candida Flashcards
How much bigger is the bio-film of yeast and what does it provide
approx. 25-50x the biovolume of bacteria as Fungi occupy high physical volume in colonisation and infection
Provide physical scaffold for bacteria – ‘Mycofilms’
Create protective environment
What are the risk factors for developing candidasis
Immuno-compromised patients
Immunosuppressive drugs
Advanced HIV infection
Intra-abdominal surgery
Central venous catheter
Parenteral nutrition
Broad-spectrum antibiotics
Dialysis
Colonization at a sterile siteDiabetes
Burn unit patient
Trauma patient
Long-term corticosteroid use
What are the different infection types of candidal disease
periodontitis
Dental implants
Denture stomatitis
CF lung infections
Ventillator associated pneumonia
UTI’S
Infectious kidney stones
Sutures
chronic wounds
many more
What are the classifications of oral candidosis
Psuedomembranous
-Thrush
Erythematous
-Atrophic
-Denture related
Hyper-plastic
- Candidal leukoplakia
Angular cheilitis
how does denture induced stomatitis occure
The fungi Adhere and colonise acrylic surfaces leading to
-Co-aggregation, biofilm formation
What are the S&S of denture induced stomatitis
Inflamed mucosa – particularly under upper denture
Burning sensation
Discomfort
Bad taste
What are the candida species
Candida albicans
Candida glabrata
(These are the worst ones)
Candida parapsilosis
Candida tropicalis
There is over 150 species
What is a difference between Candida albicans and Candida glabrata
Albicans is sensitive to fluconazole and itraconazole whereas Glabarta is not
Albicans has Hypha
What is the prevalence of Albicans
Present in 71% of healthy individuals
-Oral carriage varies (35-55%)
What is the mortality rate of Albicans
35% mortality rate
What is a hydrolytic enzyme
An enzyme that catalyzes the hydrolysis of a substrate through the addition of water
What can chronic candida lead to
Head and neck cancer
how could you diagnose oral candidosis
smear for microscopy
Oral rinse
Oral swab
Foam pad
Biopsy to histology
Name azole antifungal therapies and how do they work
Fluconazole
Voriconazole
Posaconazole
They affect the ergoserol and inhibit to be synthesised
the are fungicstatic
Name Polyenes antifungal treatment and how do they work
Nystatin
Amphotericin B
Liposomal AmB
They bind to ergosterol in the cell membrane directly and lead to cell death
They are fungicidal
Name Echinocandins antifungal treatment and how do they work
Caspofungin
Micafungin
Anidulafungin
They act on the beta 1,3 glucan synthase which results in destabilising of the cell wall and then cell death
What are azoles ineffective against
Biofilms
If patient has candida is immunocompetent and has poor OH what would the treatment do
Improve OH and use chlorhexidine mouthwash
If patient has candida is immunocompetent and has good OH with no dry mouth or no large erosive lesions what would the treatment do
Any topical or systemic antifungal
If patient has candida is immunocompetent and has dry mouth what would the treatment be
Topical antifungal, avoid systemic
If patient has candida is immunocompetent and has large erosive lesions what would the treatment do
Systemic antifungals + topical antifungals/ chlorhexidine rinse
What microorganism is related to endodontics
Enterococcus faecalis
How to treat C. Glabrata
Caspofungin
- Are there systemic implications of an indwelling prosthesis for the patient
Possibility of aspiration pneumonia
