Investigating the Prevalence and Virulence Factors of Oral Candidiasis in Neonates

Abstract Background: A thrush is an oral yeast infection caused by the fungal pathogen Candida albicans. Oral thrush predominantly occurs in newborns and is typically not a dangerous problem on its own. Fifty percent of the population harbours candida in their oral cavities. Under typical conditions, Candida albicans is regulated by microorganisms. Objective: The objective is to ascertain the epidemiological agents of newborn oral candidiasis and to isolate and identify Candida spp. from the oral cavities of infants at Raparin Teaching Hospital in Erbil Province using standard laboratory procedures. Additionally, to identify the virulence factors of Candida spp., including protease and hemolysis, which play a significant role of the pathophysiology of disorders of the mouth. Patients and methods: The study comprised 65 newborns exhibiting oral lesions who were enrolled in the Medical Care and Consulting Clinic of Raparin Teaching Hospitals, as well as the Neonatal Care Unit of Erbil Maternity Teaching Hospital. Samples gathered between February 2024 and April 2024. The control group consisted of 30 ostensibly children in good health who provided mouth swabs for collection. Biochemical assay, culture, and direct inspection were used to identify the isolated yeasts. API – 20 C system and the Vitek II, subsequently assessing protease activity and hemolysis in Candida species obtained from oral lesions. Results: The results of the present study indicated that over 62.07% of participants were male, and more than half of the instances occurred within the first three months of age. Approximately 59% of cases involve mothers with a low level of education, specifically at the primary level. It has been demonstrated that 46.55% of infants are delivered via cesarean section. About 58.62% of the mothers had a history of birth canal infections. 43.10% of neonatal patients were artificially fed. The fungal isolates in the current study exhibited a range of virulence factors. Hemolysin and protease production were observed in C. albicans at rates of 12 (100%) and 9 (75%), respectively, while C. glabrata exhibited hemolysin production at 1 (50%) and protease production at 1 (50%). Additionally, C. parapsilosis isolates generated both protease and hemolysin. C. krusei produced just hemolysin 1 (100%). Conclusions: The oral lesions revealed the presence of Candida albicans and other yeasts. and additional causes, demonstrating the infection was spread to and from the afflicted children. Proteinase and hemolysin, two crucial virulence factors, are produced by the isolates in Candida albicans much more frequently than in other yeasts.