Investigation of yeast in mouth swab samples of patients using inhaled steroid drugs

Introduction and Aim: The oral cavity is in constant contact with the external environment and is colonized with infectious agents since infancy. Candida species are microorganisms found in the human microbiota, but when suitable conditions occur, they can turn into opportunistic pathogens and cause infections. The purpose of this study; is to determine the rates of yeast-related infections in patients using inhaled steroids, the diversity of yeast species isolated from these samples, and antifungal resistance rates. Method: 51 patients using inhaled steroids and 30 healthy individuals who did not use inhaled steroids as a control group were included in the study. Sabouraud Dextrose Agar, Blood agar and chocolate agar were used to grow bacteria. VITEK MS System (bioMérieux, Inc.) was used to identify the isolated yeasts and VITEK 2 Compact System (bioMérieux, Inc.) was used to determine antifungal susceptibility. Results: It was determined that 54.9% of the individuals participating in the study had COPD, 21.6% had asthma, 15.17% had extrapulmonary diseases, 3.9% had dyspnea, and one each had bronchiectasis and pleurisy. The most frequently isolated species in the study was C. albicans with 75.8%. While the other species were C. kefyr with 9.1%, C. tropicalis and C. glabrata with 6.1%, the least isolated species was C. dubliniensis with 3%. It was determined that 28% of C. albicans strains were resistant to fluconazole and voriconazole. All C. albicans strains were detected to be sensitive to flucytosine. All C. glabrata strains were found to be moderately sensitive to fluconazole and sensitive to other antifungals. C. kefyr, C. dubliniensis and C. tropicalis strains were determined to be sensitive to antifungals. Conclusıon: The most frequently isolated agent responsible for oral candidiasis in patients was C. albicans in this study. The highest resistance rate was detected against fluconazole and voriconazole. Overall, no significant resistance pattern to antifungals was detected. In vitro antifungal susceptibility studies should be performed to select appropriate and effective antifungal therapy in specific patient groups and to monitor the development of resistance.