Retrospective Evaluation of the Prevalence and Drug Susceptibility of Candida Species and an Analysis of Risk Factors for Oral Candidiasis

This study retrospectively evaluated the prevalence and drug susceptibility of Candida species in patients diagnosed with oral mucosal candidiasis at the Department of Periodontal and Oral Mucosal Diseases, Silesian Medical University, from 2018 to 2022. A total of 1286 patients were examined (788 females, 498 males) through mycological testing to identify Candida strains and assess their drug resistance to amphotericin B, nystatin, flucytosine, econazole, ketoconazole, miconazole, and fluconazole. Among the 958 patients with positive results, Candida albicans accounted for 66.79% of infections, followed by non-albicans Candida (NAC) strains (33.21%), with rare strains identified in 0.82%. Drug resistance in C. albicans was less than 10% for most antifungals but reached 30% for azoles, while NAC strains exhibited more than 40% resistance, with C. krusei being the most resistant. Key risk factors for candidiasis included removable denture use and uncontrolled diabetes mellitus. The study highlights an increase in NAC infections, multi-strain infections, and decreasing efficacy of antifungal treatments, especially for NAC strains, with more severe cases observed in patients with multiple risk factors.