Isolation, Identification, and Antifungal Susceptibility of Candida Species From the Oral Cavities of Patients With Diabetes

Diabetes remains a serious health issue with a high prevalence rate, causing more deaths worldwide. Fungal infections are a global public health problem associated with high mortality. This study aimed to identify the species and virulence factors of Candida in the oral cavities of adult patients with diabetes attending the Federal Medical center Owerri, Imo state, Nigeria. A total of 50 patients with diabetes attending the General Outpatient Clinic of Federal Medical center, Owerri were included in this study. The swab sample was collected using the swab testing technique. Candida species were isolated from patients on Sabouraud Dextrose Agar (SDA) media. The identification and characterization of the fungal isolates were performed using cultural and morphological characteristics, microscopic examination, and biochemical tests. The fungal isolates were differentiated using the germ tube test. The Kirby–Bayer disk diffusion method was used to determine the antifungal susceptibility of the fungal isolates. The virulence factors of the Candida species were evaluated using biofilms, heamolysin formation, and phospholipase and coagulase activity. The results showed that C. albicans (40 %), C. glabrata (26 %), C. tropicalis (22 %), and C. krusei (12 %) were present in the oral cavity of patients with diabetes. Candida albicans demonstrated high biofilm production efficiency (92.31 %) and heamolysin (92.31%) coupled with high phospholipase activity (100 %) of phospholipase activity. C. krusei and C. glabrata showed resistance to clotrimazole up to 100 % and 80 %, respectively. C. albicans had a higher percentage of resistance (92.31 %) to pasoconazole. C. tropicalis displayed a higher percentage of 100 % resistance to both pasoconazole and nystatin. A high percentage prevalence of Candida albicans, Candida glabrata, Candida tropicalis, and Candida kruseiwas isolated and identified from the oral cavity of patients with diabetes, with Candida albicans being the most prevalent. All isolates were clotrimazole-resistant, pasoconazole, and nystatin