Oral candida prevalence and species specificity in leprosy

Abstract

Background: Leprosy represents a chronic progressive debilitating disease. The severe morbidity associated with leprosy predisposes the patients to opportunistic infections. To assess the oral candida prevalence and species specificity in lepromatous leprosy patients. Methods: The cross-sectional study included 70 lepromatous leprosy patients under a multi-drug regimen for less than 1 year (group 1) and 70 healthy volunteers (group 2). Both group 1 and 2 were matched for potential confounding factors including age, gender, ethnicity, absence of HIV co-infection. Oral swab samples obtained from both groups were subjected to a series of conventional and molecular diagnostic modalities. Results: Yeast growth was statistically higher (0.0006) in group 1 (45.7%) than in group 2 (18.5%). 28 of the 32 yeast growth in group 1 and all 13 yeast growth in group 2 were identified as candida. Among the 28 candida species in group 1, 23 (71.88%) were Candida albicans, 3 (9.37%) were Candida parapsilosis, 1 (3.13%) was Candida lusitaniae and 1 (3.13%) was Candida nivariensis. Among group 2, 11 (84.6%) were Candida albicans, 1 (7.7%) was Candida parapsilosis and 1 was Candida tropicalis. Conclusion: Oral candida prevalence is higher in leprosy patients than in healthy individuals, indicating a predisposition towards opportunistic infections. The increasing prevalence of the non-candida albicans species in leprosy is a major concern as they have shown to possess inherent resistant towards common anti-fungal agents.