Genetic Typing of Candida albicans Strains Isolated from the Oral Cavity of Patients with Denture Stomatitis before and after Itraconazole Therapy

Abstract

This study determined, by molecular typing of C. albicans species isolated from denture stomatitis patients with a mycological relapse six months after successful itraconazole therapy, whether there had been recurrence of infection with the same strain(s), selection of particular strains or infection with new strains of C. albicans. Forty patients with long-standing Candida-associated denture stomatitis were assigned either cyclodextrin itraconazole solution or itraconazole capsules (100mg b.d. for 15 days). Palatal erythema was measured and imprint cultures undertaken at baseline and at 15 days, four weeks and six months after treatment commenced. Yeast isolates were formally identified and chromosomal DNA was extracted from pairs of isolates from those patients with C. albicans present at baseline and six months after treatment commenced. Southern blotting of EcoRI-digested chromosomal DNA was performed using the C. albicans-specific 27A repetitive element as a probe. Eighteen of 36 patients were infected with C. albicans at baseline and six months after treatment commenced. Overall, 13 genetically different strains of C. albicans were found. However, in 17 of 18 patients, the C. albicans strains isolated prior to itraconazole therapy and six months later were the same. Thus recurrence of denture stomatitis in these individuals was due to re-colonisation by the original strain, rather than re-infection with a different strain.