Oral Prevalence of Candida Species in Patients Undergoing Systemic Glucocorticoid Therapy and the Antifungal Sensitivity of the Isolates

Figures & data

Table 1 Demographic Data of Patients Undergoing Treatment with Systemic Glucocorticoids (n=120) and Non-Users (n=120)

Criteria	Corticosteroid Users				P
	Yes		No
	n	%	n	%
Age (years)
<30	0	0	3	2.5	/
30–50	59	49.17	60	50	/
>50	61	50.83	57	47.5	/
Sex
Female	77	64.17	75	62.5	/
Male	43	35.83	45	37.5	/
Oral problems
Periodontitis	48	40	28	23.33	0.006
Impacted tooth	15	12.5	25	20.83	0.083
Caries	38	31.67	23	19.17	0.026
Residual root	6	5	11	9.17	0.208
Other oral diseases	13	10.83	38	31.67	<0.05
Underlying disease					<0.05
RA	23	19.17	/	/	/
SLE	11	9.17	/	/	/
Scleroderma	5	4.17	/	/	/
Other connective tissue disease	18	15	/	/	/
Organ transplantation	10	8.33	/	/	/
Inflammatory bowel disease	4	3.33	/	/	/
Allergic diseases	15	12.5	/	/	/
Cancer	13	10.83	2	1.67	/
Cutaneous vasculitis	8	6.67	/	/	/
Other disease	13	10.83	23	19.17	/
Oropharyngeal candidiasis symptoms	52	43.33	14	11.67	<0.05
White patches	23	19.17	6	5	0.927
Redness or soreness	5	4.17	0	0	0.227
Cotton-like feeling in the mouth	2	1.67	1	0.83	0.599
Loss of taste	8	6.67	2	1.67	0.919
Pain while eating or swallowing	6	5	2	1.67	0.780
Cracking and redness at the corners of the mouth	8	6.67	3	2.5	0.590

Abbreviations: RA, rheumatoid arthritis; SLE, systemic lupus erythematosus.

Table 2 Frequency of Yeast Strains Isolated from the Oral Cavities of Patients Undergoing Treatment with Systemic Glucocorticoids (n=88) vs Non-Users (n=48)

Species	Corticosteroid Users						P****
	Yes		No
	n	%	n	%
Candida albicans*	40	45.45	31	66.67			0.033
Non-Candida albicans**	45	51.14	16	33.33			0.046
Candida parapsilosis	13	14.77	5	10.42			0.474
Candida glabrata	14	15.91	3	6.25			0.104
Candida tropicalis	8	9.09	3	6.25			0.561
Candida krusei	6	6.82	4	8.33			0.746
Candida lusitaniae	3	3.41	1	2.08			0.662
Candida guilliermondii	1	1.14	0	0			0.459
Saccharomyces cerevisiae	3	3.41	1	2.08			0.662
Multi-fungal***
Candida albicans + Candida parapsilosis	1	1.18	0	/			0.455
Candida albicans + Candida glabrata	1	1.18	0	/			0.455
Candida albicans + Candida krusei	1	1.18	1	2.13			0.668

Notes: *Including C. albicans strains from multi-fungal isolates; **Including non-C. albicans strains from multi-fungal isolates; ***Multi-fungal isolates from patients undergoing treatment with SGCs (n = 85) and from non-users (n = 47); ****Statistically significant differences (P < 0.05)

Table 3 Antifungal Sensitivity of Candida Spp. Isolated from Patients Undergoing Treatment with Systemic Glucocorticoids (n=85) vs Non-Users (n=47)

Antifungal Agents	Candida Albicans			Candida Parapsilosis			Candida Glabrata			Candida Tropicalis			Candida Krusei			Candida Lusitaniae			Candida Guilliermondii
	Yes (n=40)	No (n=31)	P	Yes (n=13)	No (n=5)	P	Yes (n=14)	No (n=3)	P	Yes (n=8)	No (n=3)	P	Yes (n=6)	No (n=4)	P	Yes (n=3)	No (n=1)	P	Yes (n=1)	No (n=0)	P
Anidulafungin			0.119			0.457			0.633			0.521			0.389			/			/
S+I, WT	37	31		12	4		13	3		7	3		5	4		3	1		0	0
R, Non-WT	3	0		1	1		1	0		1	0		1	0		0	0		1	0
Amphotericin B			0.412			/						/			/			/			/
WT	39	29		13	5		14	3	/	8	3		6	4		3	1		1	0
Non-WT	1	2		0	0		0	0		0	0		0	0		0	0		0	0
Micafungin			0.253									/			/			/			/
S+I, WT	40	30		13	5	/	14	3	/	8	3		6	4		3	1		1	0
R, Non-WT	0	1		0	0		0	0		0	0		0	0		0	0		1	0
Caspofungin			0.07			0.457						/			/			/			/
S+I, WT	36	31		12	4		14	3	/	8	3		6	4		3	1		0	0
R, Non-WT	4	0		1	1		0	0		0	0		0	0		0	0		1	0
5-Flucytosine			0.347			0.814			0.659			0.521			/			/			/
WT	33	28		11	4		11	2		7	3		6	4		3	1		1	0
Non-WT	7	3		2	1		3	1		1	0		0	0		0	0		0	0
Posaconazole			0.375			0.523			/			/			/			/			/
WT	39	31		12	5		14	3		8	3		6	4		3	1		1	0
Non-WT	1	0		1	0		0	0		0	0		0	0		0	0		0	0
Voriconazole			0.594			0.814			/			0.521			0.747			/			/
S+I, WT	36	29		11	4		14	3		7	3		5	3		3	1		1	0
R, Non-WT	4	2		2	1		0	0		1	0		1	1		0	0		0	0
Itraconazole			0.004			0.888			0.659			0.898			0.778			0.505			/
S+SDD, WT	24	28		10	4		11	2		5	2		4	3		2	1		1	0
R, Non-WT	16	3		3	1		3	1		3	1		2	1		1	0		0	0
Fluconazole			0.001			0.814			0.201			0.201			/			/			/
S+SDD, WT	22	28		7	3		13	2		2	2		0	0		3	1		1	0
R, Non-WT	18	3		6	2		1	1		6	1		6	4		0	0		0	0

Notes: WT and Non-WT were defined by epidemiological cutoff values; S, I, SDD, and R were determined according to clinical breakpoints.

Abbreviations: WT, wild type; Non-WT, non-wild type; S, susceptible; SDD, susceptible/dose dependent; I, intermediate; R, resistant.