Background
Methods
Subjects
Analysis of background variables of Candida-isolated patients
Collection of Candida from the oral cavity and bacterial culture
Identification of Candida species
Diagnosis of OC
Evaluation of susceptibility to antifungal drugs
Informed consent and ethical guideline
Statistical analysis
Results
Background variables
2006-2007 | 2012-2013 | Test | |||||
---|---|---|---|---|---|---|---|
Subjects number | Total | 57 | 112 | ||||
Gender | Male | 19 | (33.3) | 30 | (26.8) | Fisher’s exact probability test | |
Female | 38 | (66.7) | 82 | (73.2) | [2 × 2] | N.S. | |
Age | Average [max-min] | 67.9 | [26–90] | 69.6 | [21–97] | Student’s t-test | N.S. |
Chief Complaints | Heat sensation(HS) | 23 | (40.4) | 46 | (41.1) | ||
Taste abnormality (TA) | 2 | (3.5) | 0 | (0) | |||
Xerostomia (X) | 5 | (8.8) | 26 | (23.2) | |||
Tylosis linguae (TL) | 4 | (7.0) | 0 | (0) | Fisher’s exact probability test | ||
Rubor/Erosion (R/E) | 4 | (7.0) | 8 | (7.1) | [2 × 8] | ||
HS + TA + X | 9 | (15.8) | 16 | (14.3) | p < 0.05 | ||
HS + TA + R/E | 5 | (8.8) | 8 | (7.1) | |||
HS + TL | 5 | (8.8) | 8 | (7.1) | |||
Total | 57 | (100) | 112 | (100) | |||
Systemic disease | Yes | 44 | (77.2) | 97 | (86.6) | Fisher’s exact probability test | |
None | 13 | (28.8) | 15 | (13.4) | [2 × 2] | ||
Total | 57 | (100) | 112 | (100) | N.S. | ||
Endocrine | 22 | (29.3) | 22 | (17.3) | |||
Cardiovascular | 18 | (24.0) | 28 | (22.0) | |||
Gastrointestinal | 123 | (16.0) | 12 | (9.4) | Fisher’s exact probability test | ||
Malignant tumor | 8 | (10.7) | 12 | (9.4) | [2 × 7] | ||
CNS | 4 | (5.3) | 10 | (7.9) | N.S. | ||
Viral | 6 | (8.0) | 8 | (6.3) | |||
Autoimmune | 5 | (6.7) | 35 | (27.6) | |||
Total | 75 | (100) | 127 | (100) | |||
Steroid | Dose | 12 | (21.1) | 28 | (25.0) | Fisher’s exact probability test | |
Non-dosed | 45 | (78.9) | 84 | (75.0) | [2 × 2] | ||
Total | 57 | (100) | 112 | (100) | N.S. | ||
Denture | Wearer | 37 | (64.9) | 57 | (50.9) | Fisher’s exact probability test | |
Non-wearer | 20 | (35.1) | 55 | (49.1) | [2 × 2] | ||
Total | 75 | (100) | 112 | (100) | N.S. | ||
Oral candidiasis | Pseudomembranous | 42 | (73.7) | 42 | (37.5) | ||
Erythematous | 11 | (19.3) | 52 | (46.4) | Fisher’s exact probability test | ||
Hypertrophic | 2 | (3.5) | 4 | (3.6) | [2 × 2] | ||
Mixed | 2 | (3.5) | 14 | (12.5) | N.S. | ||
Total | 55 | (100) | 112 | (100) |
Classification of oral candidiasis (OC)
Isolated Candida species
Candida species | Number of patients (%) | Test | |||
---|---|---|---|---|---|
2006-2007 | 2012-2013 | ||||
Single species isolated | |||||
Candida albicans (CA) | 49 | (86.0) | 71 | (63.4) | |
Candida glabrata (CG) | 1 | (1.8) | 0 | (0) | |
Candida tropicalis (CT) | 0 | (0) | 0 | (0) | |
Candida parapsilosis (CP) | 0 | (0) | 0 | (0) | |
Candida krusei (CK) | 0 | (0) | 0 | (0) | Fisher’s exact probability test |
Plural species isolated | [2 × 10] | ||||
CA + CG | 6 | (10.5) | 36 | (32.1) | p < 0.01 |
CA + CT | 0 | (0) | 3 | (2.7) | |
CA + CP | 0 | (0) | 1 | (0.9) | |
CA + CG + CT | 1 | (1.8) | 0 | (0) | |
CA + CP + CK | 0 | (0) | 1 | (0.9) | |
Total | 57 | (100) | 112 | (100) | |
Candida
species
|
Total number of
Candida
strains isolated (%)
|
Test
| |||
2006-2007
|
2012-2013
| ||||
Candida albicans
| 56 | (86.2) | 112 | (72.8) | |
Candida glabrata
| 8 | (12.3) | 36 | (23.4) | |
Candida tropicalis
| 1 | (1.5) | 3 | (1.9) | Fisher’s exact probability test |
Candida parapsilosis
| 0 | (0) | 2 | (1.3) | [2 × 5] |
Candida krusei
| 0 | (0) | 1 | (0.6) | p < 0.01 |
Total | 65 | (100) | 154 | (100 |
Susceptibility to antifungal drugs
a. amphotericin B (AMPH-B) | ||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Year | Strain | No. of strains | MIC (μg/mL) | MIC50
| MIC90
| |||||||||||
<0.03 | 0.03 | 0.06 | 0.125 | 0.25 | 0.5 | 1 | 2 | 4 | 8 | 16 | >16 | |||||
2006-2007 |
C. albicans
| 56 | 8 | 43 | 3 | 2 | 0.5 | 0.5 | ||||||||
C. glabrata
| 8 | 1 | 2 | 2 | 2 | 1 | 0.5 | 2 | ||||||||
C. tropicalis
| 1 | 1 | 0.25 | 0.25 | ||||||||||||
2012-2013 |
C. albicans
| 112 | 4 | 12 | 86 | 9 | 1 | 0.5 | 1 | |||||||
C. glabrata
| 36 | 1 | 2 | 16 | 14 | 2 | 1 | 0.5 | 1 | |||||||
C. tropicalis
| 3 | 1 | 2 | 1 | 1 | |||||||||||
C. parapsilosis
| 2 | 2 | <0.03 | <0.03 | ||||||||||||
C. krusei
| 1 | 1 | 0.5 | 0.5 | ||||||||||||
b. flucytosine (5-FC)
| ||||||||||||||||
Year
|
Strain
|
No. of strains
|
MIC (μg/mL)
|
MIC
50
|
MIC
90
| |||||||||||
<0.125
|
0.125
|
0.25
|
0.5
|
1
|
2
|
4
|
8
|
16
|
32
|
64
|
>64
| |||||
2006-2007 |
C. albicans
| 56 | 18 | 8 | 24 | 3 | 1 | 2 | 0.25 | 0.5 | ||||||
C. glabrata
| 8 | 4 | 1 | 1 | 2 | <0.125 | 16 | |||||||||
C. tropicalis
| 1 | 1 | 0.125 | 0.125 | ||||||||||||
2012-2013 |
C. albicans
| 112 | 56 | 1 | 43 | 3 | 3 | 4 | 1 | 1 | 0.25 | 1 | ||||
C. glabrata
| 36 | 20 | 6 | 6 | 2 | 1 | 1 | <0.125 | 8 | |||||||
C. tropicalis
| 3 | 3 | <0.125 | <0.125 | ||||||||||||
C. parapsilosis
| 2 | 2 | 2 | |||||||||||||
C. krusei
| 1 | 1 | 1 | 0.25 | 0.25 | |||||||||||
c. fluconazole (FLCZ)
| ||||||||||||||||
Year
|
Strain
|
No. of strains
|
MIC (μg/mL)
|
MIC
50
|
MIC
90
| |||||||||||
<0.125
|
0.125
|
0.25
|
0.5
|
1
|
2
|
4
|
8
|
16
|
32
|
64
|
>64
| |||||
2006-2007 |
C. albicans
| 56 | 22 | 22 | 5 | 1 | 1 | 1 | 1 | 3 | 0.5 | 4 | ||||
C. glabrata
| 8 | 1 | 2 | 2 | 1 | 1 | 1 | 2 | >64 | |||||||
C. tropicalis
| 1 | 1 | >64 | >64 | ||||||||||||
2012-2013 |
C. albicans
| 112 | 4 | 33 | 51 | 2 | 1 | 3 | 3 | 3 | 0.5 | 2 | ||||
C. glabrata
| 36 | 4 | 1 | 5 | 6 | 7 | 7 | 2 | 16 | 64 | ||||||
C. tropicalis
| 3 | 1 | 2 | 32 | 32 | |||||||||||
C. parapsilosis
| 2 | 2 | 2 | 2 | ||||||||||||
C. krusei
| 1 | 1 | 2 | 2 | ||||||||||||
d. miconazole (MCZ)
| ||||||||||||||||
Year
|
Strain
|
No. of strains
|
MIC (μg/mL)
|
MIC
50
|
MIC
90
| |||||||||||
<0.03
|
0.03
|
0.06
|
0.125
|
0.25
|
0.5
|
1
|
2
|
4
|
8
|
16
|
>16
| |||||
2006-2007 |
C. albicans
| 56 | 2 | 22 | 20 | 8 | 1 | 3 | 0.125 | 0.25 | ||||||
C. glabrata
| 8 | 1 | 2 | 2 | 1 | 2 | 1 | 4 | ||||||||
C. tropicalis
| 1 | 0.125 | 0.125 | |||||||||||||
2012-2013 |
C. albicans
| 112 | 2 | 20 | 64 | 18 | 1 | 1 | 1 | 2 | 3 | 0.25 | 0.5 | |||
C. glabrata
| 36 | 1 | 5 | 12 | 7 | 3 | 3 | 2 | 3 | 2 | 16 | |||||
C. tropicalis
| 3 | 1 | 1 | 1 | 1 | 4 | ||||||||||
C. parapsilosis
| 2 | 1 | 1 | 1-2 | 2 | |||||||||||
C. kurusei
| 1 | 1 | 4 | 4 | ||||||||||||
e. itraconazole (ITCZ)
| ||||||||||||||||
Year
|
Strain
|
No. of strains
|
MIC (μg/mL)
|
MIC
50
|
MIC
90
| |||||||||||
<0.015
|
0.015
|
0.03
|
0.06
|
0.125
|
0.25
|
0.5
|
1
|
2
|
4
|
8
|
>8
| |||||
2006-2007 |
C. albicans
| 56 | 4 | 20 | 14 | 9 | 2 | 1 | 3 | 1 | 2 | 0.06 | 1 | |||
C. glabrata
| 8 | 1 | 1 | 1 | 1 | 1 | 1 | 2 | 0.05 | >8 | ||||||
C. tropicalis
| 1 | >8 | >8 | |||||||||||||
2012-2013 |
C. albicans
| 112 | 2 | 12 | 34 | 50 | 5 | 4 | 1 | 1 | 3 | 0.125 | 0.25 | |||
C. glabrata
| 36 | 1 | 3 | 3 | 5 | 9 | 8 | 2 | 5 | 1 | >8 | |||||
C. tropicalis
| 3 | 1 | 1 | 1 | 1 | 2 | ||||||||||
C. parapsilosis
| 2 | 1 | 1 | 0.25 | 0.25 | |||||||||||
C. kurusei
| 1 | 1 | 0.5 | 0.5 | ||||||||||||
f. micafungin (MCFG)
| ||||||||||||||||
Year
|
Strain
|
No.of strains
|
MIC (μg/mL)
|
MIC
50
|
MIC
90
| |||||||||||
<0.03
|
0.03
|
0.06
|
0.125
|
0.25
|
0.5
|
1
|
2
|
4
|
8
|
16
|
>16
| |||||
2006-2007 |
C. albicans
| 56 | 32 | 9 | 13 | 1 | 1 | <0.03 | 0.06 | |||||||
C. glabrata
| 8 | 1 | 2 | 2 | 1 | 1 | 1 | 0.125 | >16 | |||||||
C. tropicalis
| 1 | 1 | 0.06 | 0.06 | ||||||||||||
2012-2013 |
C. albicans
| 112 | 95 | 12 | 2 | 1 | 1 | 1 | <0.03 | 0.06 | ||||||
C. glabrata
| 36 | 16 | 1 | 1 | 3 | 5 | 6 | 1 | 2 | 1 | 0.125 | 1 | ||||
C. tropicalis
| 3 | 2 | 1 | <0.03 | 00.6 | |||||||||||
C. parapsilosis
| 2 | 2 | <0.03 | <0.03 | ||||||||||||
C. kurusei
| 1 | 0.5 | 0.5 |