Beatriz Benito-Cruz1, Saray Aranda-Romo2, Francisco Javier López-Esqueda3, Estela de la Rosa-García4, Rebeca Rosas-Hernández5, Luis Octavio Sánchez-Vargas6. 1. Master in Biomedical Science, Faculty of Medicine, University Autonomous of San Luis Potosí, Mexico. 2. Oral Microbiology, Pathology and Biochemical laboratory, Faculty of Stomatology, University Autonomous of San Luis Potosí, Mexico. 3. Geriatric Unit. Central Hospital "Ignacio Morones Prieto", University Autonomous of San Luis Potosí, Mexico. 4. Department of Attention to Health, Metropolitan Autonomous University, Xochimilco, México City, Mexico. 5. Molecular Biophysics laboratory, Physics Institute "Manuel Sandoval Vallarta", University Autonomous of San Luis Potosí, Mexico. 6. Oral Microbiology, Pathology and Biochemical laboratory, Faculty of Stomatology, University Autonomous of San Luis Potosí, Mexico. Electronic address: lo.sanchezvargas@gmail.com.
Abstract
OBJECTIVES: To assess the epidemiologic and microbiologic profile and in vitro fluconazole susceptibility of yeasts isolated from the oral mucosa colonization/infection of elderly patients. BACKGROUND: It has been reported that in older adults increases the oral colonization by Candida particularly C. non-albicans, showing a decreased response to fluconazole, which increases the risk of recalcitrant local and disseminated candidiasis. MATERIALS AND METHODS: This was a prospective cross-sectional study conducted in 120 elderly patients. Oral samples were obtained of mucosal Candida colonization or infection by swabbing. Each sample was plated on CHROMagar(®)Candida and incubated (36±1.5°C) for two days. The yeast species were identified using the API(®)ID32-C-AUX. Fluconazole susceptibility was tested using a broth microdilution assay according to the CLSI methods. RESULTS: The yeast colonization/infection frequency in the total population was 65.8%. The frequency of the highest Candida carriers was 67.4% in the 70-79-year-old-group. Oral candidiasis was present in 20%, with a tendency to increase with age (33.3% of adults aged>80years), it was determined that the use of prosthesis is associated with a higher colonization rate (Chi2, p=0.011). The frequency of colonization/infection cases with more than one species showed a tendency to increase with age; 18.9% in the 60-69 year-old-group, 20.9% in the 70-79-year-old-group and 29.2% in the ≥80 year-old-group. About fluconazole susceptibility: for C. albicans, 20.3%, about Candida non-albicans species 15.3% were dose dependently susceptible (DDS) and 17.9% were resistant. CONCLUSIONS: After 80 years of age, there is a considerable increase in Candida non-albicans species and a reduced susceptibility to fluconazole.
OBJECTIVES: To assess the epidemiologic and microbiologic profile and in vitro fluconazole susceptibility of yeasts isolated from the oral mucosa colonization/infection of elderly patients. BACKGROUND: It has been reported that in older adults increases the oral colonization by Candida particularly C. non-albicans, showing a decreased response to fluconazole, which increases the risk of recalcitrant local and disseminated candidiasis. MATERIALS AND METHODS: This was a prospective cross-sectional study conducted in 120 elderly patients. Oral samples were obtained of mucosal Candida colonization or infection by swabbing. Each sample was plated on CHROMagar(®)Candida and incubated (36±1.5°C) for two days. The yeast species were identified using the API(®)ID32-C-AUX. Fluconazole susceptibility was tested using a broth microdilution assay according to the CLSI methods. RESULTS: The yeast colonization/infection frequency in the total population was 65.8%. The frequency of the highest Candida carriers was 67.4% in the 70-79-year-old-group. Oral candidiasis was present in 20%, with a tendency to increase with age (33.3% of adults aged>80years), it was determined that the use of prosthesis is associated with a higher colonization rate (Chi2, p=0.011). The frequency of colonization/infection cases with more than one species showed a tendency to increase with age; 18.9% in the 60-69 year-old-group, 20.9% in the 70-79-year-old-group and 29.2% in the ≥80 year-old-group. About fluconazole susceptibility: for C. albicans, 20.3%, about Candida non-albicans species 15.3% were dose dependently susceptible (DDS) and 17.9% were resistant. CONCLUSIONS: After 80 years of age, there is a considerable increase in Candida non-albicans species and a reduced susceptibility to fluconazole.
Authors: B G J Dekkers; A Veringa; D J E Marriott; J M Boonstra; K C M van der Elst; F F Doukas; A J McLachlan; Jan-Willem C Alffenaar Journal: Drugs Aging Date: 2018-09 Impact factor: 3.923