Isolation of pathogenic Candida species from oral cavity of postpartum females, and its association with obstetric and dental problems.

Objective: The aim of the current study was to investigate pathogenic Candida spp. Colonization in oral cavity of postpartum females and its association with adverse pregnancy outcomes (APOs) and dental issues.
Methods: Saliva samples and clinico-demographic data were collected from 267 postpartum females along with 54 non-pregnant females (Jan 2016-March 2018). Isolation of Candida was carried out by using standard microbiological methods and different virulence factors (Esterase activity, phospholipase activity and biofilm formation) were evaluated.
Results: Candidacolonization was high in postpartum females (p<0.001, OR = 4.28). This colonization was not significant among females with APOs, however, one to three folds risk was seen with different obstetric and dental factors. High esterase activity was seen among Candida isolates from postpartum females in comparison to control group (p = 0.01). Phospholipase activity of C.albicans isolates from this group was also high (p = 0.001). Majority of the Candida isolates (66.87%) from postpartum females were biofilm formers. Increase in antifungal activity was seen among isolates from postpartum females, with 85% isolates resistant to Fluconazole and Voriconazole (p<0.001) and Amphotericin B resistance was present in 64.38% isolates (p<0.001).
Conclusion: Postpartum females are more susceptible to oral Candida colonization, which exhibit enhanced virulence characteristics and its carriage are associated with increased risk for development of APOs and dental problems.
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