K Zomorodian1, F Kavoosi2, G R Pishdad3, P Mehriar4, H Ebrahimi5, A Bandegani2, K Pakshir6. 1. Basic Sciences in Infectious Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran; Department of Medical Mycology and Parasitology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran. Electronic address: zomorodian@sums.ac.ir. 2. Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran. 3. Department of Internal Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran. 4. Department of Advanced Periodontology, Herman Ostrow School of Dentistry, University of Southern California, California, USA. 5. Department of Oral Health, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran. 6. Department of Medical Mycology and Parasitology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
Abstract
OBJECTIVES OF THE STUDY: We aimed to assess the prevalence of oral Candida colonization in patients with diabetes and its relationship with factors such as Candida species, serum glucose level, and the susceptibility rate of isolated yeasts to antifungals. PATIENTS: Random samples were obtained from 113 patients with type 2 diabetes, 24 patients with type 1 diabetes, and 105 healthy controls. MATERIALS AND METHODS: The samples were taken by swabbing the oral mucosa of patients with diabetes mellitus and healthy individuals. Afterwards the samples were inoculated onto CHROMagar-Candida. The growing colonies were counted, and the isolated yeasts were identified by PCR-RFLP and RapID methods. Various isolated species of Candida were also subjected to susceptibility testing of antibiotic drugs. Blood samples were taken to evaluate glycosylated hemoglobin (HbA1c). RESULTS: Although the Candida carriage rate and density were statistically higher in diabetics than healthy individuals, no direct association was found between having high Candida-burden and glycosylated hemoglobin. The most commonly isolated species in both diabetics and controls was Candida albicans. Of the tested antifungal drugs, the highest rate of resistance was found against itraconazole, followed in frequency by ketoconazole and fluconazole. CONCLUSIONS: This study identified a significant association between the poor glycemic control and the higher prevalence rates of Candida carriage and density in diabetic patients. In addition, a high prevalence of C. dubliniensis in diabetic patients was found, which might be misdiagnosed with its morphologically related species, C. albicans.
OBJECTIVES OF THE STUDY: We aimed to assess the prevalence of oral Candida colonization in patients with diabetes and its relationship with factors such as Candida species, serum glucose level, and the susceptibility rate of isolated yeasts to antifungals. PATIENTS: Random samples were obtained from 113 patients with type 2 diabetes, 24 patients with type 1 diabetes, and 105 healthy controls. MATERIALS AND METHODS: The samples were taken by swabbing the oral mucosa of patients with diabetes mellitus and healthy individuals. Afterwards the samples were inoculated onto CHROMagar-Candida. The growing colonies were counted, and the isolated yeasts were identified by PCR-RFLP and RapID methods. Various isolated species of Candida were also subjected to susceptibility testing of antibiotic drugs. Blood samples were taken to evaluate glycosylated hemoglobin (HbA1c). RESULTS: Although the Candida carriage rate and density were statistically higher in diabetics than healthy individuals, no direct association was found between having high Candida-burden and glycosylated hemoglobin. The most commonly isolated species in both diabetics and controls was Candida albicans. Of the tested antifungal drugs, the highest rate of resistance was found against itraconazole, followed in frequency by ketoconazole and fluconazole. CONCLUSIONS: This study identified a significant association between the poor glycemic control and the higher prevalence rates of Candida carriage and density in diabeticpatients. In addition, a high prevalence of C. dubliniensis in diabeticpatients was found, which might be misdiagnosed with its morphologically related species, C. albicans.