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Canadian Journal of Infectious Diseases and Medical Microbiology
Volume 2017, Article ID 4846363, 7 pages
https://doi.org/10.1155/2017/4846363
Research Article

Oral Yeast Colonization and Fungal Infections in Peritoneal Dialysis Patients: A Pilot Study

1i3S-Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
2INEB-Instituto de Engenharia Biomédica, Universidade do Porto, Rua Alfredo Allen 208, 4200-180 Porto, Portugal
3Faculty of Medicine, University of Porto, Porto, Portugal
4Faculty of Dental Medicine, University of Porto, Porto, Portugal
5Department of Nephrology, São João Hospital Center, EPE, Porto, Portugal
6Department of Physiology and Cardiothoracic Surgery, Cardiovascular R&D Center, Faculty of Medicine, University of Porto, Porto, Portugal
7Department of Renal, Urological and Infectious Diseases, Faculty of Medicine, University of Porto, Porto, Portugal
8Ipatimup, Institute of Molecular Pathology and Immunology of the University of Porto, Porto, Portugal
9Department of Medical Biotechnology, School of Medicine, Flinders University, Adelaide, SA 5042, Australia

Correspondence should be addressed to Benedita Sampaio-Maia; tp.pu.dmf@aiamb

Received 28 August 2017; Accepted 6 November 2017; Published 21 December 2017

Academic Editor: Jorge Garbino

Copyright © 2017 Liliana Simões-Silva et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Peritonitis and exit-site infections are important complications in peritoneal dialysis (PD) patients that are occasionally caused by opportunistic fungi inhabiting distant body sites. In this study, the oral yeast colonization of PD patients and the antifungal susceptibility profile of the isolated yeasts were accessed and correlated with fungal infection episodes in the following 4 years. Saliva yeast colonization was accessed in 21 PD patients and 27 healthy controls by growth in CHROMagar-Candida® and 18S rRNA/ITS sequencing. PD patients presented a lower oral yeast prevalence when compared to controls, namely, Candida albicans. Other species were also isolated, Candida glabrata and Candida carpophila. The antifungal susceptibility profiles of these isolates revealed resistance to itraconazole, variable susceptibility to caspofungin, and higher MIC values of posaconazole compared to previous reports. The 4-year longitudinal evaluation of these patients revealed Candida parapsilosis and Candida zeylanoides as PD-related exit-site infectious agents, but no correlation was found with oral yeast colonization. This pilot study suggests that oral yeast colonization may represent a limited risk for fungal infection development in PD patients. Oral yeast isolates presented a variable antifungal susceptibility profile, which may suggest resistance to some second-line drugs, highlighting the importance of antifungal susceptibility assessment in the clinical practice.