Candidal infections Flashcards
what are risk factors for developing candidal infections
immunocompromised
immunosuppressed
long term steroid use
broad spectrum antibiotics
diabetes
what are the classifications of candidal infections
pseudomembranous - white plaque that can be scrapped off
erythematous - denture stomatitis
hyperplastic - cant be scraped off, need biopsy - pre-malignant
angular chelitis
name two candida species
candida albicans
candida glabrata
name virulence factors for candida
phospholipase - penetrate into host cells
haemolysin
proteinase
hyphae
name advantages and disadvantages of oral swab and oral rinse
oral swab - site specific so definitive but not quantatitve
oral rinse - whole mouth so not specific but can get lots - quantatitive
how do azoles and polyenes work
azoles - fungal static - prevent synthesis of cell
polyene - fungal cidal - causes cell lysis and death
why would you use a polyene over an azole
if suspect candida glabrata - it is resistant to azoles
also azoles are not effective against biofilm
if a patient is immunocompromised with a candidal infecton - what is the treatment
systemic antifungal (fluconazole or nystatin) + topical antifungal gel or chlorhexidine
name medications useful against fungal infections
miconazole, fluconazole, nystatin, chlorhexidine
how is candida glabrata resistant to azoles
increase in production of MDR and ERG - efflux of drug
how is antibiotic stewardship done
only prescribe antibiotic when required
correct antibiotic at correct dose
shortest duration possible
what role does pus sampling play in antibiotic stewardship in dentistry and what limitations does this have clinically?
monitoring bacteria present
checking which antibiotics are effective
ensuring correct antibiotics are being prescribed
limitations - patients cant wait for lab results to be returned for solution
