- Volume 46 Issue 2
DOI QR Code
Clinical Characteristics of Patients with Oral Candidiasis
- Kim, Ji Hoo (Department of Dentistry, Graduate School, Chosun University) ;
- Ahn, Jong-Mo (Department of Oral Medicine, School of Dentistry, Chosun University)
- Received : 2021.05.10
- Accepted : 2021.05.28
- Published : 2021.06.30
Purpose: Oral candidiasis is the most common fungal infection in the oral cavity which is usually diagnosed from clinical findings. A retrospective study was conducted to identify risk factors for oral candidiasis and to characterize the demographic and clinical features of affected patients. Methods: From January 1, 2019 to December 31, 2019, it consisted of 90 oral candidiasis patients diagnosed based on clinical finding and treated with antifungal drugs. As a retrospective study of those people, surveys were conducted on sex, age, systemic disease, a use of dentures, complaints of dry mouth, smoking and alcohol consumption, culture on potato dextrose agar (PDA) medium, culture on chromogenic agar (CA) medium and a duration of antifungal treatment. Results: Among 90 selected patients, the male and female ratio was 41:49. Overall, female had a higher infection rate than male in all age groups. In this study, oral candidiasis was not clearly susceptible to dry mouth, smoking or drinking, wearing dentures and association with systemic disease. Among 90 patients with oral candidiasis, 83 had colonies formed on PDA medium and 53 had colonies formed on CA medium. The duration of antifungal treatment was highest between 5 and 8 weeks. In addition, there was statistical significance between the culture results in CA medium and the duration of antifungal treatment. Conclusions: Generally, old age or infants, dry mouth, smoking, a use of dentures and endocrine abnormalities are risk factors to increase oral candidiasis; however, in this study, it was mainly found in the elderly aged 60 or older regardless of sex and the incidence of oral candidiasis was not obviously related with patients with dry mouth, smoking or drinking, denture wearers and endocrine abnormalities. Interestingly, when the fungi were cultured in CA medium, the duration of antifungal treatment was increased.
- Glick M, Feagans WM. Burket's oral medicine. 12th ed. Shelton: People's Medical Publishing House; 2015. pp. 93-99.
- Hu L, He C, Zhao C, Chen X, Hua H, Yan Z. Characterization of oral candidiasis and the Candida species profile in patients with oral mucosal diseases. Microb Pathog 2019;134:103575. https://doi.org/10.1016/j.micpath.2019.103575
- Korean Academy of Orofacial Pain and Oral Medicine. Diagnosis and treatment of oral soft tissue disease. Seoul: Shinhung International; 2010. pp. 274-281.
- Kossioni AE. The prevalence of denture stomatitis and its predisposing conditions in an older Greek population. Gerodontology 2011;28:85-90. https://doi.org/10.1111/j.1741-2358.2009.00359.x
- Mima EG, Vergani CE, Machado AL, et al. Comparison of Photodynamic Therapy versus conventional antifungal therapy for the treatment of denture stomatitis: a randomized clinical trial. Clin Microbiol Infect 2012;18:E380-E388. https://doi.org/10.1111/j.1469-0691.2012.03933.x
- Maciag J, Osmenda G, Nowakowski D, et al. Denture-related stomatitis is associated with endothelial dysfunction. Biomed Res Int 2014;2014:474016. https://doi.org/10.1155/2014/474016
- Tay LY, Jorge JH, Herrera DR, Campanha NH, Gomes BP, Andre Dos Santos F. Evaluation of different treatment methods against denture stomatitis: a randomized clinical study. Oral Surg Oral Med Oral Pathol Oral Radiol 2014;118:72-77. https://doi.org/10.1016/j.oooo.2014.03.017
- Reinhardt LC, Nascente PDS, Ribeiro JS, Etges A, Lund RG. A single-center 18-year experience with oral candidiasis in Brazil: a retrospective study of 1,534 cases. Braz Oral Res 2018;32:e92.
- Odds FC, Bernaerts R. CHROMagar Candida, a new differential isolation medium for presumptive identification of clinically important Candida species. J Clin Microbiol 1994;32:1923-1929. https://doi.org/10.1128/jcm.32.8.1923-1929.1994
- Akpan A, Morgan R. Oral candidiasis. Postgrad Med J 2002;78: 455-459. https://doi.org/10.1136/pmj.78.922.455
- Saintrain MV, Holanda TG, Bezerra TM, de Almeida PC. Prevalence of soft tissue oral lesion in elderly and its relations with deleterious habits. Gerodontology 2012;29:130-134. https://doi.org/10.1111/j.1741-2358.2011.00618.x
- Semlali A, Killer K, Alanazi H, Chmielewski W, Rouabhia M. Cigarette smoke condensate increases C. albicans adhesion, growth, biofilm formation, and EAP1, HWP1 and SAP2 gene expression. BMC Microbiol 2014;14:61. https://doi.org/10.1186/1471-2180-14-61
- Gendreau L, Loewy ZG. Epidemiology and etiology of denture stomatitis. J Prosthodont 2011;20:251-260. https://doi.org/10.1111/j.1532-849X.2011.00698.x
- Anil S, Vellappally S, Hashem M, Preethanath RS, Patil S, Samaranayake LP. Xerostomia in geriatric patients: a burgeoning global concern. J Investig Clin Dent 2016;7:5-12. https://doi.org/10.1111/jicd.12120
- Ohga N, Yamazaki Y, Sato J, et al. Elimination of oral candidiasis may increase stimulated whole salivary flow rate. Arch Oral Biol 2016;71:129-133. https://doi.org/10.1016/j.archoralbio.2016.06.028
- Billings M, Dye BA, Iafolla T, Grisius M, Alevizos I. Elucidating the role of hyposalivation and autoimmunity in oral candidiasis. Oral Dis 2017;23:387-394. https://doi.org/10.1111/odi.12626
- Torres SR, Peixoto CB, Caldas DM, et al. Relationship between salivary flow rates and Candida counts in subjects with xerostomia. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2002;93:149-154. https://doi.org/10.1067/moe.2002.119738
- Lee J, Taneja V, Vassallo R. Cigarette smoking and inflammation: cellular and molecular mechanisms. J Dent Res 2012;91:142-149. https://doi.org/10.1177/0022034511421200
- Weinstein RL, Francetti L, Maggiore E, Marchesi G. [Alcohol and smoking. The risk factors for the oral cavity]. Minerva Stomatol 1996;45:405-413. Italian.
- Uittamo J, Siikala E, Kaihovaara P, Salaspuro M, Rautemaa R. Chronic candidosis and oral cancer in APECED-patients: production of carcinogenic acetaldehyde from glucose and ethanol by Candida albicans. Int J Cancer 2009;124:754-756. https://doi.org/10.1002/ijc.23976
- Goncalves LS, Junior AS, Ferreira SM, et al. Factors associated with specific clinical forms of oral candidiasis in HIV-infected Brazilian adults. Arch Oral Biol 2013;58:657-663. https://doi.org/10.1016/j.archoralbio.2012.10.007
- Epstein JB, Freilich MM, Le ND. Risk factors for oropharyngeal candidiasis in patients who receive radiation therapy for malignant conditions of the head and neck. Oral Surg Oral Med Oral Pathol 1993;76:169-174. https://doi.org/10.1016/0030-4220(93)90199-E
- Madhavan P, Jamal F, Chong PP, Ng KP. Identification of local clinical Candida isolates using CHROMagar CandidaTM as a primary identification method for various Candida species. Trop Biomed 2011;28:269-274.
- Pfaller MA, Houston A, Coffmann S. Application of CHROMagar Candida for rapid screening of clinical specimens for Candida albicans, Candida tropicalis, Candida krusei, and Candida (Torulopsis) glabrata. J Clin Microbiol 1996;34:58-61. https://doi.org/10.1128/jcm.34.1.58-61.1996
- Houang ET, Chu KC, Koehler AP, Cheng AF. Use of CHROMagar Candida for genital specimens in the diagnostic laboratory. J Clin Pathol 1997;50:563-565. https://doi.org/10.1136/jcp.50.7.563
- Quindos G, Gil-Alonso S, Marcos-Arias C, et al. Therapeutic tools for oral candidiasis: current and new antifungal drugs. Med Oral Patol Oral Cir Bucal 2019;24:e172-e180.
- Lyu X, Zhao C, Yan ZM, Hua H. Efficacy of nystatin for the treatment of oral candidiasis: a systematic review and meta-analysis. Drug Des Devel Ther 2016;10:1161-1171.
- Cha R, Sobel JD. Fluconazole for the treatment of candidiasis: 15 years experience. Expert Rev Anti Infect Ther 2004;2:357-366. https://doi.org/10.1586/14787188.8.131.527
- Epstein JB, Gorsky M, Caldwell J. Fluconazole mouthrinses for oral candidiasis in postirradiation, transplant, and other patients. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2002;93:671-675. https://doi.org/10.1067/moe.2002.122728
- Goins RA, Ascher D, Waecker N, Arnold J, Moorefield E. Comparison of fluconazole and nystatin oral suspensions for treatment of oral candidiasis in infants. Pediatr Infect Dis J 2002;21:1165-1167. https://doi.org/10.1097/00006454-200212000-00017