Department of Oral Surgery, Kagoshima University Medical and Dental Hospital, 8-35-1 Sakuragaoka, Kagoshima 890-8544, Japan.
BMC Oral Health. 2014 Feb 20;14:14. doi: 10.1186/1472-6831-14-14.
The isolation frequency and susceptibility to antifungal agents of oral Candida isolates from patients with oral candidiasis (OC) were compared between studies conducted in 2006-2007 and 2012-2013.
A total158 strains was isolated from 112 patients who visited Kagoshima University Hospital for the treatment of OC during the 14-month period from February 2012 and March 2013, and evaluated on the isolation frequency of each Candida strain and the susceptibility against antifungal drugs as compared to those evaluated in 2006-2007.
There was a higher frequency of xerostomia as a chief complaint and of autoimmune disease in the 2012-2013 study than in the 2006-2007 study. More than 95% of Candida isolates were C. albicans and C. glabrata. In addition, the proportion of the latter increased from 12.3% in the 2006-2007 study to 23.4% in the 2012-2013 study, while the proportion of the former decreased from 86.2% to 72.8%, respectively. C. albicans was isolated in almost all patients, while C. glabrata was only isolated concomitantly with C. albicans. Minimal inhibitory concentrations (MICs) were not significantly different between groups with a few exceptions. Candida isolates, of which MICs surpassed break points, apparently increased for miconazole and itraconazole against C. glabrata in the 2012-2013 study, but this was not statistically significant. As a result, more cases of autoimmune disease, a greater number of C. glabrata isolates, and higher resistance to azoles were seen in the 2012-2013 study than in the 2006-2007 study.
These data indicate that with recent increases in C. glabrata infection, a causative fungus of OC, and in C. glabrata resistance to azoles, caution is needed in the selection of antifungal drugs for the treatment of OC.
本研究旨在比较 2006-2007 年和 2012-2013 年期间开展的研究中,口腔念珠菌病(OC)患者口腔念珠菌分离株的分离频率和抗真菌药物敏感性。
本研究共从 2012 年 2 月至 2013 年 3 月期间在鹿儿岛大学医院就诊并接受 OC 治疗的 112 例患者中分离出 158 株念珠菌,评估了每种念珠菌分离株的分离频率以及与 2006-2007 年评估结果相比的抗真菌药物敏感性。
与 2006-2007 年研究相比,2012-2013 年研究中口干作为主诉和自身免疫性疾病的发生率更高。超过 95%的念珠菌分离株为白念珠菌和光滑念珠菌。此外,后一种念珠菌的比例从 2006-2007 年的 12.3%增加到 2012-2013 年的 23.4%,而前一种念珠菌的比例从 86.2%下降到 72.8%。几乎所有患者均分离出白念珠菌,而仅在与白念珠菌同时分离出光滑念珠菌。除少数例外,各组之间的最小抑菌浓度(MIC)无显著差异。在 2012-2013 年研究中,白念珠菌和光滑念珠菌对咪康唑和伊曲康唑的 MIC 值超过了临界点,因此念珠菌分离株对咪康唑和伊曲康唑的耐药性明显增加,但无统计学意义。因此,与 2006-2007 年研究相比,2012-2013 年研究中自身免疫性疾病的病例更多,光滑念珠菌的分离株更多,对唑类药物的耐药性更高。
这些数据表明,随着 OC 致病真菌光滑念珠菌感染的增加和对唑类药物的耐药性增加,在选择治疗 OC 的抗真菌药物时需要谨慎。