sample collection for diagnosis of oral candida in pss patients

pSS 관련 구강 칸디다의 진단 및 균주 식별

Candidiasis is caused by Candida spp., which are opportunistic pathogens. Common strains include Candida albicans, Candida krusei, Candida glabrata, Candida parapsilosis, and Candida dubliniensis1. Opportunistic infections caused by Candida spp. include superficial Candida infections and invasive candidiasis. Invasive candidiasis mainly happens in immunocompromised individuals; for example, in patients with acquired immunodeficiency syndrome (AIDS), invasive candidiasis can significantly threaten the quality of life or even the life span2. Superficial Candida infection, such as mucocutaneous candidiasis, is more common in patients3. 
Oral candidiasis, a superficial Candida infection, is the most common human fungal infection. Candida albicans is a normal commensal of the mouth; the carriage rate of Candida spp. has been reported to range from 20% to 75% in the general population without any symptoms4. Overgrowth of Candida can lead to local discomfort in patients, such as the altered taste of sensation, burning sensation in the mouth, dysphagia due to poor nutrition, delayed recovery, and prolonged hospital stay. Long-term oral candidiasis can lead to severe invasive candidiasis, resulting in significant morbidity and mortality5. Oral candidiasis can also increase the risk of oral cancer5. Impaired salivary gland function is among the risk factors for oral candidiasis6. The initiation of infection is the adhesion of Candida to epithelial cell walls. This is followed by the proliferation and filamentation of Candida and the formation and maturation of biofilm7. Biofilms are extremely difficult to eradicate and are resistant to conventional antifungal treatment, making clinical treatment a challenge for biofilm-associated oral Candida infection7.
Primary Sj&#246;gren's syndrome (pSS) is an autoimmune disease that is characterized by dry mouth, dry eyes, and other systematic symptoms8. Dry mouth is the most frequent symptom of pSS. Saliva has important physiological antifungal functions. On the one hand, it can dilute and scour the mouth and thereafter remove organisms from the mucosa. On the other hand, saliva contains antimicrobial proteins, such as lactoferrin, sialoperoxidase, lysozyme, histidine-rich polypeptides, and specific anti-candidal antibodies, which can interact with the oral mucosa and prevent the overgrowth of Candida6. The reduced saliva flow may predispose pSS patients to oral candidiasis. An observational cross-sectional study conducted in 61 pSS patients found that 13.1% of pSS patients presented oral signs of candidiasis and colony forming unit (CFU)/mL of Candida albicans was found significantly and negatively correlated with levels of unstimulated whole saliva (UWS) and stimulated whole saliva (SWS)9.
The methods introduced in this manuscript can identify oral Candida infection based on characterized morphological attributes (e.g., the hyphae and yeast cells) in direct smear or after culturing10. The strain identification of the Candida using a Candida diagnostic agar is based on the formation of different colored colonies with varied morphology, which result from the cleavage of chromogenic substrates by species-specific enzymes11. In this manuscript, systematic methods for detecting oral Candida infection are introduced, including traditional oral Candida culture and rapid examination by potassium hydroxide (KOH) smear test and calcofluor white (CFW) staining assay10. Additionally, the antifungal susceptibility test, which can guide clinical oral Candida infection treatment, has been introduced. In actual situations, it is not necessary to perform all of the introduced methods in this manuscript; the oral Candida detection method(s) can be selected according to the purpose. The examination of oral Candida infection and the determination of Candida strains in pSS patients not only benefit the disease treatment but also help assess the characterization of oral candidiasis and the species profiles.

저자 스포트라이트: pSS 환자를 위한 임상 치료 요법을 발전시키기 위한 경구용 칸디다 진단

원발성 쇼그렌 증후군 환자의 구강 칸디다 감염 검사

In this research, we present a protocol for the examination of oral candida infection in patients with primary Sjogren syndrome, which can be used for timely treatment to avoid infection-related complications. We provide a series of systematic, simple, and feasible methods for detecting oral candida infections, identifying candida strains, and testing the antifungal susceptibility of commonly-used drugs in patients with primary Sjogren's syndrome. Maybe our focus on the role of oral candida infection in the onset and the progression of primary Sjogren's syndrome pathologists in our future studies.

pSS 환자의 구강 칸디다 진단을 위한 검체 수집

시작하려면 프레임된 포함 기준에 따라 참가자를 선택합니다. 타액 채취를 위해 환자에게 깔때기로 튜브를 잡고 타액이 아랫입술을 따라 튜브로 서서히 흐르도록 지시합니다. 마지막에 참가자에게 남은 타액을 모두 튜브에 뱉어내도록 요청합니다.타액 흐름이 적고 자극되지 않는 경우, 감염이 의심되는 부위의 구강 점막을 10회 이상 면봉으로 닦고 환자가 1분 동안 5mL의 PBS로 입을 헹구도록 합니다. 그런 다음 50밀리리터의 멸균 튜브에 구강 세정제를 모으고 면봉을 넣습니다. 채취한 타액에 PBS 1밀리리터를 넣고 1분 동안 튜브를 소용돌이치게 합니다.

sample-collection-for-diagnosis-of-oral-candida-in-pss-patients

Research

JoVE Journal

Medicine

Sample Collection for Diagnosis of Oral Candida in pSS Patients

49 조회수. 시작하려면 프레임된 포함 기준에 따라 참가자를 선택합니다. 타액 채취를 위해 환자에게 깔때기로 튜브를 잡고 타액이 아랫입술을 따라 튜브로 서서히 흐르도록 지시합니다. 마지막에 참가자에게 남은 타액을 모두 튜브에 뱉어내도록 요청합니다.타액 흐름이 적고 자극되지 않는 경우, 감염이 의심되는 부위의 구강 점막을 10회 이상 면봉으로 닦고 환자가 1분 동안 5mL?...

비디오: pSS 환자의 구강 칸디다 진단을 위한 검체 수집

Examination of Oral Candida Infection in Primary Sj&#246;gren&#39;s Syndrome Patients

Primary Sj&#246;gren's syndrome (pSS) is an autoimmune disease characterized by symptoms such as dry mouth, dry eyes, and other systematic symptoms. Due to the hyposalivation experienced by pSS patients, oral dysbacteriosis often occurs. A common complication of pSS is the oral Candida infection. In this article, the authors describe systematic methods that can effectively diagnose oral Candida infection and identify the Candida strains using saliva, oral mucosal swabs, or mouthwash from pSS patients. The Sabouraud's Dextrose Agar (SDA), hyphal formation assay, potassium hydroxide (KOH) smear test, and calcofluor white (CFW) staining assay are used for the diagnosis of oral Candida infection. A Candida diagnostic agar is used for the identification of Candida strains. Finally, antifungal susceptibility testing is used to determine appropriate antifungal drug treatment. This standardized method can enhance the diagnosis, treatment, and future research of pSS-related oral Candida infections. Early diagnosis, using this method, can also prevent any complications arising due to delay in receiving appropriate treatment.

Here, we present a protocol for the examination of oral Candida infection in patients with primary Sj&#246;gren's syndrome, which can be used for timely treatment and, thereafter, avoiding related complications.

Primary Sj&#246;gren's syndrome (pSS) is an autoimmune disease characterized by symptoms such as dry mouth, dry eyes, and other systematic symptoms. Due ...

연구

의학

To begin, select the participants based on the framed inclusion criteria. For saliva collection, instruct the patient to hold the tube with a funnel and let the saliva flow gradually into the tube along the lower lip for 15 minutes. At the end, ask the participant to spit all the remaining saliva into the tube.In case of low, unstimulated saliva flow, swab the oral mucosa in infection-suspected areas at least 10 times, and let the patient rinse their mouth with five milliliters of PBS for one minute. Then collect the mouthwash in a 50-milliliter sterile tube and put the swab into it. Add one milliliter of PBS to the collected saliva and vortex the tube for one minute.