Distribution of Yeast Species and Risk Factors of Oral Colonization after Oral-Care Education among the Residents of Nursing Homes

Abstract

Most yeasts causing infections in humans are part of commensal microflora and etiological agents of different infections when hosts become susceptible, usually due to becoming immunocompromised. The colonization of potentially pathogenic microbes in the oral cavity is increased by poor oral hygiene. This follow-up survey was conducted approximately two months after providing information on proper oral care at 10 nursing homes in Taiwan. Among the 117 of 165 residents colonized by yeasts, 67 were colonized by more than one yeast species. A total of 231 isolates comprising eight fungal genera and 25 species were identified. Candida albicans (44.6%) was the dominant species, followed by Candida glabrata (17.7%), Candida parapsilosis (8.7%), Candida tropicalis (7.8%), and Candida pararugosa (7.3%). Residents having a yeast colony-forming unit >10 (OR, 8.897; 95% CI 2.972−26.634; p < 0.001) or using a wheelchair (OR, 4.682; 95% CI 1.599−13.705; p = 0.005) were more likely to be colonized by multiple species. By comparing before and after oral-care education, dry mouth (OR, 3.199; 95% CI 1.448−7.068; p = 0.011) and having heart disease (OR, 2.681; 95% CI 1.068−6.732; p = 0.036) emerged as two independent risk factors for increased density of colonizing yeast.

Keywords: aging; denture wearer; dry mouth; elderly; oral-care education; yeast colonization.

Figure 1

Distribution of species of 231 isolates. The number in front of the name of a species refers to the number of isolates recovered in the present study.

Figure 2

Distribution of species composition of residents colonized by multiple species. The number in parentheses refers to the number of the combination of species. Where a number is not given, there was only one case in the combination.