The dissertation is devoted to the study of species composition, frequency of selection of representatives of the genus Candida isolated from oral biotopes (cheek mucosa, back of tongue, palate, corner of mouth) among relatively healthy individuals and among carriers of cancer and type 1 of diabetes mellitus. The frequency of detection of members of the genus Candida in the oral biotopes of cancer carriers is 72,0%. The level of candidiasis was 25,0%, 47,0% were candidiasis diagnosed. From the representatives of the genus Candida in the subtopes of the oral habitat of cancer carriers: C. albicans – 70,3% 9,9% – C. glabrata, 12,9% – C. krusei, 6,9% – C. tropicalis. The frequency of isolation of yeast-like fungi in the oral biotope among diagnosed with type 1 of diabetes mellitus was 66,1%. The level of oral candidiasis among patients with type 1 of diabetes mellitus was 5,1% and 61,0% of patients had candidiasis. Among the clinical isolates exuded from patients with type I of mellitus diabetes, C. albicans occupies 67,8%, C. glabrata – 10,0%, C. krusei – 16,7%, C. tropicalis – 3,3%, С. kefyr – 2,2%.
For the first time, topographic features of colonization of the oral biotope by yeast-like fungi of the genus Candida were established among relatively healthy individuals, cancer carriers and type 1 of diabetes mellitus. The highest level of colonization among subbiotopes by Candida in patients with cancer and type I diabetes was observed on the mucous membrane of the tongue wall – 32,7% and 34,4%, respectively. The lowest number of associations among candida was observed in relatively healthy individuals – 1,7%. 98,3% of strains were isolated in monoculture. The cancer carrier has got 94,1% of fungi of the Candida genus were isolated in monoculture, and 5,9% in associations. Among patients of type 1 of mellitus diabetes, Candida was isolated in monoculture in 93,3% of cases, and 6,7% – in the associations of fungi of the Candida genus.
Among all strains isolated from the surveyed individuals, C. albicans is prevalent in 4 subbiotopes of the oral cavity.
For the first time, monitoring of candidiasis in the oral cavity among practically healthy people of Kyiv was conducted during 2014-2018, the need for microbiological monitoring was analyzed and scientifically substantiated. The growth of a condition of candidacy at conditionally healthy persons is established during the 5 years of research. In 2014, the candidacy level was 43,1%, in 2015 – 45,5%, in 2016 – 46,6%, in 2017 – 52,3%, in 2018 – 56,8%.
The sensitivity of Candida isolates exuded by oral biotopes in relatively healthy individuals, type I of mellitus diabetes and cancer carriers, to modern antifungals (amphotericin B, fluconazole, itraconazole) was studied. It was found that the resistance of clinical isolates of Candida was 94,6% to itraconazole, 25,1% – to fluconazole, 10,5% – to amphotericin B while analyzing the levels of sensitivity to antifungals.
For the first time, prospect of using chemically newly synthesized alkyl (aryloxyethoxy) dialkylaminopropanol derivatives to create new antifungal drugs has been experimentally confirmed. Among the compounds, Kc22 had the highest activity, in a concentration of 0,24-0,97 μg / ml inhibited 59% of strains.
The results of the work have scientific and practical significance. The monitoring of the species spectrum and frequency of detection of yeast-like fungi of the Candida genus in the oral biotopes of the cancer carriers and of type 1 diabetes mellitus confirmed the need for accurate species identification of the causative agent of candidiasis for rational antifungal therapy of patients. It is practically proved that the newly synthesized alkyl (aryloxyethoxy) derivatives of dialkylaminopropanol are promising substances for the development of effective antifungal drugs and indicate the prospects for further research to better understand their mechanisms of action.
