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口腔念珠菌病的风险:对巴西东南部一家三级医院皮肤科门诊收治患者的剖析

Risk of oral candidiasis: profile analysis of patients admitted to the dermatology clinic of a tertiary hospital in southeast of Brazil.

作者信息

Cadavid Ana Maria Hoyos, Gimenes Viviane Mazo Favero, Freitas Vera Lúcia Teixeira de, Cavalcante Sonia Cristina, Siqueira Lumena Pereira Machado, Palomar Caroline Evelin Moraes, Nunes Ricardo Spina, Nico Marcello Menta Simonsen, Lourenço Silvia Vanessa

机构信息

Universidad de Antioquia, Facultad de Odontología, Departamento de Estomatología, Medellín, Antioquia, Colombia.

Universidade de São Paulo, Faculdade de Odontologia, Departamento de Estomatologia, São Paulo, São Paulo, Brazil.

出版信息

Rev Inst Med Trop Sao Paulo. 2025 Aug 18;67:e54. doi: 10.1590/S1678-9946202567054. eCollection 2025.

Abstract

The Candida genus colonizes the oral mucosa of immunocompetent individuals and healthy people, which is maintained by the innate immune system. However, any disturbance in this relationship, such as immunodepression, can turn this normally harmless yeast into a dangerous pathogen. This study evaluates the prevalence and risk factors for oral candidiasis (OC) among patients hospitalized in the dermatology department of a tertiary public hospital and identifies the Candida species involved. This cross-sectional study involves 240 patients. Oral candidiasis was diagnosed via clinical evaluation and mycological examination, with species confirmed using MALDI-TOF mass spectrometry. The prevalence of Candida species was 32.1%, in which C. albicans was the most common (92.1% of OC cases), followed by Nakaseomyces glabrata, Pichia kudriavzevii, C. tropicalis, and C. parapsilosis. Univariate analysis indicated that aging, use of oral prostheses, need for dental intervention, immunosuppression, and autoimmune diseases increase the risk of candidiasis. Multivariate analysis confirmed that aging, necessity for dental treatment, and immunosuppression were in 80% of OC cases. Given the great prevalence of oral candidiasis in hospitalized patients, dentists need to assess them for oral candidiasis and provide information on oral hygiene and healthy practices. Although C. albicans is the main microorganism responsible for these infections, other species have also been identified, highlighting the need for immediate identification and awareness of risk factors.

摘要

念珠菌属定殖于免疫功能正常个体和健康人的口腔黏膜,这种定殖由先天免疫系统维持。然而,这种关系中的任何干扰,如免疫抑制,都可能使这种通常无害的酵母转变为危险的病原体。本研究评估了一家三级公立医院皮肤科住院患者口腔念珠菌病(OC)的患病率和危险因素,并确定了相关的念珠菌种类。这项横断面研究涉及240名患者。通过临床评估和真菌学检查诊断口腔念珠菌病,使用基质辅助激光解吸电离飞行时间质谱(MALDI-TOF)确认菌种。念珠菌属的患病率为32.1%,其中白色念珠菌最为常见(占OC病例的92.1%),其次是光滑假丝酵母、季也蒙毕赤酵母、热带念珠菌和近平滑念珠菌。单因素分析表明,年龄增长、使用口腔修复体、需要牙科干预、免疫抑制和自身免疫性疾病会增加念珠菌病的风险。多因素分析证实,年龄增长、牙科治疗的必要性和免疫抑制在80%的OC病例中存在。鉴于住院患者口腔念珠菌病的高患病率,牙医需要对他们进行口腔念珠菌病评估,并提供口腔卫生和健康习惯方面的信息。虽然白色念珠菌是这些感染的主要微生物,但也已鉴定出其他菌种,这突出了立即识别和了解危险因素的必要性。

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