Moritz Hertel1, Andrea Maria Schmidt-Westhausen2, Frank-Peter Strietzel2. 1. Charité Centre 3, Department of Oral Medicine, Dental Radiology and Oral Surgery, Charité Universitätsmedizin Berlin, Aßmannshauser Str. 4, 14197, Berlin, Germany. moritz.hertel@charite.de. 2. Charité Centre 3, Department of Oral Medicine, Dental Radiology and Oral Surgery, Charité Universitätsmedizin Berlin, Aßmannshauser Str. 4, 14197, Berlin, Germany.
Abstract
OBJECTIVES: In order to identify oral candidiasis patients being at risk of carrying potentially drug-resistant Candida, the aim of the study was to detect local, systemic, demographic, and health-related factors influencing (I) yeast spectrum composition and (II) antifungal administration frequency. Additionally, the aim was to investigate (III) species shift occurrence. MATERIALS AND METHODS: Data from 798 patients (496 females, 302 males; mean age 59.7) with oral candidiasis diagnosed based on positive clinical and microbial findings (species identification and CFU count) between 2006 and 2011 were retrospectively analyzed using Pearson's chi(2) test and regression analysis. RESULTS: Among 958 isolates, Candida albicans was the most frequently detected (76.8 %). Also, species intrinsically resistant to azoles were frequently isolated (15.8 and 17.7 % of isolates and patients). (I) Infections only caused by C. albicans were significantly associated with the use of inhalation steroids (p = 0.001) and antibiotics (p = 0.04), super-infection of lichen planus (p = 0.002), and the absence of removable dentures (p < 0.001). (II) Anti-mycotics were significantly more frequently administered in patients using inhalation steroids (p = 0.001), suffering from asthma/COPD, or smoking heavily (p = 0.003) and if C. albicans and non-albicans species were detected together (p = 0.001). (III) Pathogen composition did not change over time within the examined period (p = 0.239). CONCLUSIONS: Different variables enhance the presence of certain Candida and the antifungal prescription frequency. No species shift was evident. CLINICAL RELEVANCE: The major pathogen in oral candidiasis remains C. albicans. Nevertheless, therapeutic problems may be caused by the frequent presence of species intrinsically resistant to azoles, especially in patients wearing dentures.
OBJECTIVES: In order to identify oral candidiasispatients being at risk of carrying potentially drug-resistant Candida, the aim of the study was to detect local, systemic, demographic, and health-related factors influencing (I) yeast spectrum composition and (II) antifungal administration frequency. Additionally, the aim was to investigate (III) species shift occurrence. MATERIALS AND METHODS: Data from 798 patients (496 females, 302 males; mean age 59.7) with oral candidiasis diagnosed based on positive clinical and microbial findings (species identification and CFU count) between 2006 and 2011 were retrospectively analyzed using Pearson's chi(2) test and regression analysis. RESULTS: Among 958 isolates, Candida albicans was the most frequently detected (76.8 %). Also, species intrinsically resistant to azoles were frequently isolated (15.8 and 17.7 % of isolates and patients). (I) Infections only caused by C. albicans were significantly associated with the use of inhalation steroids (p = 0.001) and antibiotics (p = 0.04), super-infection of lichen planus (p = 0.002), and the absence of removable dentures (p < 0.001). (II) Anti-mycotics were significantly more frequently administered in patients using inhalation steroids (p = 0.001), suffering from asthma/COPD, or smoking heavily (p = 0.003) and if C. albicans and non-albicans species were detected together (p = 0.001). (III) Pathogen composition did not change over time within the examined period (p = 0.239). CONCLUSIONS: Different variables enhance the presence of certain Candida and the antifungal prescription frequency. No species shift was evident. CLINICAL RELEVANCE: The major pathogen in oral candidiasis remains C. albicans. Nevertheless, therapeutic problems may be caused by the frequent presence of species intrinsically resistant to azoles, especially in patients wearing dentures.
Entities:
Keywords:
Candida species; Fungal drug resistance; Oral candidiasis
Authors: A M Willis; W A Coulter; D J Sullivan; D C Coleman; J R Hayes; P M Bell; P J Lamey Journal: J Oral Pathol Med Date: 2000-02 Impact factor: 4.253
Authors: Javier Fernández-Feijoo; Pedro Diz-Dios; Xosé Luis Otero-Cepeda; Jacobo Limeres-Posse; Javier de la Fuente-Aguado; Antonio Ocampo-Hermida Journal: Med Oral Patol Oral Cir Bucal Date: 2005 Jan-Feb
Authors: Ismail H Sahand; José L Maza; Elena Eraso; Miguel Montejo; María D Moragues; José M Aguirre; Guillermo Quindós; José Pontón Journal: J Med Microbiol Date: 2009-07-16 Impact factor: 2.472
Authors: Moritz Hertel; Eyke Schuette; Isabell Kastner; Stefan Hartwig; Andrea Maria Schmidt-Westhausen; Robert Preissner; Sebastian Paris; Saskia Preissner Journal: Clin Oral Investig Date: 2017-06-10 Impact factor: 3.573
Authors: Danielle da Nóbrega Alves; Ana Karoline Vieira Melo; Adriano Francisco Alves; Maria Rejane Cruz de Araújo; Rubens da Silva Araújo; Ricardo Dias de Castro Journal: Clin Oral Investig Date: 2022-03-19 Impact factor: 3.606
Authors: Florian Molkenthin; Moritz Hertel; Konrad Neumann; Andrea Maria Schmidt-Westhausen Journal: Clin Oral Investig Date: 2021-06-18 Impact factor: 3.606