Prevalence of Candida spp. in the oral cavity of patients admitted to the dermatology ward service of a level 3 hospital in Sao Paulo, Brazil

Abstract

Candida spp. are responsible for most opportunistic fungal infections. The rapid and accurate identification of this type of yeast in hospitalized patients is critical for their effective treatment and prevention of complications arising from resistant strains. Objective: Evaluate the prevalence, as well as factors that are associated with oral candidiasis in 240 patients who were admitted to the dermatology infirmary of a tertiary hospital in Sao Paulo, Brazil. Methods: It is a descriptive, observational, and cross-sectional study, in which the clinical condition of each patient was analyzed and a direct mycological examination and culture for fungi were performed. Microorganisms were identified using phenotypic methods and mass spectrometry (MALDI-TOF). Results: The prevalence of Candida spp. was 28.7%. C. albicans was the most common species (84%), followed by C. glabrata (4.34%), C. tropicalis (4.34%), C. parapsilosis (4.34%), C. krusei (1.4%), and C. dubliniensis (1.4%). As discovered by univariate and multivariate logistic regression analysis, such factors as the use of oral prosthesis and immunosuppression increased the risk of candidiasis. Conclusion: Hospitalized patients showed a significant prevalence of oral candidiasis, related to predisposing local and systemic factors, which affected their microbiota. Although C. albicans was the primary microorganism of the infection, other species were identified. Clinical relevance: The techniques that were used in this study identified the precise causative agent of the infection in a short period, allowing us to modify the therapeutic regimen so that, in turn, direct implications on the patient’s health were presented.