Caries-, Candida- and Candida antigen/antibody frequency in children after heart transplantation and children with congenital heart disease.

The aim of this study was to determine the incidence of oral/intestinal Candida colonization and Candida-antigen/antibody in immunosuppressed children after HTx (group III, n = 31), in children with CHD (group II, n = 24) and in children with healthy hearts (comparison group, group I, n = 23) aged 2-16 yr according to their dental status between 2004 and 2007. Candida species in saliva, dental plaque, carious lesions and stool were detected with Sabouraud-/CHROMagar and Auxacolor system. Candida-specific-antigen/antibody assays were used for serological diagnosis. Dental status was determined on the basis of the DMF/dmf(T/t)-index. We found significant group differences in fecal Candida colonization (p = 0.027). In relation to dental status, oral Candida colonization increased within group III from 28.5% [DMF/dmf(T/t) = 0] to 66.7% [DMF/dmf(T/t) > or = 1] up to 100.0% [D/d(T/t) > or = 1], similar in groups I and II. Candida-mannan-antigen was determined to be positive in 16.1% (HTx), 5.5% (CHD) and 13.0% (comparison group). We show correlation between oral Candida colonization and (carious) dental status. We assume that high oral Candida and their descending/resorption through the gastrointestinal tract may lead to serologic Candida accumulation or rather candidiasis. Therefore, healthy oral cavity (especially before/after HTx) is an important precondition to prevent Candida infections.