<p>Oral Prevalence of <em>Candida</em> Species in Patients Undergoing Systemic Glucocorticoid Therapy and the Antifungal Sensitivity of the Isolates</p>

Abstract

Background Candida species are commonly detected as colonizers of the oral cavity; candidiasis or candidemia can develop in patients who are immunocompromised. Use of topical or inhaled glucocorticoids can alter the spectrum of Candida species and can promote oral candidiasis. The present study aims to evaluate the diversity of Candida species in the oral cavity and their susceptibility to antifungal agents in patients undergoing treatment with systemic glucocorticoids (SGCs) compared with non-users. Methods We conducted a descriptive, analytical, cross-sectional study that enrolled 120 patients with oral problems who were undergoing treatment with SGCs and who were admitted to the hospital of the First Affiliated Hospital, College of Medicine, Zhejiang University and Zhejiang Hospital, Hangzhou, China, between February 2019 and September 2019. One hundred and twenty age-and sex-matched patients were recruited as the SGC non-user control group. Demographic data included oral complaints and underlying diseases; symptoms of oral candidiasis were identified on physical examination. Candida species were collected using a concentrated oral rinse. Identification of fungal isolates was based on conventional phenotypic methods assisted by DNA sequence analysis of the internal transcribed spacer (ITS) rDNA gene region. Antifungal activities of anidulafungin, amphotericin B, micafungin, caspofungin, 5-flucytosine, posaconazole, voriconazole, itraconazole, and fluconazole were evaluated using the Sensititre YeastOne TM YO10 panel supplemented by the CLSI-M27-A3 protocol. Results Fifty-two (43.33%) out of the 120 patients undergoing with SGCs were diagnosed with oral candidiasis, compared with 14 (11.67%) of the non-users ( P < 0.05). Likewise, we collected 88 strains from 73.33% of the SGC users compared with only 48 (40%) from non-users ( P < 0.05). Candida albicans was detected most frequently in both groups (45.45% vs 66.67%, respectively; P = 0.033); the overall frequency of non- Candida albicans (NCA) strains isolated from patients treated with SGCs were significantly higher than that identified among non-users (51.14% vs 33.33%, respectively; P = 0.046), although there were no significant differences concerning any single species of NCA. Resistance of C. albicans to itraconazole ( P = 0.004) and fluconazole ( P = 0.001) was significantly higher in patients treated with SGCs than in non-users; however, echinocandins, amphotericin B, voriconazole, and posaconazole were all active against strains from both participant groups with no significant differences detected. Conclusion ...

Prevalence and Antifungal Susceptibility Profile of Oral Candida spp. Isolates from a Hospital in Slovakia

“…isolated in people living with HIV with diabetes (50%). Other similar results (China and Iran) corroborate our results, with this species being the most or one of the most NCAC isolated (both in single and multi-fungal cultures) [ 55 , 56 , 57 ].…”

“…Previous research showed the effectiveness of Vcz and AmB Candida spp. isolates [ 25 , 26 , 55 , 58 , 59 , 60 , 61 , 62 ] (Portugal, Brazil, Korea, US, Japan), but also of both AmB and Flu (China) [ 57 ], as seen in this work. A recent study involving immunosuppressed patients (with diabetes mellitus), showed a predominance of C. albicans , but among denture wearers, C. glabrata was prevalent.…”

Multiple Candida strains causing oral infection in COVID-19 patients under corticosteroids and antibiotic therapy: An observational study

“…In addition, the duration of corticosteroid therapy was greater in these patients compared to patients with OC caused by one Candida species. Similar to our findings, Xia et al reported corticosteroid therapy caused an increased prevalence of OC by non-albicans strains (Xiao et al, 2020). Moreover, Nambiar et al noted that the development of OC in COVID-19 patients could be due to prolonged mechanical ventilation in the ICU and the long-term use of broad-spectrum antibiotics.…”

Distribution and antifungal susceptibility pattern ofCandidaspecies from mainland China: A systematic analysis

“…For example, a study reported 85% fluconazole susceptibility in 2013, while in 2020, 48% susceptibility was reported against C. glabrata [ 18–21 ]. Likewise, a study for C. parapsilosis in 2012 reported 98.6% susceptibility, while 76.93% susceptibility was reported in 2020 against itraconazole [ 22 , 23 ]. Likewise, a study in 2014 reported 100% itraconazole susceptibility rate against C. krusei , while in 2016, a study reported 16.7% susceptibility rate [ 24 , 80 ].…”