Oral Candida isolates and fluconazole susceptibility patterns in older Mexican women
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Objectives: To assess the epidemiologic and microbiologic profile and in vitro fluconazole susceptibility of yeasts isolated from the oral mucosa colonization/infection of elderly patients. Background: It has been reported that in older adults increases the oral colonization by Candida particularly C. non-albicans, showing a decreased response to fluconazole, which increases the risk of recalcitrant local and disseminated candidiasis. Materials and methods: This was a prospective cross-sectional study conducted in 120 elderly patients. Oral samples were obtained of mucosal Candida colonization or infection by swabbing. Each sample was plated on CHROMagar® Candida and incubated (36 ± 1.5 °C) for two days. The yeast species were identified using the API®ID32-C-AUX. Fluconazole susceptibility was tested using a broth microdilution assay according to the CLSI methods. Results: The yeast colonization/infection frequency in the total population was 65.8%25. The frequency of the highest Candida carriers was 67.4%25 in the 70-79-year-old-group. Oral candidiasis was present in 20%25, with a tendency to increase with age (33.3%25 of adults aged > 80 years), it was determined that the use of prosthesis is associated with a higher colonization rate (Chi2, p = 0.011). The frequency of colonization/infection cases with more than one species showed a tendency to increase with age, 18.9%25 in the 60-69 year-old-group, 20.9%25 in the 70-79-year-old-group and 29.2%25 in the ≥80 year-old-group. About fluconazole susceptibility: for C. albicans, 20.3%25, about Candida non-albicans species 15.3%25 were dose dependently susceptible (DDS) and 17.9%25 were resistant. Conclusions: After 80 years of age, there is a considerable increase in Candida non-albicans species and a reduced susceptibility to fluconazole. © 2016 Elsevier Ireland Ltd.
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Candida; Diabetes; Elderly; Epidemiology; Infection fluconazole; antifungal agent; fluconazole; adult; age; aged; antibiotic resistance; antibiotic sensitivity; Article; Candida; Candida albicans; Candida glabrata; Candida tropicalis; controlled study; cross-sectional study; female; fungal colonization; fungal strain; fungus identification; human; in vitro study; major clinical study; Mexican; mouth mucosa; mycosis; nonhuman; Pichia kudriavzevii; priority journal; prospective study; thrush; treatment response; very elderly; antifungal resistance; Candida; Candidiasis, Oral; isolation and purification; male; Mexico; microbiology; mouth mucosa; Aged; Aged, 80 and over; Antifungal Agents; Candida; Candidiasis, Oral; Cross-Sectional Studies; Drug Resistance, Fungal; Female; Fluconazole; Humans; Male; Mexico; Mouth Mucosa; Prospective Studies
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