Detection of Biofilm Formation by Candida Species in the Oral Cavities of Diabetic Patients Using the Oral Rinse Technique in Erbil City
DOI:
https://doi.org/10.15218/edj.2026.4Keywords:
Candida spp., Biofilm, Diabetes mellitus, Oral rinse, Antifungal resistanceAbstract
Background and Objective: Biofilm formation is a type of virulence factor of Candida spp. that promotes growth and protects against antifungal activity, especially in the oral cavity of diabetic patients.
Aim: The objective of this study is to detect biofilm formation by Candida spp. to determine the relationship between colony-forming units (CFU/mL) and blood sugar levels, and to assess the impact of biofilm formation on antifungal activity.
Method: In this current study, which includes two groups: group 1, Diabetic mellitus (55 males and 45 females) (31 Type 1 and 69 Type 2), and group 2, non-diabetic individuals (23 males and 27 females) in Erbil city. Oral rinses were collected for identification using Chromagar Candida and the Vitek 2 ID system. For biofilm formation, Congo Red Agar, tube adherence tests, and the Microtiter plate method were used. Antifungal discs (Voriconazole 1mg), (Fluconazole 25mg), (Miconazole 30mg), (Ketoconazole 10mg), and (Nystatin 100mg). Statistical analysis was performed using GraphPad Prism version 9.0, including independent-samples t-tests and ANOVA, and categorical variables were presented as frequencies and percentages.
Result: Candida spp. were detected in 60% (60/100) of people with diabetes and in 24% (12/50) of non-diabetic individuals. The study identified 15 of 60 isolates (25%) as biofilm producers in diabetic patients. A significant relationship between blood sugar level and oral Candida (CFU/mL) (P =0.0001). Moreover, biofilm formation increases resistance to an antifungal agent (P = 0.0001).
Conclusion: Biofilm formation was associated with increased antifungal resistance. Higher blood glucose levels were associated with increased Candida colony counts.
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