and redness could be due to Candida albicans.

Transmission of fluconazole-resistant Candida albicans between patients with AIDS and oropharyngeal candidiasis documented by pulsed-field gel electrophoresis.

Electrophoretic karyotype and restriction endonuclease analysis of genomic DNA were used for the typing of nine isolates of Candida albicans from the oral cavities of two patients with AIDS--a husband and wife--whose infections became resistant to treatment with fluconazole (400 mg/d). The in vitro susceptibilities of sequential isolates to fluconazole and two other triazoles, itraconazole and the investigational drug D0870, were also evaluated. DNA analysis showed that the isolates responsible for fluconazole-resistant episodes of oropharyngeal candidiasis in the two patients were genetically related. In vitro susceptibility to fluconazole correlated well with clinical outcome. Although the minimal inhibitory concentrations of itraconazole and D0870 for fluconazole-resistant isolates were higher than those for fluconazole-susceptible isolates, both of the former triazoles exhibited good in vitro activity against the isolates tested.