title: Frequency of clinically isolated strains of oral Candida species at Kagoshima University Hospital, Japan, and their susceptibility to antifungal drugs in 2006-2007 and 2012-2013.
abstract: BACKGROUND
  The isolation frequency and susceptibility to antifungal agents of oral Candida isolates from patients with oral candidiasis (OC) were compared between studies conducted in 2006-2007 and 2012-2013.
  
  
  METHODS
  A total158 strains was isolated from 112 patients who visited Kagoshima University Hospital for the treatment of OC during the 14-month period from February 2012 and March 2013, and evaluated on the isolation frequency of each Candida strain and the susceptibility against antifungal drugs as compared to those evaluated in 2006-2007.
  
  
  RESULTS
  There was a higher frequency of xerostomia as a chief complaint and of autoimmune disease in the 2012-2013 study than in the 2006-2007 study. More than 95% of Candida isolates were C. albicans and C. glabrata. In addition, the proportion of the latter increased from 12.3% in the 2006-2007 study to 23.4% in the 2012-2013 study, while the proportion of the former decreased from 86.2% to 72.8%, respectively. C. albicans was isolated in almost all patients, while C. glabrata was only isolated concomitantly with C. albicans. Minimal inhibitory concentrations (MICs) were not significantly different between groups with a few exceptions. Candida isolates, of which MICs surpassed break points, apparently increased for miconazole and itraconazole against C. glabrata in the 2012-2013 study, but this was not statistically significant. As a result, more cases of autoimmune disease, a greater number of C. glabrata isolates, and higher resistance to azoles were seen in the 2012-2013 study than in the 2006-2007 study.
  
  
  CONCLUSIONS
  These data indicate that with recent increases in C. glabrata infection, a causative fungus of OC, and in C. glabrata resistance to azoles, caution is needed in the selection of antifungal drugs for the treatment of OC.
authors.affiliation: Department of Oral Surgery, Kagoshima University Medical and Dental Hospital, 8-35-1 Sakuragaoka, Kagoshima 890-8544, Japan. Kamikawa@dent.kagoshima-u.ac.jp.
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Kamikawa
authors.forename: Youichirou
authors.initials: Y
authors.lastname: Mori
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Nagayama
authors.forename: Junichi
authors.initials: J
authors.lastname: Fujisaki
authors.forename: Daisuke
authors.initials: D
authors.lastname: Hirabayashi
authors.forename: Ryoichi
authors.initials: R
authors.lastname: Sakamoto
authors.forename: Tomofumi
authors.initials: T
authors.lastname: Hamada
authors.forename: Kazumasa
authors.initials: K
authors.lastname: Sugihara
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use*; D001327:Autoimmune Diseases / Q000382:microbiology; D058491:Bacterial Load; D002175:Candida / Q000145:classification / Q000187:drug effects / Q000302:isolation & purification*; D002176:Candida albicans / Q000187:drug effects / Q000302:isolation & purification; D041221:Candida glabrata / Q000187:drug effects / Q000302:isolation & purification; D002180:Candidiasis, Oral / Q000188:drug therapy / Q000382:microbiology*; D060085:Coinfection / Q000382:microbiology; D025141:Drug Resistance, Fungal; D054714:Echinocandins / Q000627:therapeutic use; D005260:Female; D015725:Fluconazole / Q000627:therapeutic use; D005437:Flucytosine / Q000627:therapeutic use; D006801:Humans; D017964:Itraconazole / Q000627:therapeutic use; D007564:Japan; D055666:Lipopeptides / Q000627:therapeutic use; D008297:Male; D000077551:Micafungin; D008825:Miconazole / Q000627:therapeutic use; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D014987:Xerostomia / Q000382:microbiology
chemical_list: D000935:Antifungal Agents; D054714:Echinocandins; D055666:Lipopeptides; D017964:Itraconazole; D008825:Miconazole; D000666:Amphotericin B; D015725:Fluconazole; D005437:Flucytosine; D000077551:Micafungin