Original article/Article originalPrevalence of Candida species in the buccal cavity of diabetic and non-diabetic individuals in and around PondicherryPrévalence des espèces de Candida dans la cavité buccale des sujets diabétiques et des sujets non diabétiques aux alentours et à Pondichéry
Introduction
Diabetes mellitus is a multisystemic disorder characterized by high blood sugar levels for a prolonged period. This is due to deficiency of insulin secretion or action. Researchers have reported that in the 21st century, diabetes mellitus is one of the largest emerging threats to health [1]. Although, there is an increase in the diabetes mellitus population in India, there are no clear-cut published studies to evaluate the oral fungal infection, which are prevalent in these diabetic individuals [22]. During the last 10 years, there is an increase in candidal infection and also changes have been noted in the species causing candidiasis [24]. In human beings, Candida albicans is one of the normal micro flora which is isolated from the oral cavity. The colonization of Candida species occurs on the mucosal surface immediately after birth and the risk of endogenous infection is persistent throughout the life of an individual [12]. Manifestations of oral candidiasis may occur in individuals infected with the HIV, with nutritional deficiencies, malignancies or with metabolic disorders, like diabetics mellitus [39]. Isolation of Candida species from the oral cavity of diabetes mellitus individual was frequent but the importance of Candida is a controversy [7]. In diabetes mellitus patients, the frequency of occurrence of these organisms varies from 18 to 80% [37]. The presence of dentures exerts a greater effect on the species of Candida isolated from the buccal cavity than the diabetic status [9], [17]. The differences in the Candida recovery are due to the methods followed in the laboratory, the number of subjects, the characteristics of the subjects, and also the techniques used in sampling [4], [13], [17]. The purpose of this study was to define the prevalence of Candida in the buccal cavity of type II diabetes mellitus individuals and healthy individuals, attending a diabetic clinic in Pondicherry. The in vitro antifungal susceptibility pattern of the isolated Candia species was also determined using the E-test method [3], [28].
Section snippets
Collection of buccal samples
The present study was approved by the Institutional Ethics Committee of Madras Diabetes Research Foundation. A part of the study was carried out at Dr. Mohan's Diabetes and Endocrine Specialties, Pondicherry.
Buccal swabs [20], [21] were obtained from 400 subjects of both sexes (200 diabetic individuals and 200 non-diabetic individuals). The diabetic group comprised 200 randomly chosen outpatients, 99 females and 101 males with the age group between 25 to 65 years, attending a diabetic clinic and
Results
A total of 400 buccal swabs were collected, of which 200 each was collected from diabetic and non-diabetic healthy individuals. The diabetic and non-diabetic healthy control groups in terms of age, sex, dental status and smoking habits are shown (Table 1). Out of the 200 samples screened from diabetic individuals and non-diabetic individuals, 64 and 17 samples were positive for Candida species, respectively.
Identification was based on the colony morphology on Sabouraud's dextrose agar as fast
Discussion
The comparison and correlation of candidal colonization in the buccal cavity of diabetic and non-diabetic individuals have been a subject of research in several parts of the world. The isolation of Candida on Sabouraud's dextrose agar medium may indicate infection and identification of the isolate is necessary. The colonies grown on the isolation plates show remarkable variation infringes characteristics and surface texture. Brown–Thomsen first observed such a colony variation and this was
Conclusion
Diabetic patients had higher candidal harbouring rates, when compared to healthy individuals. There may a positive correlation between glycemic control and candidal colonization. Improving blood glucose control may reduce the risk of candidal infection among diabetic individuals. Antifungal susceptibility testing must be done before treatment to candidosis caused by any species of Candida. This study shows that ketoconazole was the most effective followed by fluconazole, itraconazole, and
Disclosure of interest
The authors declare that they have no competing interest.
Acknowledgements
I am really thankful to Dr. Mohans Diabetes and Endocrine Specialities, Pondicherry for allowing me to collect samples. A whole hearted thanks to Dr. Vijay Baskar Reddy, for helping me during the process of sample collection. I would also like to thank Dr. V. S. Saravanan, Assistant Professor, who had helped me during my work.
References (42)
- et al.
Factors affecting the prevalence of yeast in the oral cavity of patients with diabetes mellitus
J Med Mycol
(2008) - et al.
Kid diabetic kidney disease: act now or pay later
Saudi Kidney Dis Transpl
(2010) - et al.
Evaluation of a simplified diagnostic aid (Oricult-N) for detection of oral candidoses
Scan J Dent Res
(1985) - et al.
Susceptibility of clinical Candida species isolates to antifungal agents by E-test, Southern Iran: a five-year study
Iran J Microbiol
(2011) - et al.
Candidal overgrowth in diabetic patients: potential predisposing factors
Mycoses
(2005) - et al.
Culture and identification of Candida albicans from vaginal ulcer and separation of enolase on SDS-PAGE
IJB
(2010) - et al.
Polymorphic internal transcribed spacer region 1 DNA sequence identify medically important yeast
J Clin Microbiol
(2001) - et al.
The relationship between colonization, secretor status and in vitro adhesion of Candida albicans to buccal epithelial cells from diabetics
J Med Microbiol
(1990) - et al.
Speciation of Candida species isolated from clinical specimens by using Chrom agar and conventional methods
IJSRP
(2014) - et al.
Non-insulin dependent diabetes mellitus as a risk factor for denture stomatitis
J Oral Pathol Med
(1996)
Amphotericin B: spectrum and resistance
J Antimicrobiol Chemother
Study on classification and treatment of vulvovaginal candidiasis
Zhonghua Fu Chan Ke Za Zhi
Adelberg's: Textbook of Medical Microbiology. Publisher Mc Graw Hill Medical: 24th edition; Chapter 5
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
In vitro susceptibility of oral Candida to seven antifungal agents
Oral Microbiol Immunol
Clinical study of Candida vaginitis in Ahvaz, Iran and susceptibility of agents to topical antifungal
Pak J Med Sci
The isolation, identification and molecular analysis of Candida spp, isolated from the oral cavities of patients with diabetes mellitus
Oral Microbiol Immunol
Analysis of the strain relatedness of oral Candida albicans in patients with diabetes mellitus using polymerase chain reaction-fingerprinting
Oral Microbiol Immunol
Speciation of Candida by Hichrome agar and sugar assimilation test in both HIV infected and non-infected patients
Int J Biol Med Res
Identification of Candida spp. by phenotypic tests and PCR
Braz J Microbiol
Oral fungal infections
Oral Microbiol
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