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Exposure to Subtherapeutic Concentrations of Polyene Antifungals Suppresses the Adherence of Candida Species to Denture Acrylic

Background: The adherence of Candida species to denture acrylic is the initial event leading to Candida-associated denture stomatitis, with Candida albicans being the main aetiological agent. However, the increased incidence of immunocompromised patients in the community has resulted in the emergence of a number of non-albicans Candida species as causative agents of this disease, which is commonly managed by topically delivered polyene antifungals. Hence, we investigated the effect of the exposure of denture acrylic surfaces to nystatin and amphotericin B on the subsequent adhesion of six different Candida species. Methods: Acrylic strips were exposed to subtherapeutic concentrations of the two polyenes for 30 min, and the adhesion of 4 isolates each of C. albicans, Candida glabrata, Candida guilliermondii, Candida krusei, Candida parapsilosis and Candida tropicalis was assessed using a previously described in vitro method with slight modifications. Results: Overall, the results indicated a 35.9% (p < 0.01) and 63.1% (p < 0.01) reduction, respectively, in yeast adhesion to denture acrylic following exposure to nystatin and amphotericin B, although this effect was not uniform for all the tested isolates. Thus, all C. glabrata, 3 C. guilliermondii and a single isolate each of C. krusei, C. parapsilosis and C. tropicalis were not significantly affected by nystatin exposure, and a single isolate each of C. glabrata and C. guilliermondii were not significantly affected by amphotericin B. Conclusions: The present data, the first on the effect of polyenes on a wide range of Candida species, indicate that the in vitro exposure of denture acrylic to subtherapeutic concentrations of nystatin and amphotericin B suppresses the adherence of pathogenic Candida species in general.