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Adherence of Candida albicans to buccal epithelial cells in children and adults.

Adherence of Candida albicans to BEC was determined in 20 children with oral candidiasis, 20 with oral colonization with C. albicans, and 40 uninfected controls not receiving antibiotics. Mean adherence was 15.3 +/- 0.08 yeast/cell in controls and significantly increased to 16.2 +/- 0.5 in colonized children (p less than 0.001) and 19.3 +/- 0.8 in children with oral candidiasis (p less than 0.001). Adherence was the same in normal adults and children, suggesting a stable cell receptor system that is not age dependent. Adherence was also tested daily in 15 initially noncolonized, previously healthy children receiving antibiotics. Normally adherent background bacteria decreased significantly (p less than 0.004) on the first day of narrow- or broad-spectrum antibiotic therapy. C. albicans adherence increased significantly (p less than 0.004) on the second day. Oral colonization with C. albicans occurred on the third day of therapy. None of the children developed oral candidiasis over 3 to 9 days of observation. Healthy control children showed no change in adherence when tested daily for 1 week. Increased fungal adherence to BEC during antibiotic therapy may explain, in part, the increased incidence of Candida colonization in patients receiving antibiotics. Persistence of organisms may then permit disease to develop.