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Host Age and Denture Wearing Jointly Contribute to Oral Colonization with Intrinsically Azole-Resistant Yeasts in the Elderly

In elderly patients, several morbidities or medical treatments predisposing for fungal infections occur at a higher frequency, leading to high mortality and morbidity in this vulnerable patient group. Often, this is linked to an innately azole-resistant yeast species such as Candida glabrata or C. k...

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Autores principales: Wojak, Klaus-Peter, Ungermann, Gertrud F., Ichsan, Ichsan, Gomez-Molero, Emilia, Jung, Klaus, Weig, Michael, Nauck, Friedemann, Ziebolz, Dirk, Gräser, Yvonne, Nau, Roland, Groß, Uwe, Alt-Epping, Bernd, Bader, Oliver
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8400291/
https://www.ncbi.nlm.nih.gov/pubmed/34442706
http://dx.doi.org/10.3390/microorganisms9081627
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author Wojak, Klaus-Peter
Ungermann, Gertrud F.
Ichsan, Ichsan
Gomez-Molero, Emilia
Jung, Klaus
Weig, Michael
Nauck, Friedemann
Ziebolz, Dirk
Gräser, Yvonne
Nau, Roland
Groß, Uwe
Alt-Epping, Bernd
Bader, Oliver
author_facet Wojak, Klaus-Peter
Ungermann, Gertrud F.
Ichsan, Ichsan
Gomez-Molero, Emilia
Jung, Klaus
Weig, Michael
Nauck, Friedemann
Ziebolz, Dirk
Gräser, Yvonne
Nau, Roland
Groß, Uwe
Alt-Epping, Bernd
Bader, Oliver
author_sort Wojak, Klaus-Peter
collection PubMed
description In elderly patients, several morbidities or medical treatments predisposing for fungal infections occur at a higher frequency, leading to high mortality and morbidity in this vulnerable patient group. Often, this is linked to an innately azole-resistant yeast species such as Candida glabrata or C. krusei. Additionally, host age per se and the wearing of dentures have been determined to influence the mix of colonizing species and, consequently, the species distribution of invasive fungal infections. Since both old age and the wearing of dentures are two tightly connected parameters, it is still unclear which of them is the main contributor. Here, we performed a cross-sectional study on a cohort (N = 274) derived from three groups of healthy elderly, diseased elderly, and healthy young controls. With increasing host age, the frequency of oral colonization by a non-albicans Candida species, mainly by C. glabrata, also increased, and the wearing of dentures predisposed for colonization by C. glabrata irrespectively of host age. Physically diseased hosts, on the other hand, were more frequently orally colonized by C. albicans than by other yeasts. For both C. albicans and C. glabrata, isolates from the oral cavity did not generally display an elevated biofilm formation capacity. In conclusion, intrinsically azole-drug-resistant, non-albicans Candida yeasts are more frequent in the oral cavities of the elderly, and fungal cells not contained in biofilms may predispose for subsequent systemic infection with these organisms. This warrants further exploration of diagnostic procedures, e.g., before undergoing elective abdominal surgery or when using indwelling devices on this patient group.
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spelling pubmed-84002912021-08-29 Host Age and Denture Wearing Jointly Contribute to Oral Colonization with Intrinsically Azole-Resistant Yeasts in the Elderly Wojak, Klaus-Peter Ungermann, Gertrud F. Ichsan, Ichsan Gomez-Molero, Emilia Jung, Klaus Weig, Michael Nauck, Friedemann Ziebolz, Dirk Gräser, Yvonne Nau, Roland Groß, Uwe Alt-Epping, Bernd Bader, Oliver Microorganisms Article In elderly patients, several morbidities or medical treatments predisposing for fungal infections occur at a higher frequency, leading to high mortality and morbidity in this vulnerable patient group. Often, this is linked to an innately azole-resistant yeast species such as Candida glabrata or C. krusei. Additionally, host age per se and the wearing of dentures have been determined to influence the mix of colonizing species and, consequently, the species distribution of invasive fungal infections. Since both old age and the wearing of dentures are two tightly connected parameters, it is still unclear which of them is the main contributor. Here, we performed a cross-sectional study on a cohort (N = 274) derived from three groups of healthy elderly, diseased elderly, and healthy young controls. With increasing host age, the frequency of oral colonization by a non-albicans Candida species, mainly by C. glabrata, also increased, and the wearing of dentures predisposed for colonization by C. glabrata irrespectively of host age. Physically diseased hosts, on the other hand, were more frequently orally colonized by C. albicans than by other yeasts. For both C. albicans and C. glabrata, isolates from the oral cavity did not generally display an elevated biofilm formation capacity. In conclusion, intrinsically azole-drug-resistant, non-albicans Candida yeasts are more frequent in the oral cavities of the elderly, and fungal cells not contained in biofilms may predispose for subsequent systemic infection with these organisms. This warrants further exploration of diagnostic procedures, e.g., before undergoing elective abdominal surgery or when using indwelling devices on this patient group. MDPI 2021-07-30 /pmc/articles/PMC8400291/ /pubmed/34442706 http://dx.doi.org/10.3390/microorganisms9081627 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Wojak, Klaus-Peter
Ungermann, Gertrud F.
Ichsan, Ichsan
Gomez-Molero, Emilia
Jung, Klaus
Weig, Michael
Nauck, Friedemann
Ziebolz, Dirk
Gräser, Yvonne
Nau, Roland
Groß, Uwe
Alt-Epping, Bernd
Bader, Oliver
Host Age and Denture Wearing Jointly Contribute to Oral Colonization with Intrinsically Azole-Resistant Yeasts in the Elderly
title Host Age and Denture Wearing Jointly Contribute to Oral Colonization with Intrinsically Azole-Resistant Yeasts in the Elderly
title_full Host Age and Denture Wearing Jointly Contribute to Oral Colonization with Intrinsically Azole-Resistant Yeasts in the Elderly
title_fullStr Host Age and Denture Wearing Jointly Contribute to Oral Colonization with Intrinsically Azole-Resistant Yeasts in the Elderly
title_full_unstemmed Host Age and Denture Wearing Jointly Contribute to Oral Colonization with Intrinsically Azole-Resistant Yeasts in the Elderly
title_short Host Age and Denture Wearing Jointly Contribute to Oral Colonization with Intrinsically Azole-Resistant Yeasts in the Elderly
title_sort host age and denture wearing jointly contribute to oral colonization with intrinsically azole-resistant yeasts in the elderly
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8400291/
https://www.ncbi.nlm.nih.gov/pubmed/34442706
http://dx.doi.org/10.3390/microorganisms9081627
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