Pathogenic characteristics of Candida albicans isolated from oral cavities of denture wearers and cancer patients wearing oral prostheses.

Candida albicans cause opportunistic infections including oral candidiasis in immunocompromised patients. It has an ability to cause infection due to its virulence factors. This study investigated the pathogenic characteristics of C. albicans isolated from the oral cavities of healthy subjects and two vulnerable groups, denture wearers and cancer patients wearing oral prostheses. Oral rinse samples were collected and cultured for the quantitative and qualitative analysis of Candida. Twenty strains of C. albicans isolated from the healthy individuals and denture wearers and, 14 strains isolated from the cancer patients were selected and their pathogenic characteristics were measured. The results of the study groups were compared using a Scheffe test for pairwise comparison and a chi square test. Denture wearer and cancer patients with prostheses carried significantly higher number (p < 0.01) and a variety of Candida than the normal individuals. Denture wearer and cancer patients carried several Candida species. The adherence abilities (p = 0.01) as well as phospholipase (p < 0.01) and proteinase (p = 0.03) production were significantly higher in the strains from denture wearers. In addition, high number of isolates from the denture wearers produced phospholipase and proteinase (85% and 80% respectively) compared to the strains from normal subjects (25% and 60% respectively). Only the germ tube formation and adherence ability were significantly higher in the strains from the cancer patients with prostheses (p = 0.05 and p < 0.01 respectively). In conclusion, during the commensal state, the increased expression of virulence factors in the denture wearers suggests the readiness of these strains to cause infection in this group. The high number of C. albicans and their increased adherence ability in the two study groups suggest that hygiene of oral cavity and prostheses is important in the prevention of colonization of Candida and the development of oral candidiasis.