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Nefrología (Madrid)
On-line version ISSN 1989-2284Print version ISSN 0211-6995
Abstract
ROSA-GARCIA, Estela de la; MIRAMONTES-ZAPATA, Mónica; SANCHEZ-VARGAS, Luis O. and MONDRAGON-PADILLA, Arnoldo. Oral colonisation and infection by Candida sp. in diabetic and non-diabetic patients with chronic kidney disease on dialysis. Nefrología (Madr.) [online]. 2013, vol.33, n.6, pp.764-770. ISSN 1989-2284. https://dx.doi.org/10.3265/Nefrologia.pre2013.Aug.11790.
Introduction: Oral candidiasis (OC) is a common opportunistic infection in immunocompromised patients. Species identification is sometimes important for treatment. Objective: to determine the prevalence of different Candida species colonising or infecting the oral mucosa (OM) of diabetic (DM) and non-diabetic (non-DM) chronic kidney disease patients, comparing both groups and exploring potential risk factors. Methods: 56 DM and 80 non-DM patients on chronic dialysis were examined. OM swabs were cultured on Sabouraud dextrose agar plates. Candida species were identified with API® galleries. OC was confirmed by exfoliative cytology. Statistical associations were analysed using χ2, Fisher's exact test (ET), and multiple logistic regression. Results: Candida prevalence was 43.4%: 53.6% DM and 36.3% non-DM, (p=.045). The species identified were C. albicans 74.6%, C. glabrata 22.0%, C. tropicalis 15.2%, C. parapsilosis 3.4 %, C. kefyr 3.4% and C. famata 1.7% without difference between groups. DM patients had a higher xerostomia prevalence (p=.002) and lower salivary flow (p=.008) and lower serum albumin (p=.018). 16.9% of patients had OC, 23.2% DM compared with 12.5% non-DM, (p=.101). The following were associated with the presence of Candida in the OM: the use of dental prostheses (odds ratio [OR] 25.6, 95% confidence interval [CI] 2.5 to 253, P=.001), xerostomia (OR 9.6, 95% CI 2.4 to 38.1, P=.001) and low serum albumin values (OR 0.41, 95% CI 0.22 to 0.98, P=.044). Conclusions: The presence of Candida sp. in the OM was associated with dental prostheses, xerostomia and low serum albumin.
Keywords : Candida albicans; Candida glabrata; Diabetes mellitus; Serum albumin; Chronic kidney disease; Haemodialysis.
