<i>Candida</I> species and other yeasts in the oral cavities of type 2 diabetic patients in Cali, Colombia
Abstract
Objective: To determine the prevalence of Candida species and to study factors associated to oral cavity colonization in patients with type 2 diabetes mellitus.
Methods: A total of 107 diabetics were classified into controlled and uncontrolled according to glycosylated hemoglobin values. Each patient was assessed for stimulated salivary flow rates, pH, and an oral rinse to search for yeast. The study also determined the state of oral health via Klein and Palmer CPO indexes for permanent dentition, dental plaque by O’Leary, and a periodontal chart.
Results: We found yeasts in 74.8% of the patients. A total of 36 of the 52 subjects with controlled diabetes presented yeasts and 44 in the uncontrolled; no significant differences (p= 0.2) were noted among the presence of yeasts and the control of blood glucose. The largest number of isolates corresponded to C. albicans, followed by C. parapsilosis. Uncontrolled individuals presented a significantly higher percentage of yeast different from C.albicans (p= 0.049).
Conclusions: We found a high percentage of Candida colonization and uncontrolled individuals had greater diversity of species. The wide range of CFU/mL found both in patients with oral candidiasis, as well as in those without it did not permit distinguishing between colonization and disease. We only found association between isolation of yeasts and the low rate of salivary flow.
Authors
Downloads
Keywords
- Type 2 diabetes mellitus
- <i>Candida</i> sp
- candidiasis
- <i>Prototheca</i>
- Colombia
References
1. Tekeli A, Dolapci I, Emral R, Cesur S. Candida carriage and Candida dublinienis in oropharyngeal samples of type-1 diabetes mellitus patients. Mycoses. 2004; 47: 315-8.
2. Soysa N, Samaranayake L, Ellepola A. Diabetes mellitus as a contributory factor in oral candidiasis. Diabet Med. 2006; 23: 455-9.
3. Kadir T, Pisiriciler R, Akyüz S, Yarat A, Emekli N, Ipbüker A. Mycological and cytological examination of oral candidal carriage in diabetic patients and non-diabetic control subjects: thorough analysis of local aetiologic and systemic factors. J Oral Rehabil. 2002; 29: 452-7.
4. Belazi M, Velegraki A, Fleva A, Gidarakou I, Papanaum L, Baka D, et al. Candidal overgrowth in diabetic patients: potential predisposing factors. Mycoses. 2005; 48: 192-6.
5. Manfredi M, Al-Karaawi Z, McCullough M, Hurel S, Porter S. The isolation, identification and molecular analysis of Candida spp. isolated from the oral cavities of patients with diabetes mellitus. Oral Microbiol Immunol. 2002; 17: 181-5.
6. Khosravi A,Yarahmadi S, Baiat M, Shokri H, Pourkabireh M. Factors affecting the prevalence of yeasts in the oral cavity of patients with diabetes mellitus. J Med Mycol. 2008; 18: 83-8.
7. Fletcher RH, Fletcher SW. Clinical Epidemiology: the essentials. 4th ed. Philadelphia: Lippincott Williams & Wilkins; 2005.
8. Municipio de Santiago de Cali. Departamento Administrativo de Planeación. Cali Censo 2005. [Accesed 23 january de 2012] available in: http://planeacion.cali.gov.co/Publicaciones/Demografia/Cali Censo 2005 DEF1.pdf
9. Aschner P, King H, Triana TM, Rodriguez M. Glucose intolerance in Colombia: a population-based survey in an urban community. Diabetes Care. 1993; 16: 90-3.
10. Quirino MR, Birman EG, Paula CR. Oral manifestations of diabetes mellitus in controlled and uncontrolled patients. Braz Dent J. 1995; 6: 131-6.
11. American Diabetes Association. Standards of Medical Care in Diabetes 2006. Diabetes Care. 2006; 29: S4-S42.
12. Torres SR, Peixoto CB, Caldas DM, Silva EB, Akiti T, Nucci M, et al. Relationship between salivary flow rates and Candida counts in subjects with xerostomia. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002; 93: 149-54.
13. Diaz-Arnold AM, Marek CA. The impact of saliva on patient care: A literature review. J Prosthet Dent. 2002; 88: 337-43.
14. Álvarez MI, Suárez BL, Caicedo LD. Isolation of Candida dubliniensis for the first time in Cali, Colombia, and its identification with phenotyping methods. Mycopathol. 2009; 167: 19-24.
15. Cuenca E, Baca P. Odontología preventiva y comunitaria. Principios, métodos y aplicaciones. 3ª edición. España: Elsevier Masson 2005. p.347-50.
16. Arrieta JJ, Bartolomé B, Jiménez E, Saavedra P, Arrieta FJ. Problemas bucodentales en pacientes con diabetes mellitus (II): Indice gingival y enfermedad periodontal. Med Oral. 2003; 8: 233-47.
17. Castro LA, Álvarez MI, Martinez E. Pseudomembranous candidiasis HIV/AIDS patients in Cali, Colombia, Mycopathol. 2013; 175: 95-8.
18. Todd JR, King JW, Oberle A, Matsumoto T, Odaka Y, Fowler M, et al. Protothecosis: report of a case with 20 year follow-up and review of previously published cases: Med Mycol. 2012; 50: 673-89
19. Hintao J,Teanpaisan R, Chongsuvivatwong V, Ratarasan C, Dahlen G. The microbiological profiles of saliva, supragingival and subgingival plaque and dental caries in adults with and without type 2 diabetes mellitus. Oral Microbiol Immunol. 2007; 22: 175-81.
20. Sánchez LO, Pérez P, Romo J, Corona FP, Hidalgo Franco F. Determinación de pH salival y cultivo en pacientes con candidosis bucal VIH positivos y VIH negativos. Rev Iberoam Micol. 2002; 19: 155-60.
21. Moore PA, Guggenheimer J, EtzelKR, Weyant RJ, Orchard T. Type 1 diabetes mellitus, xerostomia and salivary flow rates. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2001; 92: 281-91.
22. Hibino K, Samaranayake L, Häg U, Wong R, Lee W. The role of salivary factors in persistent oral carriage of Candida in humans. Arch Oral Biol. 2009; 54: 678-83.
23. Sousa MG, Costa A de L, Roncalli AG. Clinical study of the oral manifestations and related factor in type 2 diabetics patients. Braz J Otorhinolaryngol. 2011; 77: 145-52.
24. Trofa D, Gácser A, Nosanchuk JD. Candida parapsilosis, an emerging fungal pathogen. Clin Microbiol Rev. 2008; 21: 606-25.
25. López C, Bulacio L, Espejo T, Paz M, Pairoba C, Escovich L. Prevalence of chronic hyperplasic candidiasis. Its association to risk factors in an oral medicine service in Rosario, Argentina. J Mycol Med. 2012; 22: 35-41.
The copy rights of the articles published in Colombia Médica belong to the Universidad del Valle. The contents of the articles that appear in the Journal are exclusively the responsibility of the authors and do not necessarily reflect the opinions of the Editorial Committee of the Journal. It is allowed to reproduce the material published in Colombia Médica without prior authorization for non-commercial use