Oral colonisation and infection by Candida sp. in diabetic and non-diabetic patients with chronic kidney disease on dialysis.
BACKGROUND
Oral candidiasis (OC) is a common opportunistic infection in immunocompromised patients. Species identification is sometimes important for treatment. objective: to determine the prevalence of different Candida species colonising or infecting the oral mucosa (OM) of diabetic (DM) and non-diabetic (non-DM) chronic kidney disease patients, comparing both groups and exploring potential risk factors.


METHODS
56 DM and 80 non-DM patients on chronic dialysis were examined. OM swabs were cultured on Sabouraud dextrose agar plates. Candida species were identified with API® galleries. OC was confirmed by exfoliative cytology. Statistical associations were analysed using χ2, Fisher's exact test (ET), and multiple logistic regression.


RESULTS
Candida prevalence was 43.4%: 53.6% DM and 36.3% non-DM, (p=.045). The species identified were C. albicans 74.6%, C. glabrata 22.0%, C. tropicalis 15.2%, C. parapsilosis 3.4 %, C. kefyr 3.4% and C. famata 1.7% without difference between groups. DM patients had a higher xerostomia prevalence (p=.002) and lower salivary flow (p=.008) and lower serum albumin (p=.018). 16.9% of patients had OC, 23.2% DM compared with 12.5% non-DM, (p=.101). The following were associated with the presence of Candida in the OM: the use of dental prostheses (odds ratio [OR] 25.6, 95% confidence interval [CI] 2.5 to 253, P=.001), xerostomia (OR 9.6, 95% CI 2.4 to 38.1, P=.001) and low serum albumin values (OR 0.41, 95% CI 0.22 to 0.98, P=.044).


CONCLUSIONS
The presence of Candida sp. in the OM was associated with dental prostheses, xerostomia and low serum albumin.
Estela
E
de la Rosa-García
Mónica
M
Miramontes-Zapata
Luis-Octavio
LO
Sánchez-Vargas
Arnoldo
A
Mondragón-Padilla
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002175:Candida / Q000302:isolation & purification*; D002180:Candidiasis, Oral / Q000453:epidemiology*; D002353:Carrier State / Q000453:epidemiology / Q000382:microbiology; D015897:Comorbidity; D003430:Cross-Sectional Studies; D017266:Dental Prosthesis / Q000009:adverse effects; D048909:Diabetes Complications / Q000453:epidemiology / Q000382:microbiology*; D003928:Diabetic Nephropathies / Q000453:epidemiology / Q000382:microbiology / Q000628:therapy; D004198:Disease Susceptibility; D005260:Female; D006801:Humans; D034141:Hypoalbuminemia / Q000453:epidemiology / Q000382:microbiology; D008297:Male; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D009055:Mouth / Q000382:microbiology*; D009894:Opportunistic Infections / Q000453:epidemiology / Q000382:microbiology; D015995:Prevalence; D016459:Prosthesis-Related Infections / Q000453:epidemiology / Q000382:microbiology; D006435:Renal Dialysis; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology / Q000382:microbiology* / Q000628:therapy; D012307:Risk Factors; D013045:Species Specificity; D014987:Xerostomia / Q000453:epidemiology / Q000382:microbiology; D055815:Young Adult