Candida albicans colonization of dental plaque in elderly dysphagic patients.
BACKGROUND
Dysphagia is a common disorder among the elderly population. As many as 50% of nursing home residents suffer from dysphagia. It is important to identify patients at increased risk for colonization of dental and denture plaque by pathogenic organisms in order to prevent associated disease.


OBJECTIVE
To quantify the prevalence and evaluate the effect of dental and denture plaque colonization by Candida albicans in hospitalized elderly dysphagic patients as a complication of stroke, as well as the effect of systemic antimicrobial therapy on C. albicans colonization in these patients.


METHODS
We evaluated dysphagia and antibiotic therapy as risk factors for dental and denture plaque colonization by C. albicans in elderly stroke rehabilitating patients with dysphagia, as compared to elderly non-dysphagic stroke and non-stroke rehabilitating patients on days 0, 7 and 14 following admission to the Fliman Geriatric Rehabilitation Hospital.


RESULTS
The risk of C. albicans colonization of dental plaque was greater in dysphagic patients than in those without dysphagia on day 0 (50% vs. 21%, P = 0.076), day 7 (58 vs. 15.2%, P = 0.008) and day 14 (58 vs. 15.2%, P = 0.08). Similarly, patients on antibiotic therapy were at greater risk for C. albicans colonization of dental plaque on day 0 (56 vs. 11%, P = 0.002), day 7 (44 vs. 14.8%, P = 0.04) and day 14 (39 vs. 19%, P = 0.18). The risk of C. albicans colonization of denture plaque as opposed to dental plaques in non-dysphagic patients was significantly greater on day 0 (45.7 vs. 21.2%, P = 0.03), day 7 (51.4 vs. 15.1%, P = 0.0016) and day 14 (54.3 vs. 15.1%, P = 0.0007). Dysphagia did not increase the risk of denture plaque colonization by C. albicans.


CONCLUSIONS
Both dysphagia and antibiotic therapy are risk factors for C. albicans colonization of dental plaque, and although dysphagia does not significantly increase colonization of denture plaque, denture wearers are at greater risk of such colonization.
Aizen
Efraim
E
Dept of Geriatrics, Fliman Geriatric Hospital, Haifa, Israel. eaizen_il@yahoo.com
Feldman
Paul A
PA
Madeb
Ralph
R
Steinberg
Jordan
J
Merlin
Steven
S
Sabo
Edmond
E
Perlov
Valery
V
Srugo
Isaac
I
D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002176:Candida albicans / Q000302:isolation & purification / Q000472:pathogenicity*; D002177:Candidiasis / Q000453:epidemiology / Q000209:etiology*; D003680:Deglutition Disorders / Q000150:complications*; D003773:Dental Plaque / Q000382:microbiology*; D003778:Dentures; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D009735:Nursing Homes; D012047:Rehabilitation Centers; D012307:Risk Factors; D000071939:Stroke Rehabilitation
D000900:Anti-Bacterial Agents