Cross Laura J, Williams David W, Sweeney Caroline P, Jackson Margaret S, Lewis Michael A O, Bagg Jeremy
Restorative Dentistry, Infection and Immunity Section, University of Glasgow Dental School of Glasgow, Scotland.
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2004 Mar;97(3):351-8. doi: 10.1016/j.tripleo.2003.10.006.
The aim of the study was to determine the recurrence rate of denture stomatitis and persistence of Candida in 22 patients (5 male and 17 female, mean age 71 years) over a 3-year period.
Denture hygiene practice, denture cleanliness, and the presence of palatal erythema were assessed for each patient at the start of the study (baseline). The oral cavity was sampled for yeasts by imprint culture and denture discs. Ten patients received a capsular form of itraconazole (100 mg twice daily for 15 days) and 12 patients were provided with 100 mg of itraconazole in the form of a mouthwash (10 mL twice daily), which was then swallowed. No further antifungal treatment was administered to any of the patients. Clinical and microbiological assessments were repeated for each patient at 6 months and 3 years after the original appointment. Yeasts were identified by colony color on CHROMagar Candida, germ-tube formation, and API-32C profiling. Selected isolates were then typed by inter-repeat polymerase chain reaction (IR PCR).
Candida albicans was isolated at baseline from all patients either alone (12 patients) or in combination with another species (10 patients). Other yeast species recovered were C glabrata (5 patients), C tropicalis (1 patient), C guilliermondii (1 patient), C krusei (1 patient), C parapsilosis (1 patient), C kefyr (1 patient), and Saccharomyces cerevisiae (2 patients). Candida albicans and/or C glabrata were recovered from 11 of the 22 patients after 6 months or 3 years. A complete and consistent change of yeast species from baseline was observed in 6 patients after 6 months and at 3 years. The remaining 5 patients were yeast-free at the follow-up assessments. PCR fingerprinting of C albicans and C glabrata indicated strain persistence over 6 months in 10 patients and in 4 patients after 3 years. A switch in strain type occurred for 1 patient after 6 months and for 3 patients after 3 years.
The recurrence of denture stomatitis in patients who maintained a high standard of denture cleanliness was low. Although itraconazole was beneficial in reducing the fungal load, there may be strain persistence or subsequent recolonization of the oral cavity by a broader range of potentially less sensitive yeast species.
本研究旨在确定22例患者（5例男性，17例女性，平均年龄71岁）在3年期间义齿性口炎的复发率及念珠菌的持续存在情况。
在研究开始时（基线）对每位患者的义齿卫生习惯、义齿清洁度和腭部红斑情况进行评估。通过印迹培养和义齿盘对口腔进行酵母采样。10例患者接受胶囊剂型的伊曲康唑（每日2次，每次100mg，共15天），12例患者使用含100mg伊曲康唑的漱口水（每日2次，每次10mL，随后咽下）。所有患者均未再接受进一步的抗真菌治疗。在初次就诊后6个月和3年对每位患者重复进行临床和微生物学评估。通过CHROMagar念珠菌显色培养基上的菌落颜色、芽管形成及API - 32C分析鉴定酵母。然后通过重复序列间聚合酶链反应（IR PCR）对选定的分离株进行分型。
在基线时，所有患者均分离出白色念珠菌，单独分离出白色念珠菌的有12例患者，与其他菌种混合分离出的有10例患者。分离出的其他酵母菌种有光滑念珠菌（5例患者）、热带念珠菌（1例患者）、季也蒙念珠菌（1例患者）、克鲁斯念珠菌（1例患者）、近平滑念珠菌（1例患者）、解脂念珠菌（1例患者）和酿酒酵母（2例患者）。6个月或3年后，22例患者中有11例再次分离出白色念珠菌和/或光滑念珠菌。6个月及3年后，6例患者的酵母菌种与基线相比发生了完全且一致的变化。其余5例患者在随访评估时未检测到酵母。白色念珠菌和光滑念珠菌的PCR指纹图谱显示，10例患者在6个月内及4例患者在3年后菌株持续存在。1例患者在6个月后及3例患者在3年后发生了菌株类型转换。
保持高标准义齿清洁度的患者义齿性口炎复发率较低。尽管伊曲康唑有助于降低真菌载量，但可能存在菌株持续存在或口腔随后被更广泛的潜在敏感性较低的酵母菌种重新定植的情况。
