Exploring Oral Colonization Of Candida Species In Diabetic Individuals In Erbil City, Iraq: A Case-Control Study
DOI:
https://doi.org/10.23918/eajse.v11i2p19Keywords:
Candida albicans, HiCromeTM Candida differential agar, Colony forming unit, Diabetes, Oral candidiasisAbstract
Oral candidiasis is a prevalent opportunistic infection of the oral cavity, primarily caused by the overgrowth of Candida species, with Candida albicans being the most common. This case-control study aimed to compare oral clonization by different Candida species and their colony-forming units (CFU/ml) in the oral cavity of diabetic versus non-diabetic individuals. Oral rinse samples were collected from 50 individuals (25 diabetic and 25 non-diabetic) attending Layla Qasim Health Center, Erbil city, from February to March 2024. Samples were cultured on Sabouraud’s dextrose agar and HiCromeTM Candida differential agar for species identification. Of the 50 samples, 44 (88%) yielded positive culture for Candida sp. The total Candida carriage rate was similar in both the diabetic and control groups (88%). Multiple Candida species were identified, with Candida albicans and Candida krusei being the most prevalent. Diabetic patients had significantly higher colony-forming unit (CFU/ml) compared to the control group, indicating a greater fungal load despite similar carriage rates between groups (p value<0.01).
References
[1] Sharma M, Chakrabarti A. Candidiasis and other emerging yeasts. Current Fungal Infection Reports. 2023;17(1):15-24.https://doi.org/10.1099/jmm.0.46155-0.
[2] Mohammadi F, Javaheri MR, Nekoeian S, Dehghan P. Identification of Candida species in the oral cavity of diabetic patients. Current medical mycology. 2016;2(2):1.https://doi.org/10.18869/acadpub.cmm.2.2.4.
[3] Manikandan C, Amsath A. Isolation and rapid identification of Candida species from the oral cavity. Int J Pure App Biosci. 2013;1(1):23-7.https://doi.org/10.4103/njms.NJMS_80_19.
[4] Bhuyan L, Hassan S, Dash KC, Panda A, Behura SS, Ramachandra S. Candida species diversity in oral cavity of type 2 diabetic patients and their in vitro antifungal susceptibility. Contemporary clinical dentistry. 2018;9(Supp 1):S83-S8.https://doi.org/10.4103/ccd.ccd_70_18.
[5] Rodrigues CF, Rodrigues ME, Henriques M. Candida sp. infections in patients with diabetes mellitus. Journal of clinical medicine. 2019;8(1):76.https://doi.org/10.3390/jcm8010076.
[6] Maheshwari M, Kaur R, Chadha S. Candida species prevalence profile in HIV seropositive patients from a major tertiary care hospital in New Delhi, India. Journal of pathogens. 2016;2016(1):6204804.https://doi.org/10.1155/2016/6204804.
[7] Perlroth J, Choi B, Spellberg B. Nosocomial fungal infections: epidemiology, diagnosis, and treatment. Medical mycology. 2007;45(4):321-46.https://doi.org/10.1080/13693780701218689.
[8] Al-Attas SA, Amro SO. Candidal colonization, strain diversity, and antifungal susceptibility among adult diabetic patients. Annals of Saudi medicine. 2010;30(2):101-8.https://doi.org/10.4103/0256-4947.60514.
[9] Karaa A, Goldstein A. The spectrum of clinical presentation, diagnosis, and management of mitochondrial forms of diabetes. Pediatric diabetes. 2015;16(1):1-9.https://doi.org/10.1111/pedi.12223.
[10] King H, Aubert RE, Herman WH. Global burden of diabetes, 1995–2025: prevalence, numerical estimates, and projections. Diabetes care. 1998;21(9):1414-31.https://doi.org/10.2337/diacare.21.9.1414.
[11] Sun H, Saeedi P, Karuranga S, Pinkepank M, Ogurtsova K, Duncan BB, et al. IDF Diabetes Atlas: Global, regional and country-level diabetes prevalence estimates for 2021 and projections for 2045. Diabetes research and clinical practice. 2022;183:109119.https://doi.org/10.1016/j.diabres.2021.109119.
[12] Lu S-Y. Oral candidosis: pathophysiology and best practice for diagnosis, classification, and successful management. Journal of Fungi. 2021;7(7):555.https://doi.org/10.3390/jof7070555.
[13] Vijan S. In the clinic. Type 2 diabetes. Annals of internal medicine. 2010;152(5).https://doi.org/10.7326/0003-4819-152-5-201003020-01003.
[14] Rohani B. Oral manifestations in patients with diabetes mellitus. World journal of diabetes. 2019;10(9):485.https://doi.org/10.4239/wjd.v10.i9.485.
[15] Abdulaziz SM. Occurrence and pattern of antibiotic resistance among dental plaque bacteria from gingivitis patients and their clinical correlation. Journal of Baglasdesh College of Dentistry. 2018;30(2):12-234
[16] Abdulaziz SM, Muhammad AA. Oral Candida in β-thalassemia major and healthy population and their fluconazole susceptibility pattern. IJDSR. 2014;2(2):27-31
[17] Abdulaziz SM, Shaswary IA, Muhammad AA. In vitro antifungal activity of essential oils from local plants against fluconazole-resistant oral Candida albicans isolates. Zanco Journal of Medical Sciences (Zanco J Med Sci). 2015;19(2):965-71
[18] Corchuelo J, Ulloa FC. Oral manifestations in a patient with a history of asymptomatic COVID-19: Case report. International journal of infectious diseases. 2020;100:154-7.https://doi.org/10.1016/j.ijid.2020.08.071.
[19] 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. Journal of oral rehabilitation. 2002;29(5):452-7.https://doi.org/10.1046/j.1365-2842.2002.00837.x.
[20] Ganapathy DM, Joseph S, Ariga P, Selvaraj A. Evaluation of the influence of blood glucose level on oral Candidal colonization in complete denture wearers with Type-II Diabetes Mellitus: An in vivo Study. Dental research journal. 2013;10(1):87.https://doi.org/10.4103/1735-3327.111806.
[21] Zuza-Alves DL, Silva-Rocha WP, Chaves GM. An update on Candida tropicalis based on basic and clinical approaches. Frontiers in microbiology. 2017;8:1927.https://doi.org/10.3389/fmicb.2017.01927.
[22] Jamiu A, Albertyn J, Sebolai O, Pohl C. Update on Candida krusei, a potential multidrug-resistant pathogen. Medical mycology. 2021;59(1):14-30.https://doi.org/10.1093/mmy/myaa031.
[23] Taei M, Chadeganipour M, Mohammadi R. An alarming rise of non-albicans Candida species and uncommon yeasts in the clinical samples; a combination of various molecular techniques for identification of etiologic agents. BMC research notes. 2019;12:1-7.https://doi.org/10.1186/s13104-019-4811-1.
[24] Chouhan S, Kallianpur S, Prabhu KT, Tijare M, Kasetty S, Gupta S. Candidal prevalence in diabetics and its species identification. International Journal of Applied and Basic Medical Research. 2019;9(1):49-54.https://doi.org/10.4103/ijabmr.IJABMR_259_18.
[25] Ozcan K, Ilkit M, Ates A, Turac-Bicer A, Demirhindi H. Performance of Chromogenic Candida agar and CHROMagar Candida in recovery and presumptive identification of monofungal and polyfungal vaginal isolates. Medical mycology. 2010;48(1):29-34.https://doi.org/10.3109/13693780802713224.
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Sazan Moffaq Abdulaziz , HJ Ahmed, Rezhin Sleman Ashqi , Saba Hawar Mustafa , Samyan Elham Khalid

This work is licensed under a Creative Commons Attribution 4.0 International License.

Eurasian J. Sci. Eng is distributed under the terms of the Creative Commons Attribution License 4.0 (CC BY-4.0) https://creativecommons.org/licenses/by/4.0/
