INTRODUCTION:

Diabetes mellitus is a metabolic disease, in which there are high blood sugar levels over a prolonged period. It is associated with deficiency of insulin secretion or action. Diabetes is considered as one of the largest emerging threats of the 21^st century. It is estimated that around 380 million people worldwide will be suffering from this disease by 2025.⁽¹⁾

Diabetes mellitus has been associated with reduced response of T cells, neutrophil function, and disorders of humoral immunity.⁽²⁾Consequently, it is also associated with a number of infections⁽³⁾like periodontitis, pneumonia, urinary tract infections and skin infections.⁽⁴⁾The most common oral manifestation seen in patients with poorly controlled diabetes is oral candidiasis.

The Candida species are considered as commensal yeast on cutaneous and mucocutaneous surfaces particularly in the gastrointestinal tract⁽⁵⁾ and the oral microbiota. Candida albicans is capable of causing superficial mycoses to deep seated infections. These infections occur when the Candida species becomes pathogenic and invades host tissue. Oral and vaginal candidiasis are the most commonly encountered superficial infections.⁽⁶⁾

Groups usually considered at an increased risk for candidiasis are cancer patients, patients receiving antibiotics, corticosteroids or other immunosuppressants⁽⁷⁾and diabetic patients.⁽⁸⁾

MATERIALS AND METHODS:

SAMPLE COLLECTION

20 oropharyngeal swabs were collected. 10 swabs were obtained from diabetic patients who were already receiving treatment for diabetes mellitus and the other 10 swabs were collected from non-diabetic patients.

CHARACTERIZATION OF CANDIDA SPECIES

Candida species were characterized by using Hichrom agar. (Himedia, Mumbai)

PREPARATION OF HICHROM AGAR

CHROM agar Candida (HiMedia, Mumbai) was prepared following manufacturer’s instructions.

About 21.02g HiChrome Candida differentiation agar base (modified) was suspended in 500ml of distilled water. It was heated to boiling gently to dissolve the medium completely. Then it was allowed to cool to 50º C and rehydrated. One vial contents of HiChrome Candida selective supplement was added under aseptic conditions. It was mixed well and poured into Petri dishes. Isolated on HiChrome agar are based upon the characteristic color of the colony by subculturing from Sabouraud’s chloramphenicol agar plates.

Figure 1: Picture showing Candida albicans on HiChrome agar agar

The swabs were streaked on the Candida HiChrome plates and the plates were incubated at 37ºC for 24-48 hours.

RESULTS:

When the incubated plates were checked after 48 hours, we found that of the 20 plates that were streaked, only 5/20 (25%) gave positive cultures for Candida albicans. All five of the positive cultures were samples obtained from diabetic patients.

DISCUSSION:

A study conducted by LM Tapper Jones, et al in 1980 at the Welsh National School of Medicine screened for the prevalence of oral candidiasis and the frequency of isolation of Candida species in the mouths of 50 patients with diabetes mellitus and 50 healthy volunteers. They found that Candida was more prevalent in the mouths of diabetic patients than in those of the healthy patients.⁽⁹⁾

Another study conducted by Khaled H Abu-Elteen, et al in 2006 at the Hashemite University in Jordan screened 262 individuals. 132 of these individuals were diabetic patients and 130 were healthy individuals. They found that none of the non diabetic controls had any clinical signs of oral candidiasis while 8.3% of the diabetic controls had positive clinical signs for oral candidiasis. Of the patients who showed positive clinical signs, 36% were overnight denture wearers and tobacco smokers. Their study concluded that smoking and continuous wearing of dentures promoted oral candidal colonisation in diabetics. ⁽¹⁰⁾

Similarly in our study, 50% of the samples obtained from diabetic patients gave positive results for Candida while none of the samples obtained from non-diabetic patients showed any trace of Candida. But none of the patients from whom samples were obtained for this study smoked or chewed tobacco.

CONCLUSION:

Thus, we can conclude from this study that though Candida species is a commensal that is present in our oral cavity, it is more prevalent in the oral cavities of diabetic patients.

ACKNOWLEDGEMENTS:

I would like to thank Dr. Bhaskar Anand and the staff at Gunasekaran Hospital, who helped to collect samples for this study.

REFERENCES:

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Received on 07.09.2016 Modified on 28.09.2016

Research J. Pharm. and Tech 2016; 9(10):1645-1646.

DOI: 10.5958/0974-360X.2016.00330.9