title: Colonization of the oral cavity by yeasts in patients with chronic renal failure undergoing hemodialysis.
abstract: OBJECTIVE
  To determine the frequency of yeast in the oral cavity of patients with chronic renal failure, undergoing hemodialysis (PCRFH); identification and antifungal susceptibility profile of yeast and demographic profile of patients.
  
  
  METHODS
  We performed mouthwash in 146 PCRFH; the rinse fluid was collected and cultured, yeasts grown were identified by phenotypic and molecular methods. The antifungal susceptibility profile was determined against nystatin, amphotericin B, fluconazole, voriconazole, and caspofungin based in Clinical and Laboratory Standards Institute (document M27-A3).
  
  
  RESULTS
  Positive culture was observed in 39% of patients, of whom 53% were women; the median of dialysis time was 2.9 years. The age of the colonized patients varied between 26 and 84 years, with a median of 52.5 years. PCRFH over 45 years were significantly more colonized (P = 0.0108) as well as denture wearers (84.0%). We isolated 81 yeasts, predominantly Candida albicans (63%) followed by Candida glabrata. In general, yeasts were sensitive to the evaluated antifungal agents, but there was significant variation in the minimum inhibitory concentration, especially among non-C. albicans Candida (NCAC) compared to fluconazole, caspofungin, and amphotericin B. NCAC required significantly higher concentrations of fluconazole (P < 0.01).
  
  
  CONCLUSIONS
  The rate of colonization by yeasts in PCRFH was high, and there was variability in species distribution and antifungal susceptibility profile. These results are little known in this group of patients and are important for controlling the risk of developing invasive fungal infections.
authors.affiliation: Section of Medical Mycology, Department of Clinical Analysis, State University of Maringá, Maringá, Parana, Brazil.
authors.forename: Janine S R
authors.initials: JS
authors.lastname: Godoy
authors.forename: Patrícia
authors.initials: P
authors.lastname: de Souza Bonfim-Mendonça
authors.forename: Sandra S
authors.initials: SS
authors.lastname: Nakamura
authors.forename: Sérgio S
authors.initials: SS
authors.lastname: Yamada
authors.forename: Cristiane
authors.initials: C
authors.lastname: Shinobu-Mesquita
authors.forename: Neli
authors.initials: N
authors.lastname: Pieralisi
authors.forename: Adriana
authors.initials: A
authors.lastname: Fiorini
authors.forename: Terezinha I E
authors.initials: TI
authors.lastname: Svidzinski
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000666:Amphotericin B / Q000494:pharmacology; D000935:Antifungal Agents / Q000494:pharmacology; D002175:Candida / Q000145:classification* / Q000187:drug effects; D002176:Candida albicans / Q000302:isolation & purification; D041221:Candida glabrata / Q000302:isolation & purification; D041022:Candida tropicalis / Q000302:isolation & purification; D000077336:Caspofungin; D015169:Colony Count, Microbial; D003778:Dentures / Q000382:microbiology; D048909:Diabetes Complications; D054714:Echinocandins / Q000494:pharmacology; D005260:Female; D015725:Fluconazole / Q000494:pharmacology; D006801:Humans; D006973:Hypertension / Q000150:complications; D007676:Kidney Failure, Chronic / Q000382:microbiology / Q000628:therapy*; D055666:Lipopeptides; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009055:Mouth / Q000382:microbiology*; D009172:Mycology / Q000379:methods; D009761:Nystatin / Q000494:pharmacology; D010641:Phenotype; D011743:Pyrimidines / Q000494:pharmacology; D006435:Renal Dialysis / Q000379:methods*; D013997:Time Factors; D014230:Triazoles / Q000494:pharmacology; D065819:Voriconazole
chemical_list: D000935:Antifungal Agents; D054714:Echinocandins; D055666:Lipopeptides; D011743:Pyrimidines; D014230:Triazoles; D009761:Nystatin; D000666:Amphotericin B; D015725:Fluconazole; D000077336:Caspofungin; D065819:Voriconazole