Prevalência de Candida spp. durante o exame radiográfico em pacientes diabéticos
Prevalence of Candida spp. during radiographic examination in Diabetes mellitus patients
Volpato, Flávia Cristina; Pires, Juliana Rico; Volpato, I. R. C.; Orrico, Silvana Regina Perez; Costa, Marciano Pires da; Spolidório, Denise Madalena Palomari; Gonçalves, Andréa
http://dx.doi.org/10.1590/S1807-25772013000100003
Rev. odontol. UNESP, vol.42, n1, p.13-19, 2013
Abstract
It is suggested that individuals with diabetes are more susceptible to Candida infections than healthy people, especially if periodontal infection is associated. Objective: This study evaluated the prevalence of colonization by Candida spp. during radiographic examination in diabetic and non-diabetic patients. Material and methods: Twenty-six patients with type 2 diabetes mellitus and 20 patients without diabetes mellitus, presenting chronic periodontitis and presence of Candida spp. in saliva were evaluated. During radiographic examination, samples of saliva were collected from: oral mucosa, conventional radiographic periapical film, digital x-ray sensor (CDR), and bite block of the receptor-positioning device. Colony forming units (cfu/mL) and identification of Candida yeasts were assessed. Result: Oral mucosa from both groups showed the highest colonization with Candida spp. if compared with others surfaces collected (p < 0.05). In diabetic patients, the mucosa of the upper left regions showed higher levels of colonization. In non-diabetic patients, the upper right molar region showed the highest level of colonization during the examination of the receptor-positioning device, the sensor and the non-sensitive film. Candida spp. levels in saliva were similar between diabetics (mean = 3.0 × 106) and non-diabetics (mean = 3.8 × 106). Conclusion: No difference in Candida spp. colonization (cfu/mL) in diabetics and non-diabetic patients was observed for the five collected surfaces and the simulated radiographic region. Candida albicans was the prevalent species of Candida spp. found on all the samples.
Keywords
Periodontal diseases, diabetes mellitus, dental digital radiography.
Resumo
Relata-se que indivíduos diabéticos são mais susceptíveis a infecções por Candida que indivíduos saudáveis, especialmente se doença periodontal estiver associada. Objetivo: Este estudo propôs avaliar a prevalência de colonização por Candida spp. durante o exame radiográfico em pacientes diabéticos e não diabéticos. Material e método: Vinte e seis pacientes com Diabetes mellitus do tipo 2 e 20 pacientes sem Diabetes mellitus, apresentando periodontite crônica e Candida spp. na saliva, foram avaliados. Durante o exame radiográfico, amostras de saliva foram coletas: da mucosa oral, do filme radiográfico periapical convencional, sensor radiográfico digital (CDR) e bloco de mordida do posicionador de filmes. Unidades formadoras de colônia (cfu/mL) e identificação das leveduras do gênero Candida foram avaliadas. Resultado: A mucosa oral de ambos os grupos mostrou maior colonização por Candida spp. quando comparada com outras superfícies coletadas (p < 0.05). Nos pacientes diabéticos, a mucosa da região esquerda superior mostrou níveis mais altos de colonização. Nos pacientes não diabéticos, a região de molar superior direito mostrou o nível mais alto de colonização durante o exame no posicionador, no sensor e no lado do filme periapical que não fica voltado para a radiação X. Os níveis de Candida spp. na saliva foram similares entre diabéticos (média = 3.0 × 106) e não diabéticos (média = 3.8 × 106). Conclusão: Nenhuma diferença na colonização por Candida spp. (cfu/mL) em pacientes diabéticos e não diabéticos foi observada nas cinco superfícies coletadas e nas regiões radiográficas simuladas. Candida albicans foi a espécie prevalente de Candida spp. encontrada em todas as amostras.
Palavras-chave
Doenças periodontais, diabetes mellitus, radiografia dentária digital.
References
1. Bartolini JA, Chariton DG, Flint DJ. Infection control practices in dental radiology. Gen Dent. 2003;51:264-71.
2. Centers for Disease Control and Prevention. Guidelines for Infection Control in Dental Health-Care Settings - 2003. MMWR 2003;52(No. RR-17):[2;31] .
3. White SC, Glaze S. Interpatient microbiological cross-contamination after dental radiographic examination. J Am Dent Assoc. 1978;96:801-4.
4. Kalathingal SM, Moore S, Know S, Schuster G, Shrout MK, Plummer K. An evaluation of microbiologic contamination on phosphor plates in a dental school. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009;107:279-82. http://dx.doi.org/10.1016/j.tripleo.2008.05.025
5. van der Stelt PF. Filmless imaging: the uses of digital radiography in dental practice. J Am Dent Assoc. 2005;136:1379-87.
6. Hokett SD, Honey JR, Ruiz F, Baisedn MK, Hoen MM. Assessing the effectiveness of direct digital radiography barrier sheaths and finger cots. J Am Dent Assoc. 2000;131:463-7.
7. Taylor GW, Borgnakke WS. Periodontal disease: associations with diabetes, glycemic control and complications. Oral Dis. 2008;14:191-203. http://dx.doi.org/10.1111/j.1601-0825.2008.01442.x
8. Spolidorio DMP, Boriollo MFG, Estrela C, Spolidorio LC. Diferentes métodos fenotípicos para isolamento e identificação de espécies de Candida. ROBRAC: Rev Odontol Brasil Central. 2009;18:18-26.
9. Lamey PJ, Darwaza A, Fisher BM, Samaranayake LP, Macfarlane TW, Frier BM. Secretor status, candidal carriage and candidal infection in patients with diabetes mellitus. J Oral Pathol. 1988;17:354-7. http://dx.doi.org/10.1111/j.1600-0714.1988.tb01549.x
10. Farah CS, Ashman RB, Challacombe SJ. Oral candidosis. Clin Dermatol. 2000;18:553-62. http://dx.doi.org/10.1016/S0738-081X(00)00145-0
11. Guggenheimer J, Moore PA, Rossie K, Myers D, Mongelluzzo MB, Block HM et al. Insulin-dependent diabetes mellitus and oral soft tissue pathologies. II. Prevalence and characteristics of Candida and candidal lesions. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2000;89:570-6. http://dx.doi.org/10.1067/moe.2000.104477
12. Willis AM, Coulter WA, Sullivan DJ, Coleman DC, Hayes JR, Bell PM, et al. Isolation of C. dubliniensis from insulin-using diabetes mellitus patients. J Oral Pathol Med. 2000;29:86-90. http://dx.doi.org/10.1034/j.1600-0714.2000.290206.x
13. Manfredi M, McCullough MJ, Al-Karaawi ZM, Hurel SJ, Porter SR. The isolation, identification and molecular analysis of Candida spp. isolated from the oral cavities of patients with diabetes mellitus. Oral Microbiol Immunol. 2002;17:181-5. http://dx.doi.org/10.1034/j.1399-302X.2002.170308.x
14. Belazi M, Velegraki A, Fleva A, Gidarakou I, Papanaum L, Baka D, et al. Candidal overgrowth in diabetic patients: potential predisposing factors. Mycoses. 2005;48:192-6. http://dx.doi.org/10.1111/j.1439-0507.2005.01124.x
15. Kumar BV, Padshetty, NS, Bai KY, Rao MS. Prevalence of Candida in the oral cavity of diabetic subjects. J Assoc Phys Indian. 2005;53:599-602.
16. Diabetes and periodontal diseases. Committee on Research, Science and Therapy. American Academy of Periodontology. J Periodontol. 2000;71:664-78. http://dx.doi.org/10.1902/jop.2000.71.4.664
17. Christgau M, Palitzsch KD, Schmalz G, Kreiner U, Frenzel S. Healing response to non-surgical periodontal therapy in patients with diabetes mellitus: clinical, microbiological, and immunological results. J Clin Periodontol. 1998;25:112-24. http://dx.doi.org/10.1111/j.1600-051X.1998.tb02417.x
18. Moore LV, Moore WE, Riley C, Brooks CN, Burmeister JA, Smibert RM. Periodontal microflora of HIV positive subjects with gingivitis or adult periodontitis. J Periodontol. 1993;64:48-56. http://dx.doi.org/10.1902/jop.1993.64.1.48
19. Lamster IB, Lalla E, Borgnakake WS, Taylor GW. The relationship between oral health and diabetes mellitus. J Am Dent Assoc. 2008;139 (Suppl):19S-24S.
20. Willis AM, Coulter WA, Fulton CR, Hayes JR, Bell PM, Lamey P-J. Oral candidal carriage and infection in insulin-treated diabetic patients. Diabet Med. 1999;16:675-9. http://dx.doi.org/10.1046/j.1464-5491.1999.00134.x
21. Colombo APV, Teles RP, Torres MC, Souto R, Rosalém Jr. W, Mendes MCS et al. Subgingival microbiota of Brazilian subjects with untreated chronic periodontitis. J Periodontol. 2002;73:360-9. http://dx.doi.org/10.1902/jop.2002.73.4.360
22. Sardi JCO, Duque C, Camargo GACG, Hofling JF, Gonçalves RB. Periodontal conditions and prevalence of putative periodontopathogens and Candida spp. in insulin-dependent type 2 diabetic and non-diabetic patients with chronic periodontitis - a pilot study. Arch Oral Biol. 2011;56:1098-105. http://dx.doi.org/10.1016/j.archoralbio.2011.03.017
23. Melton JJ, Redding SW, Kirkpatrick WR, Reasner CA, Ocampo GL, Venkatesh A, et al. Recovery of Candida dubliniensis and other Candida species from the oral cavity of subjects with periodontitis who had well-controlled and poorly controlled type 2 diabetes: a pilot study. Spec Care Dentist. 2010;30:230-4. http://dx.doi.org/10.1111/j.1754-4505.2010.00159.x
24. Armitage G. Development of a classification system for periodontal diseases and conditions. Ann Periodontol. 1999;4:1-6. http://dx.doi.org/10.1902/annals.1999.4.1.1
25. American Diabetes Association. Standards of medical care in diabetes -2010. Diabetes Care. 2010;33( Suppl 1):S11-61. http://dx.doi.org/10.2337/dc10-S011
26. Williams DW, Lewis MAO. Isolation and identification of candida from the oral cavity. Oral Dis. 2000;6:3-11. http://dx.doi.org/10.1111/j.1601-0825.2000.tb00314.x
27. Beighton D, Ludford R, Clark DT, Brailsford SR, Pankhurst CL, Tinsley GF, et al. Use of CHROMagar Candida Medium for Isolation of Yeasts from Dental Samples. J Clin Microbiol. 1995;33:3025-7.
28. Pfaller MA, Houston A, Coffmann S. Application of CHROMagar Candida for rapid screening of clinical specimens for Candida albicans, Candida tropicalis, Candida krusei, and Candida (Torulopsis) glabrata. J Clin Microbiol. 1996;34:58-61.
29. Sandven P. Laboratory identification and sensitivity testing yeast isolates. Acta Odontol Scand. 1990;48:27-36. http://dx.doi.org/10.3109/00016359009012731
30. Sullivan D, Coleman D. Candida dubliniensis: Characteristics and identification. J Clin Microbiol. 1998;36:329-34.
31. Pinjon E, Sullivan D, Salkin I, Shanley D, Coleman D. Simple, inexpensive, reliable method for differentiation of Candida dubliniensis from Candida albicans. J Clin Microbiol. 1998;36:2093-5.
32. Hill LVH, Tan MH, Pereira LH, Embil JA. Association of oral candidiasis with diabetic control. J Clin Pathol. 1989;42:502-5. http://dx.doi.org/10.1136/jcp.42.5.502
33. Soell M, Hassan M, Miliauskaite A, Haïkel Y, Selimovic D. The oral cavity of elderly patients in diabetes. Diabetes Metab. 2007;33:S10-8. http://dx.doi.org/10.1016/S1262-3636(07)80053-X
34. Negrato CA, Tarzia O. Buccal alterations in diabetes mellitus. Diabetol Metab Syndr. 2010;2:1-11. http://dx.doi.org/10.1186/1758-5996-2-3
35. Manfredi M, McCullough MJ, Vescovi P, Al-Kaarawi ZM, Porter SR. Update on diabetes mellitus and related oral diseases. Oral Dis. 2004;10:187-200. http://dx.doi.org/10.1111/j.1601-0825.2004.01019.x
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