ANTIFUNGAL TYPING OF BIOFILM PRODUCING Candida albicans ISOLATED FROM ORAL CAVITY OF DIABETIC AND NON-DIABETIC POPULATION OF DHARAN, NEPAL

Abstract

Candida are almost universal on normal adult skin and C. albicans is part of the normal flora of the mucous membranes of the respiratory, gastrointestinal, and female genital tracts. Candida albicans is normal flora, lives in 40- 80% of the human population with no harmful effects. It is acknowledged that diabetic patients are more susceptible to infections caused by Candida albicans due to increased blood glucose and inability of immune system in eradicating the fungus. Studies suggest that Gutkha consumers are also at high risk of oral Candida carriage because of poor Oral hygiene. The oral rinse was inoculated onto the Sabouraud dextrose agar with Chloramphenicol and was incubated at 37°C for 3-4 days. Candida colonies were counted. Candida albicans were identified by Germ tube test. This study reported 31.5 % prevalence of oral Candida. Out of 63 positive samples of Candida, 42 isolates were known to be Candida albicans. The Candida carriage in CFU of diabetic population was statistically significant (p<0.001). The maximum isolates were found to be Biofilm producers. There was significant association between Gutkha consumers with oral Candida carriage. The study suggests that there is higher colonization of Candida in diabetic populations than in healthy population. The result also concludes that frequency of Candida in Oral cavity of Gutkha consumers is also higher (p=0.041). All isolated strains of Candida albicans were tested for antifungal susceptibility testing by using Kirby Bauer disk diffusion method 76.19% were found to be Resistant to Fluconazole and 50% were found to be resistant to Amphotericin B. There was statistical significance in Biofilm formation and fluconazole Drug resistance. The highest prevalence of oral Candida was found to be in diabetic population and in Gutkha consumers. The greatest numbers of isolated Candida albicans were biofilm producer which showed greater frequency of Fluconazole drug resistance. Microtitre method was considered efficient method for screening biofilms.