Biofilm Formation, Virulence Factors and Antifungal Susceptibility of Candida spp. Isolated From the Oral Cavity of Diabetes Mellitus Patients

Background: Candida species colonize human microbiota and some conditions, such as immunosuppression or chronic illness, predispose the individual to fungal infections; among them, diabetes mellitus, a metabolic disorder frequently associated with higher rates of yeast infections.

Material and Methods: The prevalence of Candida species in the oral cavity of patients with diabetes mellitus was evaluated and the carriage was compared between type 1 and type 2 diabetic groups. In addition, in vitro susceptibility to antifungals, biofilm formation, cell surface hydrophobicity, and the production of hydrolytic enzymes were tested.

Results: The results demonstrated the presence of different Candida species in the oral cavity of diabetic patients; and, also showed that type 1 diabetic patients are more susceptible to Candida colonization. Almost all isolates produce virulence factors such as proteases, phospholipases, or form biofilm; and they are sensitive to fluconazole and nystatin.

Conclusion: Colonization of Candida spp. oral isolates from type 1 and type 2 diabetic patients were similar; however, type 1 presented a higher colony-forming unit counting. Overall, Candida isolates from the oral cavity of diabetic patients are potential pathogens of candidiasis.