RESUMO
Objective:To determine the prevalence ofCandidaspeciesand to study factors associated to oral cavity colonization inpatients with type 2 diabetes mellitus.Methods:A total of 107 diabetics were classified into contro-lled and uncontrolled according to glycosylated hemoglobinvalues. Each patient was assessed for stimulated salivary flowrates, pH, and an oral rinse to search for yeast. The study alsodetermined the state of oral health via Klein and Palmer CPOindexes for permanent dentition, dental plaque by OLeary,and a periodontal chart.Results:We found yeasts in 74.8 percent of the patients. A total of 36of the 52 subjects with controlled diabetes presented yeasts and44 in the uncontrolled; no significant differences (p = 0.2) werenoted among the presence of yeasts and the control of bloodglucose. The largest number of isolates corresponded toC. al-bicans, followed byC. parapsilosis.Uncontrolled individualspresented a significantly higher percentage of yeast differentfromC. albicans(p = 0.049).Conclusions:We found a high percentage of Candida colo-nization and uncontrolled individuals had greater diversityof species. The wide range of CFU/ml found both in patientswith oral candidiasis, as well as in those without it did not per-mit distinguishing between colonization and disease. We onlyfound association between isolation of yeasts and the low rateof salivary flow.
Assuntos
Candidíase , ColômbiaRESUMO
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.
OBJETIVOS: Determinar la prevalencia de las especies de Candida y estudiar factores asociados a la colonización de la cavidad oral en pacientes con diabetes mellitus tipo 2. MÉTODOS: 107 diabéticos se clasificaron en controlados y no controlados, de acuerdo con los valores de hemoglobina glucosilada. A cada paciente se le tomó una muestra de saliva estimulada y un enjuague oral, la primera se utilizó para determinar el pH y la tasa de flujo salival, la segunda para buscar levaduras. Además, se determinó el estado de salud oral mediante los índices CPO-D de Klein y Palmer para dentición permanente, el de placa bacteriana de O Leary y un periodontograma. RESULTADOS: Se hallaron levaduras en el 74,8% de los pacientes. Un total de 36 de 52 sujetos con diabetes controlada presentaron levaduras y 44 en los no controlados; sin diferencias significativas (p = 0.2) entre la presencia de levaduras y el control de la glucemia. El mayor número de aislamientos correspondió a C. albicans, seguido de C. parapsilosis. Los individuos no controlados presentaron de manera significante un porcentaje más alto de levaduras diferentes a C. albicans (p = 0.049). Sólo se encontró asociación entre el aislamiento de levaduras y la baja tasa de flujo salival. CONCLUSIÓN: Se encontró un alto porcentaje de colonización por Candida, y en los individuos no controlados hubo mayor diversidad de especies. El amplio rango de UFC/mL hallada tanto en pacientes con candidiasis oral como sin ella no permitió establecer colonización y enfermedad.
RESUMO
Candida dubliniensis is an emerging pathogenic yeast isolated mainly from the oral cavity of HIV-infected patients. The close phenotypic and genotypic relationship between C. albicans and C. dubliniensis has led to incorrectly identifying isolates of C. dubliniensis as C. albicans. The oral cavities of 107 diabetic patients were studied in Cali, Colombia, and 72 colonies of Candida, with shades of green on CHROMagar Candida culture media, were obtained. Various phenotypic tests were carried out, which included germ tube formation and production of chlamydospores on corn meal Agar. Additionally, growth studies were carried out at 42 degrees C and 45 degrees C and on Sabouraud agar with 6.5%, sodium chloride. Identification of C. dubliniensis with these tests was confirmed with API 20C Aux. We identified 65 and 7 colonies of C. albicans and C. dubliniensis, respectively. This is the first time that C. dubliniensis is identified with phenotypic methods in Colombia.