Prevalence and virulence of Candida spp. in patients with tuberculosis and their associations with salivary antifungal proteins

Abstract

Some studies have demonstrated a high prevalence of Candida species in patients with tuberculosis (TB), which, very probably, is due to long-term antimicrobial therapy. To date, there are no studies on the effects of anti-TB treatment on the prevalence, enumeration, and virulence of Candida spp, as well as on their susceptibility to antifungal agents. These effects play an important role, as TB is more prevalent among immunocompromised patients, who are eventually more susceptible to fungal infections.Whole saliva and oral rinse samples will be collected before 45 days and after 120 days of treatment from 30 patients clinically diagnosed with TB. Prevalence, enumeration, and susceptibility to fluconazole and to amphotericin B will be assessed in each time period, as well as the following virulence factors for the different Candida species isolated from the oral rinse: biofilm-forming capacity, proteinase and phospholipase production, and pseudohyphal growth. The aim of this study is to evaluate whether anti-TB treatment influences the prevalence, virulence, and antifungal resistance of Candida spp. Salivary levels of antifungals, histatin 5, and lactoferrin will be measured, seeking to associate their levels with the higher prevalence and virulence of Candida. Thirty patients not clinically diagnosed with TB will be used as controls and assessed only once, following the same methodology. (AU)