Comparison of the in Vitro Susceptibility of Isolated Oral Candida Species of Uncontrolled Diabetic Patients Against Nystatin and Fluconazole

Denture stomatitis is the most common opportunistic infection caused by candida in denture wearer’s palate, which is more common and severe among diabetic patients. Several studies have already been conducted to examine various drugs for treatment of candidiasis. Recently, some cases of drug resistance of none albicans Candida species to antifungal drugs have been reported. The aim of the present study was to compare the in vitro susceptibility of isolated Candida species of uncontrolled diabetic patients against Nystatin and Fluconazole.

In the present lab trial study, 43 patients with uncontrolled diabetes mellitus and denture stomatitis referred to Yazd Diabetes Research Center and Clinics were screened and sample were collected from the palate using sterile swabs. At that point samples were cultured to determine the differential colony counts through the color difference between the colonies and furthermore MIC of Nystatin and Fluconazole by two different methods (Broth microdilution &Disk diffusion). Data were analyzed using SPSS23 and Kruskal-Wallis test.

In the present study, the most commonly isolated species were: Candida albicans (38/3%), followed by Candida tropicalis (14/9%), Candida krusei (10/6%), Candida glabrata (8/5%) and other species (27/7%). According to both methods, Candida albicans was the most sensitive to both Nystatin and Fluconazole. The most resistant species to Nystatin and Fluconazole were Candida glabrata and Candida Krusei respectively. In 100% concentration, sensitivity of candida species to Nystatin was significantly higher than Fluconazole, except for Candida albicans (p-value=0/05).

The present study indicated that Nystatin was better than Fluconazole for treatment of denture stomatitis in uncontrolled diabetic patients.