title: Candidal carriage predicts candidiasis during topical immunosuppressive therapy: a preliminary retrospective cohort study.
abstract: OBJECTIVE
  To determine (1) the prevalence of candidal carriage in patients with oral mucosal disease to be treated with topical immunosuppressive therapy, and (2) the incidence of oral candidiasis among carriers and noncarriers after initiation of therapy to assess any correlation between carriage and the development of candidiasis.
  
  
  METHODS
  Records of patients who underwent swab cultures for Candida between January 2009 and October 2014 at the Brigham and Women's Hospital in Boston, Massachusetts, were retrospectively reviewed. The prevalence of candidal carriage and incidence of candidiasis were determined by using descriptive statistics.
  
  
  RESULTS
  Of 99 evaluable patients, 20 (20.2%) were Candida positive and 79 (79.8%) were Candida negative. Of 44 patients with follow-up, 7 (15.9%) were Candida positive and 37 (84.1%) were Candida negative; five (11.4%) developed candidiasis. Four of seven (57.1%) Candida-positive patients developed candidiasis, whereas only one of 37 (2.7%) Candida-negative patients developed candidiasis (P = .0012).
  
  
  CONCLUSIONS
  The overall prevalence of candidal carriage was low (20.2%), and there was a significant difference in the incidence of candidiasis between carriers and noncarriers (P = .0012) after topical immunosuppressive therapy. Therefore, patients who are candidal carriers should be monitored closely for the development of secondary candidiasis and may be candidates for prophylactic antifungal therapy.
authors: DMD Candidate, Harvard School of Dental Medicine, Boston, MA, USA; Department of Oral Medicine and Dentistry, Brigham and Women's Hospital, MA, USA. Electronic address: Sara_Tejani@hsdm.harvard.edu.
authors: Sara
authors: S
authors: Tejani
authors: Department of Oral Medicine and Dentistry, Brigham and Women's Hospital, MA, USA; Oral Medicine Resident, Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, MA, USA.
authors: Ahmed
authors: A
authors: Sultan
authors: Department of Oral Medicine and Dentistry, Brigham and Women's Hospital, MA, USA; Assistant Professor, Department of Oral and Maxillofacial Medicine and Diagnostic Sciences, Case Western Reserve University School of Dental Medicine, Cleveland, OH, USA.
authors: Ivan
authors: I
authors: Stojanov
authors: Associate Professor, Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, Massachusetts, USA; Director of Clinical Affairs, Department of Oral Medicine and Dentistry, Brigham and Women's Hospital, Boston, MA, USA.
authors: Sook-Bin
authors: SB
authors: Woo
mesh_terms: D000287:Administration, Topical; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001900:Boston / Q000453:epidemiology; D002180:Candidiasis, Oral / Q000453:epidemiology / Q000276:immunology*; D002353:Carrier State / Q000382:microbiology*; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects*; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009059:Mouth Diseases / Q000188:drug therapy* / Q000276:immunology*; D015995:Prevalence; D012189:Retrospective Studies
chemical_list: D007166:Immunosuppressive Agents