Isolation of Candida albicans from oral cavity of type II diabetic subjects and its relationship to total and differential white blood cell count

* Medical research centre, Erbil, Iraq. ** Department of hematology, College of Medicine, Hawler Medical University, Erbil, Iraq. Introduction Candidiasis is an infection caused by any of several species of the fungus Candida. By culture, Candida is considered normal oral flora at a frequency of 44-55%. This observation is supported by well controlled studies with exfoliative cytology. Although numerous candidal species can be isolated from the oral cavity, the predominant species affecting hospitalized patients is Candida albicans. Clinical diagnosis of oral candidiasis relies on the recognition of granular, erosive, and pseudomembranous forms of the infection, with the easily removed curd like plaques of the latter being the most common. However, substantial colonization can exist in the absence of clinical lesions. Although cultures have been favored for confirmation of clinical infections, periodic acid-Schiffstained cytologic smears are also an excellent method; they hold a marked time advantage over and are less costly than cultures. In fact, cytology offers a further advantage in facilitating a distinction on morphological grounds between a carrier state and active infection. Because the pseudohyphal phase is considered the invasive phase of the fungus, the diagnosis of mucosal candidiasis relies on the demonstration of these forms, as well as blastospores. The high carrier rate of Candida in a normal population emphasizes the advantage of cytology because it Background and objective: It is well known that oral candidiasis increase in many situations, like obesity, debility, leukemia, viral infection, use of certain drugs in addition to diabetes mellitus. The aim of this study was to estimate the prevalence of Candida albicans in the oral cavity of diabetic and non-diabetic subjects and to identify factors predisposing to colonization in the diabetic patient. The variables evaluated include absolute white blood cell counts and differentials, glycosylated hemoglobin levels, serum glucose, blood urea, serum creatinine and duration of diabetes. Methods: One hundred subjects of type II diabetes mellitus and one hundred non-diabetic subjects (control) were studied for isolation of Candida albicans from oral cavity. Further investigations for diabetic group were done regarding serum glucose, HbA1c, and total and differential white blood cell counts. Results: This study showed 56 (56%) out of 100 diabetic subjects and 30 (30%) out of 100 in non-diabetic subjects were found to carry Candida in their oral cavity. In the diabetic group, no relationship was found to total or differential white blood cell count, recent use of antibiotics, serum glucose and HbA1c values. A significant relationship was found in diabetic patients who had chronic renal disease. Conclusion: Colonization of Candida albicans in the oral cavity was found to be higher in diabetic subjects than in non-diabetic. However, glycaemic control in diabetes, total and differential white blood cells were found to bear no relation with carriage of Candida in the oral cavity.