Characterization of oral candidiasis and the Candida species profile in patients with oral mucosal diseases

Background: The oral mucosa is likely to be compromised by acquired systemic disease. There are no data available on the prevalence of oral candidiasis and the species distribution among patients with oral mucosal diseases. Therefore, it is necessary to conduct a study assessing the characterization of oral candidiasis and the species profiles in such patients. Methods: Over a period of four consecutive years, patients with oral mucosal diseases were screened for oral candidiasis by a combination of clinical presentation and laboratory findings (smear test and Candida cultures). In addition, Candida species were isolated and identified for further analysis. Results: In total, 9769 (6.09%) of the 160,357 patients screened were diagnosed with oral candidiasis on the basis of both clinical manifestations and laboratory testing. The ratio of females to males was 1:0.61, and females had higher overall infection rates than males in all age subgroups. Patients with HIV infection, anaemia-related stomatitis, Sjogren's syndrome/xerostomia, pemphigoid, and radiation-induced stomatitis were highly susceptible to oral candidiasis. Of the 11,161 isolated Candida strains, C. albicans remained the most common species (75.37%), followed by C. tropicalis (6.06%), C. krusei (2.79%), and C. glabrata (2.02%). Surprisingly, both the proportion and the number of C. glabrata isolates increased dramatically over the 4 consecutive years. Conclusions: In this large-scale population-based study, the features of oral candidiasis prevalence and the species profile among patients with oral mucosal diseases were summarized. The information gleaned will enhance the understanding of and improve management strategies for oral candidiasis and the underlying systemic and oral conditions.