Prevalence and antifungal drug sensitivity of non-albicans Candida in oral rinse samples of self-caring elderly.
OBJECTIVE
To assess the prevalence and antifungal drug sensitivity of non-albicans Candida (NAC) species in elderly outpatients.


METHODS
We investigated oral rinse samples of 194 self-caring elderly population (mean age 83 years) with emphasis on background factors for harbouring NAC. Susceptibility of Candida species to antifungal drugs was determined using standard methodology. Multiple logistic regression analysis was performed taking positive NAC count as the dependent variable and a number of known Candida risk factors as independent variables.


RESULTS
Prevalence of candidal carriage of the population was 78.4%, of which 0.5% of the subjects were NAC positive. Candida dubliniensis was the most prevalent NAC species, followed by Candida glabrata and Candida parapsilosis. The NAC positive elderly were more often edentulous with dental prostheses or had fewer teeth than Candida albicans-positive or yeast-negative subjects. Dental caries slightly increased the risk for having NAC strains (odds ratio 1.08), whilst greater age appeared to lower the risk (odds ratio 0.77). Candida species were susceptible to the commonly used antifungal agents in general, but with considerable variation among species. Occasionally, some NAC exhibited lower antifungal susceptibility.


CONCLUSIONS
The possibility of oral reservoirs of NAC strains which are resistant to common antifungals should be noted in elderly outpatients.
Meurman
Jukka H
JH
Department of Oral and Maxillofacial Diseases, Helsinki University Central Hospital, Helsinki, Finland. jukka.meurman@helsinki.fi
Pärnänen
Pirjo
P
Seneviratne
C Jaya
CJ
Samaranayake
Lakshman P
LP
Saarinen
Antti M J
AM
Kari
Kirsti
K
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002175:Candida / Q000145:classification* / Q000187:drug effects* / Q000302:isolation & purification; D025141:Drug Resistance, Fungal; D005260:Female; D006801:Humans; D057187:Independent Living; D016015:Logistic Models; D008297:Male; D008826:Microbial Sensitivity Tests; D016017:Odds Ratio; D012307:Risk Factors; D012463:Saliva / Q000382:microbiology*; D018709:Statistics, Nonparametric