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

Area of Science:

• Medical Mycology
• Infectious Diseases
• Nephrology

Background:

• Peritonitis and exit-site infections are significant complications for patients undergoing peritoneal dialysis (PD).
• Opportunistic fungi from distant body sites can cause these infections.
• Understanding the role of oral yeast colonization in PD patients is crucial for infection prevention.

Purpose of the Study:

• To investigate oral yeast colonization prevalence in PD patients compared to healthy controls.
• To determine the antifungal susceptibility profiles of isolated oral yeasts.
• To correlate oral yeast colonization with subsequent fungal infection episodes in PD patients over four years.

Main Methods:

• Saliva samples from 21 PD patients and 27 healthy controls were analyzed for yeast colonization.
• Methods included CHROMagar-Candida® growth and 18S rRNA/ITS sequencing.
• Antifungal susceptibility testing was performed on isolated yeast species.

Main Results:

• PD patients showed lower oral yeast prevalence, particularly for Candida albicans, compared to controls.
• Isolated species included Candida glabrata and Candida carpophila, with notable antifungal resistance patterns.
• No correlation was found between oral yeast colonization and PD-related exit-site infections caused by Candida parapsilosis and Candida zeylanoides.

Conclusions:

• Oral yeast colonization appears to pose a limited risk for fungal infections in PD patients.
• Isolated oral yeasts exhibited variable antifungal susceptibility, indicating potential resistance to certain drugs.
• Antifungal susceptibility assessment is important in clinical practice for PD patients.