PATTERN OF ORAL CANDIDIASIS

Diabetes mellitus (DM) is a clinical syndrome associated with deficiency of insulin secretion or action. It is considered one of the largest emerging threats to health in the 21 st century. It is estimated that there will be 380 million persons with Diabetes mellitus in 2025 (Atkins et al., 2010). Besides the classical complications of the disease, DM has been associated with reduced response of T cells, neutrophil function, and disorders of humoral immunity (Muller et al., 2005). Consequently, DM increases the susceptibility to infections, both the most common ones as well as those that almost always affect only people with DM (e.g. rhinocerebral mucormycosis)(Peleg et al., 2007). Such infections, in addition to the repercussions associated with its infectivity, may trigger DM complications such as hypoglycemia and ketoacidosis. Fungal infections are a major cause of morbidity and mortality in immune compromised individuals (such as diabetes mellitus) and Candida are among the most common pathogens in these patients (Pahwa, 2015). The prevalence of diabetes has been on the increase. Diabetes is associated with certain diseases such as candidiasis (Bader et al., 2015). Candida species are important nosocomial pathogens in critically ill patients and are associated with substantial mortality and 1 prolonged hospitalization in the intensive care unit

Oral candidiasis remains a significant opportunistic infection among HIV-infected individuals, often serving as an early marker of immune suppression. This study aimed to determine its prevalence and assess the antifungal susceptibility patterns of Candida species isolated from HIV-positive patients attending a secondary health facility in Benin City, Nigeria. Sterile cotton swab was used to collect oral specimens from each participant which were gram-stained for microscopic examination. Positive samples ere then cultured and subjected to sensitivity test. 250 participants were screened, 76 (30%) yielded positive for oral candidiasis. Among the sociodemographic factors analyzed, only age showed a significant association with the prevalence of oral candidiasis (p < 0.001). The highest occurrence of oral candidiasis was observed in patients above 50 years.
Antifungal susceptibility testing using the Kirby-Bauer disk diffusion method revealed varied resistance patterns. Amphotericin B showed the highest resistance rate (30.4%), while nystatin had the highest sensitivity rate (26%). Resistance to fluconazole, a commonly used antifungal, was also notable at 19.6%, raising concerns about self-medication and antifungal misuse in the region. Despite widespread HAART coverage, the prevalence of oral candidiasis highlights gaps in treatment adherence and monitoring. The findings emphasize the need for regular oral health assessments, targeted antifungal therapy based on susceptibility testing, and health education to improve HAART adherence and oral hygiene. These measures are crucial in reducing the burden of oral candidiasis in HIV-infected populations.