Assessement of Candida albicans of the oral mucosa among type-2 diabetes mellitus patients attending Bahteramas Hospital, Southeast Sulawesi Province
Article Sidebar
Main Article Content
Firdayanti Firdayanti
https://orcid.org/0000-0002-7571-8071
Angriani Fusvita
https://orcid.org/0000-0003-1003-2842
Ani Umar
https://orcid.org/0009-0006-2262-609X
Abstract
Diabetes Mellitus (DM) is a disease characterized by hyperglycemia resulting from either insulin deficiency or insulin resistance. Candida albicans is a fungus generally found on the surface of the mucous membrane, which usually dominates and overgrows among DM patients. This study aims to identify the presence of the C. albicans fungus on the oral mucosa of individuals with Type-2 Diabetes Mellitus at Bahteramas Hospital, Southeast Sulawesi Province, Indonesia. A descriptive study was employed, and a purposive sampling technique was used to select a sample of 62 patients. Swab samples were cultured on Potato Dextrose Agar medium for Gram staining and carbohydrate assimilation tests. The resulting culture was tested using CHROMagarTM Candida (CAC) media. Among the 62 samples, 56 samples were identified to have a convex colony, a cream-color surface, a smooth texture, and a Gram-positive nature. The carbohydrate assimilation test showed that the indicated samples could ferment glucose and maltose, but not lactose and sucrose. Green colonies are formed through CHROMagarTM Candida differential media testing. There are 56 identification results for C. albicans from oral mucosal swab samples from 62 patients with Type-2 Diabetes Mellitus at the Bahteramas Hospital, Southeast Sulawesi Province, yielding six other patients with negative results.
Downloads
Article Details
Copyright (c) 2025 Firdayanti Firdayanti, Angriani Fusvita, Ani Umar
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
References
Halimi A, Mortazavi N, Memarian A, Zahedi M, Niknejad F, Sohrabi A, et al. The relation between serum levels of interleukin 10 and interferon-gamma with oral candidiasis in type 2 diabetes mellitus patients. BMC Endocr Disord. 2022;22(1):296. https://doi.org/10.1186/s12902-022-01217-x DOI: https://doi.org/10.1186/s12902-022-01217-x
Sun H, Saeedi P, Karuranga S, Pinkepank M, Ogurtsova K, Duncan BB, et al. IDF Diabetes atlas: Global, regional and country-level diabetes prevalence estimates for 2021 and projections for 2045. Diabetes Res Clin Pract. 2022;183:1–23. https://doi.org/10.1016/j.diabres.2021.109119 DOI: https://doi.org/10.1016/j.diabres.2021.109119
Dadgal KV, Mohod S. A Case report with dual diagnosis of candidiasis in a patient with uncontrolled diabetes mellitus. cureus. 2024;16(7):1–5. https://doi.org/10.7759/cureus.65908 DOI: https://doi.org/10.7759/cureus.65908
Nouraei H, Jahromi MG, Jahromi LR, Zomorodian K, Pakshir K. Potential pathogenicity of Candida species isolated from oral cavity of patients with diabetes mellitus. Biomed Res Int. 2021;2021:9982744. https://doi.org/10.1155/2021/9982744 DOI: https://doi.org/10.1155/2021/9982744
Patel M. Oral Cavity and Candida albicans: Colonisation to the development of infection. Pathogens. 2022;11(3):335. https://doi.org/10.3390/pathogens11030335 DOI: https://doi.org/10.3390/pathogens11030335
Kuśka-Kiełbratowska A, Wiench R, Mertas A, Bobela E, Kiełbratowski M, Lukomska-Szymanska M, et al. Evaluation of the sensitivity of selected Candida strains to ozonated water—an in vitro study. Medicina. 2022;58(12):1731. https://doi.org/10.3390/medicina58121731 DOI: https://doi.org/10.3390/medicina58121731
Chouhan S, Kallianpur S, Prabhu KT, Tijare M, Kasetty S, Gupta S. Candidal prevalence in diabetics and its species identification. Int J Appl Basic Med Res. 2019;9(1):49. https://doi.org/10.4103/ijabmr.ijabmr_259_18 DOI: https://doi.org/10.4103/ijabmr.IJABMR_259_18
Xiong J, Lu H, Jiang Y. A Causal relationship between type 2 diabetes and candidiasis through two-sample mendelian randomization analysis. Microorganisms. 2024;12(10). https://doi.org/10.3390/microorganisms12101984 DOI: https://doi.org/10.3390/microorganisms12101984
Al-Janabi AAHS. A positive or negative connection of diabetes mellitus to the oral microbiota. Eurasian J Med. 2023;55(1):83–9. https://doi.org/10.5152/eurasianjmed.2023.21164 DOI: https://doi.org/10.5152/eurasianjmed.2023.21164
Hu L, He C, Zhao C, Chen X, Hua H, Yan Z. Characterization of oral candidiasis and the Candida species profile in patients with oral mucosal diseases. Microb Pathog. 2019;134:103575. https://doi.org/10.1016/j.micpath.2019.103575 DOI: https://doi.org/10.1016/j.micpath.2019.103575
Zarei N, Roudbary M, Mohammadi SR, Santos ALS Dos, Nikoomanesh F, Mohammadi R, et al. Prevalence, molecular identification, and genotyping of Candida species recovered from oral cavity among patients with diabetes mellitus from Tehran, Iran. Adv Biomed Res. 2022;11(1):29. https://doi.org/10.4103/abr.abr_26_21 DOI: https://doi.org/10.4103/abr.abr_26_21
Alzahrani AAH, Bhat N, Kukreja P, Alhassan EM, Mudawi AIA, Alzahrani FA, et al. Oral candidiasis and potential risk factors among disabled and non-disabled in Al-Baha region, Saudi Arabia. World J Clin Cases. 2024;12(27):6077–86. https://doi.org/10.12998/wjcc.v12.i27.6077 DOI: https://doi.org/10.12998/wjcc.v12.i27.6077
Raju SB, Rajappa S. Isolation and identification of Candida from the oral cavity. ISRN Dent. 2011;2011:1–7. https://doi.org/10.5402/2011/487921 DOI: https://doi.org/10.5402/2011/487921
Ma Q, Li Y, Li P, Wang M, Wang J, Tang Z, et al. Research progress in the relationship between type 2 diabetes mellitus and intestinal flora. Biomed Pharmacother. 2019;117:109138. https://doi.org/10.1016/j.biopha.2019.109138 DOI: https://doi.org/10.1016/j.biopha.2019.109138
Evren E, Göçmen JS, Hortaç İştar E, Yavuzdemir Ş, Tekeli A, Yavuz Y, et al. Medically important Candida spp. identification: An era beyond traditional methods. Turkish J Med Sci. 2022;52(3):834–40. https://doi.org/10.55730/1300-0144.5380 DOI: https://doi.org/10.55730/1300-0144.5380
Williams DW, Lewis M. Isolation and identification of candida from the oral cavity. Oral Dis. 2000;6(1):3–11. https://doi.org/10.1111/j.1601-0825.2000.tb00314.x. DOI: https://doi.org/10.1111/j.1601-0825.2000.tb00314.x
Pawlak Z, Andrusiów S, Pajączkowska M, Janczura A. Identification of fungi isolated from oral cavity of patients with HIV using maldi–tof ms. J Clin Med. 2021;10(8):1570. https://doi.org/10.3390/jcm10081570 DOI: https://doi.org/10.3390/jcm10081570
Mahmoodi M, Nouraei H, Nasr R, Zomorodian K, Khodadadi H, Pakshir K. Phenotypes characterization and ABC genotypes distribution of clinical Candida albicans isolates. J Clin Lab Anal. 2023;37(7):1–7. https://doi.org/10.1002/jcla.24888 DOI: https://doi.org/10.1002/jcla.24888
Al-Awadhi EF, Al towiti H, Al-qadri A, Alhashdi S, Alkhawlani N, Alhamoodi A. Isolation and identification of Candida species from oral of diabetic patients. J Bacteriol Mycol Open Access. 2023;11(2):77–80. https://doi.org/10.15406/jbmoa.2023.11.00348 DOI: https://doi.org/10.15406/jbmoa.2023.11.00348
Hemaid ASS, Abdelghany MME, Abdelghany TM. Isolation and identification of Candida spp. from immunocompromised patients. Bull Natl Res Cent. 2021;45(1):1-8. https://doi.org/10.1186/s42269-021-00620-z DOI: https://doi.org/10.1186/s42269-021-00620-z
Scharmann U, Kirchhoff L, Chapot V le S, Dziobaka J, Verhasselt HL, Stauf R, et al. Comparison of four commercially available chromogenic media to identify Candida albicans and other medically relevant Candida species. Mycoses. 2020;63(8):823–31. https://doi.org/10.1111/myc.13119 DOI: https://doi.org/10.1111/myc.13119
Sachivkina N, Podoprigora I, Bokov D. Morphological characteristics of Candida albicans, Candida krusei, Candida guilliermondii, and Candida glabrata biofilms, and response to farnesol. Vet World. 2021;14(6):1608–14. https://doi.org/10.14202/vetworld.2021.1608-1614 DOI: https://doi.org/10.14202/vetworld.2021.1608-1614
Saxena A, Nagi R, Sandeep T, Patil DJ, Choudhary R, Kaur A. Identification of Candida albicans and nonalbicans candida resistant species in tobacco users and oral squamous cell carcinoma patients: Comparison of HiCrome agar and automated VITEK 2 system. J Oral Maxillofac Pathol. 2021;25(3):551–2. https://doi.org/10.4103/jomfp.jomfp_411_20 DOI: https://doi.org/10.4103/jomfp.jomfp_411_20
Ghelardi E, Pichierri G, Castagna B, Barnini S, Tavanti A, Campa M. Efficacy of Chromogenic Candida Agar for isolation and presumptive identification of pathogenic yeast species. Clin Microbiol Infect. 2008;14(2):141–7. https://doi.org/10.1111/j.1469-0691.2007.01872.x DOI: https://doi.org/10.1111/j.1469-0691.2007.01872.x
Domingues PCA, Oliveira V de C, Bim FL, Aires CP, Santos AP dos, Castro DT de, et al. Influence of glucose supplementation on biofilm formation of Candida albicans and Candida glabrata isolated from diabetic and non-diabetic individuals. Arch Oral Biol. 2022;134:1–8. https://doi.org/10.1016/j.archoralbio.2021.105339 DOI: https://doi.org/10.1016/j.archoralbio.2021.105339
Sampath A, Weerasekera M, Dilhari A, Gunasekara C, Bulugahapitiya U, Fernando N, et al. Type 2 diabetes mellitus and oral Candida colonization: Analysis of risk factors in a Sri Lankan cohort. Acta Odontol Scand. 2019;77(7):508–16. https://doi.org/10.1080/00016357.2019.1607547 DOI: https://doi.org/10.1080/00016357.2019.1607547
Zomorodian K, Kavoosi F, Pishdad GR, Mehriar P, Ebrahimi H, Bandegani A, et al. Prevalence of oral Candida colonization in patients with diabetes mellitus. J Mycol Med. 2016;26(2):103–10. https://doi.org/10.1016/j.mycmed.2015.12.008 DOI: https://doi.org/10.1016/j.mycmed.2015.12.008
Mattei AS, Alves SH, Severo CB, Guazzelli L da S, Oliveira F de M, Severo LC. Use of Mueller-Hinton broth and agar in the germ tube test. Rev Inst Med Trop Sao Paulo. 2014;56:483–5. https://doi.org/10.1590/s0036-46652014000600005 DOI: https://doi.org/10.1590/S0036-46652014000600005
Talapko J, Juzbašić M, Matijević T, Pustijanac E, Bekić S, Kotris I, et al. Candida albicans-the virulence factors and clinical manifestations of infection. J Fungi. 2021;7(2):1–19. https://doi.org/10.3390/jof7020079 DOI: https://doi.org/10.3390/jof7020079
Agustina D, Chrisnawati RT, Chrismawaty BE, Wongsohardjono SB, Naritasari F, Sarasati A. Prevalence and identification of oral Candida species in patients with type 2 diabetes in Yogyakarta. Maj Kedokt Gigi Indones. 2023;9(1):57-66. https://doi.org/10.22146/majkedgiind.76176 DOI: https://doi.org/10.22146/majkedgiind.76176
Jørgensen MR. Pathophysiological microenvironments in oral candidiasis. APMIS. 2024;132(12):956–73. https://doi.org/10.1111/apm.13412 DOI: https://doi.org/10.1111/apm.13412
Preece G, Bhola S, Davidson A, Collier A, Bal AM. Epidemiology, management and outcome of Candidaemia in patients with diabetes. J R Coll Physicians Edinb. 2022;52(4):292–7. https://doi.org/10.1177/14782715221137451 DOI: https://doi.org/10.1177/14782715221137451
González-Moles MÁ, Ramos-García P. State of evidence on oral health problems in diabetic patients: A critical review of the literature. J Clin Med. 2021;10(22):5383. https://doi.org/10.3390/jcm10225383 DOI: https://doi.org/10.3390/jcm10225383
