Prevalence of Oropharyngeal Candidiasis among Diabetic Patients and Their Speciation in a Tertiary Care Hospital
Journal Title: Scholars Journal of Applied Medical Sciences - Year 2018, Vol 6, Issue 9
Abstract
C. albicans is a normal human commensal, and the most common opportunistic fungal pathogenin immunocompromised patients. Colonization of the oropharynxand/or the alimentary tract often precedes invasive yeast infections. In immunosuppressed, neutropenic patients candidemia can result in widely disseminated disease usually with a fatal outcome if untreated. Certain non-albicans species such as C. glabrata and C. krusei are less susceptible to fluconazole than C.albicans. Non-albicans isolates are more likely to require higher doses of fluconazole to achieve clinical cure and are more frequently associated with severe symptoms(1). To study the prevalence of oropharyngeal candidiasis (OPC) in uncontrolled diabetic patients and identify the associated candida species. Prospective study carried out in (uncontrolled diabetic patients with fasting blood glucose level >126mg/dl for more than a year) the diabetic outpatient department in a tertiary care hospital for a period of 6 months.A total of 112 diabetic patients were included in the study and evaluated for the occurrence of candidiasis. Patients were screened for the presence of white patch on the tongue, mucosa of the hard and soft palate, and the buccal cavity. Two oral swabs were taken from the lesions, one for direct smear and the other for culture. Identification and speciation of the yeast isolates were done asper standard reference methods.Primary isolation on Sabouraud dextrose agar (SDA) followed by subculture on Cormeal agar with Tween 80(CMA-T80) and CHRO Magar Candida (CAC). The morphology of the blastoconidia, chlamydospores and the ability to produce pseudophyphae on CMA-T80 helps in the identification of the species.CAC is a selective medium for the isolation, identification and direct differentiation of several Candida spp. Of the 112-study population, the occurrence of oropharyngeal candidiasis (OPC) was (69.7%). C. tropicalis was the predominant species in the diabetics. The incidence was more in the age group >40 years in diabetics.
Authors and Affiliations
Lalitha S, Lucy Nirmal Medona M
Keywords
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