Oral health promotion interventions on oral yeast in hospitalised and medically compromised patients: A systematic review

Mycoses

Volumn 55, Issue 2, 2012, Pages 123-142

  Lam, Otto L T ^a   Bandara, H M H N ^a   Samaranayake, Lakshman P ^a   Mcgrath, Colman ^a   Li, Leonard S W ^b  

^a UNIVERSITY OF HONG KONG   (Hong Kong)

^b TUNG WAH HOSPITAL   (Hong Kong)

Author keywords

Health promotion; Oral; Yeast

Indexed keywords

AMINFLUORIDE; ANTIFUNGAL AGENT; BENZYDAMINE; BETAINE; BETAMETHASONE VALERATE; BICARBONATE; CARBOXYMETHYLCELLULOSE; CHLORHEXIDINE; CORTICOSTEROID; CRYSTAL VIOLET; CYMBOPOGON CITRATUS EXTRACT; FLUORIDE SODIUM PLUS TRICLOSAN; LINSEED EXTRACT; MOUTHWASH; PENTAMIDINE; PLANT EXTRACT; POVIDONE IODINE; SORBITOL; TEA TREE OIL; TOOTHPASTE; UNCLASSIFIED DRUG; XYLITOL;

CANDIDIASIS; CLINICAL EFFECTIVENESS; CLINICAL TRIAL (TOPIC); COCHRANE LIBRARY; GENTIAN; HEALTH PROMOTION; HONEY; HOSPITAL PATIENT; HUMAN; IMMUNOCOMPROMISED PATIENT; IN VITRO STUDY; INCIDENCE; LEMON JUICE; LINSEED; LOZENGE; MEDLINE; MOUTH FLORA; MOUTH HYGIENE; MOUTH INFECTION; MYCOSIS; NONHUMAN; PREVALENCE; PRIORITY JOURNAL; REVIEW; SALIVATION; SYSTEMATIC REVIEW; YEAST;

EID: 84857234534     PISSN: 09337407     EISSN: 14390507     Source Type: Journal    
DOI: 10.1111/j.1439-0507.2011.02062.x     Document Type: Review

References (113)

1. Samaranayake LP. Essential Microbiology for Dentistry, 3rd edn. Edinburgh: Churchill Livingstone, 2006.
2. Cannon RD, Chaffin WL. Oral colonization by Candida albicans. Crit Rev Oral Biol Med 1999; 10: 359-83.
3. Lewis RE. Overview of the changing epidemiology of candidemia. Curr Med Res Opin 2009; 25: 1732-40.
4. Fraser VJ, Jones M, Dunkel J, Storfer S, Medoff G, Dunagan WC. Candidemia in a tertiary care hospital: epidemiology, risk factors, and predictors of mortality. Clin Infect Dis 1992; 15: 414-21.
5. Pappas PG, Rex JH, Lee J et al. A prospective observational study of candidemia: epidemiology, therapy, and influences on mortality in hospitalized adult and pediatric patients. Clin Infect Dis 2003; 37: 634-43.
6. Gudlaugsson O, Gillespie S, Lee K et al. Attributable mortality of nosocomial candidemia, revisited. Clin Infect Dis 2003; 37: 1172-7.
7. Sefer M, Boanchis A. Microbiological and immunological studies on post extraction alveolitis (Preliminary report). Arch Roum Pathol Exp Microbiol 1979; 38: 43-56.
8. Samaranayake LP, MacFarlane TW. Oral Candidosis. London: Wright, 1990.
9. Lehner T. Candidal fungaemia following extraction of teeth and its relationship to systemic candidiasis. Br Dent J 1964; 117: 253-6.
10. Gautam H, Kaur R, Goyal R, Bhalla P, Dewan R. Oral thrush to candidemia: a morbid outcome. J Int Assoc Physicians AIDS Care (Chic) 2010; 9: 325-7.
11. Redding SW, Marr KA, Kirkpatrick WR, Coco BJ, Patterson TF. Candida glabrata sepsis secondary to oral colonization in bone marrow transplantation. Med Mycol 2004; 42: 479-81.
12. Westbrook SD, Kirkpatrick WR, Freytes CO et al. Candida krusei sepsis secondary to oral colonization in a hemopoietic stem cell transplant recipient. Med Mycol 2007; 45: 187-90.
13. Barkauskas C, Perfect J. Candida pneumonia: what we know and what we don't. Curr Fungal Infect Rep 2009; 3: 21-31.
14. Yamamoto T, Ueta E, Kamatani T, Osaki T. DNA identification of the pathogen of candidal aspiration pneumonia induced in the course of oral cancer therapy. J Med Microbiol 2005; 5: 493-6.
15. Odds FC. Candida and Candidosis: A Review and Bibliography, 2nd edn. London: Bailliere Tindall, 1988.
16. Scully C, el-Kabir M, Samaranayake LP. Candida and oral candidosis: a review. Crit Rev Oral Biol Med 1994; 5: 125-57.
17. Schelenz S, Abdallah S, Gray G et al. Epidemiology of oral yeast colonization and infection in patients with hematological malignancies, head neck and solid tumors. J Oral Pathol Med 2011; 40: 83-89.
18. Slavin MA, Sorrell TC, Marriott D et al. Candidaemia in adult cancer patients: risks for fluconazole-resistant isolates and death. J Antimicrob Chemother 2010; 65: 1042-51.
19. Maenza JR, Merz WG, Romagnoli MJ, Keruly JC, Moore RD, Gallant JE. Infection due to fluconazole-resistant Candida in patients with AIDS: prevalence and microbiology. Clin Infect Dis 1997; 24: 28-34.
20. Le Guennec R, Reynes J, Mallie M, Pujol C, Janbon F, Bastide JM. Fluconazole- and itraconazole-resistant Candida albicans strains from AIDS patients: multilocus enzyme electrophoresis analysis and antifungal susceptibilities. J Clin Microbiol 1995; 33: 2732-7.
21. Niimi M, Firth NA, Cannon RD. Antifungal drug resistance of oral fungi. Odontology 2010; 98: 15-25.
22. Lam OL, Zhang W, Samaranayake LP, Li LS, McGrath C. A systematic review of the effectiveness of oral health promotion activities among patients with cardiovascular disease. Int J Cardiol 2010; PMID: 21176980.
23. Sprod A, Anderson R, Treasure ET. Effective Oral Health Promotion: Literature Review. Llanishen, Cardiff, UK: Health Promotion Wales, 1996.
24. Kay E, Locker D. Effectiveness of Oral Health Promotion: A Review. London: Health Education Authority, 1997.
25. McGrath C, Zhang W, Lo EC. A review of the effectiveness of oral health promotion activities among elderly people. Gerodontology 2009; 26: 85-96.
26. Sahay JN, Chatterjee SS, Stanbridge TN. Inhaled corticosteroid aerosols and candidiasis. Br J Dis Chest 1979; 73: 164-8.
27. Ferretti GA, Ash RC, Brown AT, Parr MD, Romond EH, Lillich TT. Control of oral mucositis and candidiasis in marrow transplantation: a prospective, double-blind trial of chlorhexidine digluconate oral rinse. Bone Marrow Transplant 1988; 3: 483-93.
28. Barasch A, Safford MM, Dapkute-Marcus I, Fine DH. Efficacy of chlorhexidine gluconate rinse for treatment and prevention of oral candidiasis in HIV-infected children: a pilot study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2004; 97: 204-7.
29. Sritrairat N, Nukul N, Inthasame P et al. Antifungal activity of lawsone methyl ether in comparison with chlorhexidine. J Oral Pathol Med 2011; 40: 90-96.
30. Torres SR, Peixoto CB, Caldas DM et al. A prospective randomized trial to reduce oral Candida spp. colonization in patients with hyposalivation. Braz Oral Res 2007; 21: 182-7.
31. Thurmond JM, Brown AT, Sims RE et al. Oral Candida albicans in bone marrow transplant patients given chlorhexidine rinses: occurrence and susceptibilities to the agent. Oral Surg Oral Med Oral Pathol 1991; 72: 291-5.
32. Ferretti GA, Raybould TP, Brown AT et al. Chlorhexidine prophylaxis for chemotherapy- and radiotherapy-induced stomatitis: a randomized double-blind trial. Oral Surg Oral Med Oral Pathol 1990; 69: 331-8.
33. Weisdorf DJ, Bostrom B, Raether D et al. Oropharyngeal mucositis complicating bone marrow transplantation: prognostic factors and the effect of chlorhexidine mouth rinse. Bone Marrow Transplant 1989; 4: 89-95.
34. Meurman JH, Laine P, Murtomaa H et al. Effect of antiseptic mouthwashes on some clinical and microbiological findings in the mouths of lymphoma patients receiving cytostatic drugs. J Clin Periodontol 1991; 18: 587-91.
35. Nittayananta W, DeRouen TA, Arirachakaran P et al. A randomized clinical trial of chlorhexidine in the maintenance of oral candidiasis-free period in HIV infection. Oral Dis 2008; 14: 665-70.
36. Spijkervet FK, van Saene HK, Panders AK et al. Effect of chlorhexidine rinsing on the oropharyngeal ecology in patients with head and neck cancer who have irradiation mucositis. Oral Surg Oral Med Oral Pathol 1989; 67: 154-61.
37. McGaw WT, Belch A. Oral complications of acute leukemia: prophylactic impact of a chlorhexidine mouth rinse regimen. Oral Surg Oral Med Oral Pathol 1985; 60: 275-80.
38. Fourrier F, Cau-Pottier E, Boutigny H, Roussel-Delvallez M, Jourdain M, Chopin C. Effects of dental plaque antiseptic decontamination on bacterial colonization and nosocomial infections in critically ill patients. Intensive Care Med 2000; 26: 1239-47.
39. Langslet A, Olsen I, Lie SO, Lokken P. Chlorhexidine treatment of oral candidiasis in seriously diseased children. Acta Paediatr Scand 1974; 63: 809-11.
40. Samaranayake LP, Robertson AG, MacFarlane TW et al. The effect of chlorhexidine and benzydamine mouthwashes on mucositis induced by therapeutic irradiation. Clin Radiol 1988; 39: 291-4.
41. Sharon A, Berdicevsky I, Ben-Aryeh H, Gutman D. The effect of chlorhexidine mouth rinses on oral Candida in a group of leukemic patients. Oral Surg Oral Med Oral Pathol 1977; 44: 201-5.
42. Epstein JB, Vickars L, Spinelli J, Reece D. Efficacy of chlorhexidine and nystatin rinses in prevention of oral complications in leukemia and bone marrow transplantation. Oral Surg Oral Med Oral Pathol 1992; 73: 682-9.
43. Wahlin YB. Effects of chlorhexidine mouthrinse on oral health in patients with acute leukemia. Oral Surg Oral Med Oral Pathol 1989; 68: 279-87.
44. Pannuti CM, Lotufo RF, Cai S, Saraiva Md Mda C, de Freitas NM, Falsi D. Effect of a 0.5% chlorhexidine gel on dental plaque superinfecting microorganisms in mentally handicapped patients. Pesqui Odontol Bras 2003; 17: 228-33.
45. Okuda M, Kaneko Y, Ichinohe T, Ishihara K, Okuda K. Reduction of potential respiratory pathogens by oral hygienic treatment in patients undergoing endotracheal anesthesia. J Anesth 2003; 17: 84-91.
46. Sato T, Abe T, Ichikawa M et al. A randomized controlled trial assessing the effectiveness of professional oral care by dental hygienists. Int J Dent Hyg 2008; 6: 63-67.
47. Epstein JB, Emerton S, Le ND, Stevenson-Moore P. A double-blind crossover trial of Oral Balance gel and Biotene (R) toothpaste versus placebo in patients with xerostomia following radiation therapy. Oral Oncol 1999; 35: 132-7.
48. Kirstila V, Lenander-Lumikari M, Soderling E, Tenovuo J. Effects of oral hygiene products containing lactoperoxidase, lysozyme, and lactoferrin on the composition of whole saliva and on subjective oral symptoms in patients with xerostomia. Acta Odontol Scand 1996; 54: 391-7.
49. Montaldo L, Montaldo P, Papa A, Caramico N, Toro G. Effects of saliva substitutes on oral status in patients with Type 2 diabetes. Diabet Med 2010; 27: 1280-3.
50. Nagy K, Urban E, Fazekas O, Thurzo L, Nagy E. Controlled study of lactoperoxidase gel on oral flora and saliva in irradiated patients with oral cancer. J Craniofac Surg 2007; 18: 1157-64.
51. Laine P, Meurman JH, Murtomaa H et al. One-year trial of the effect of rinsing with an amine fluoride-stannous-fluoride-containing mouthwash on gingival index scores and salivary microbial counts in lymphoma patients receiving cytostatic drugs. J Clin Periodontol 1993; 20: 628-34.
52. Nagy K, Szoke I, Sonkodi I et al. Inhibition of microflora associated with oral malignancy. Oral Oncol 2000; 36: 32-36.
53. Patel M, Shackleton JA, Coogan MM, Galpin J. Antifungal effect of mouth rinses on oral Candida counts and salivary flow in treatment-naive HIV-infected patients. AIDS Patient Care STDS 2008; 22: 613-8.
54. Johansson G, Andersson G, Edwardsson S, Bjorn AL, Manthorpe R, Attstrom R. Effects of mouthrinses with linseed extract Salinum without/with chlorhexidine on oral conditions in patients with Sjogren's syndrome. A double-blind crossover investigation. Gerodontology 2001; 18: 87-94.
55. Jandourek A, Vaishampayan JK, Vazquez JA. Efficacy of melaleuca oral solution for the treatment of fluconazole refractory oral candidiasis in AIDS patients. AIDS 1998; 9: 1033-7.
56. Vazquez JA, Zawawi AA. Efficacy of alcohol-based and alcohol-free melaleuca oral solution for the treatment of fluconazole-refractory oropharyngeal candidiasis in patients with AIDS. HIV Clin Trials 2002; 3: 379-85.
57. Wright SC, Maree JE, Sibanyoni M. Treatment of oral thrush in HIV/AIDS patients with lemon juice and lemon grass (Cymbopogon citratus) and gentian violet. Phytomedicine 2009; 3: 118-24.
58. Rashad UM, Al-Gezawy SM, El-Gezawy E, Azzaz AN. Honey as topical prophylaxis against radiochemotherapy-induced mucositis in head and neck cancer. J Laryngol Otol 2009; 123: 223-8.
59. Nolan A, Lamey PJ, MacFarlane TW, Aitchison TC, Shaw J, Sirel JY. The effect of nebulised pentamidine on the concentration of intra-oral Candida albicans in HIV-infected patients. J Med Microbiol 1994; 41: 95-97.
60. Soderling E, Le Bell A, Kirstila V, Tenovuo J. Betaine-containing toothpaste relieves subjective symptoms of dry mouth. Acta Odontol Scand 1998; 56: 65-69.
61. Risheim H, Arneberg P. Salivary stimulation by chewing gum and lozenges in rheumatic patients with xerostomia. Scand J Dent Res 1993; 101: 40-43.
62. Risheim H, Arneberg P, Birkhed D. Oral sugar clearance and root caries prevalence in rheumatic patients with dry mouth symptoms. Caries Res 1992; 26: 439-44.
63. Blixt-Johansen G, Ek AC, Ganowiak W et al. Improvement of oral mucosa with mucin containing artificial saliva in geriatric patients. Arch Gerontol Geriatr 1992; 14: 193-201.
64. Johansson G, Andersson G, Attstom R, Edwardsson S. Oral mucous membrane flora in patients using saliva substitutes. Gerodontology 2000; 17: 87-90.
65. Frost PM, Shirlaw PJ, Challacombe SJ, Fernandes-Naglik L, Walter JD, Ide M. Impact of wearing an intra-oral lubricating device on oral health in dry mouth patients. Oral Dis 2006; 12: 57-62.
66. Addy M, Moran JM. Clinical indications for the use of chemical adjuncts to plaque control: chlorhexidine formulations. Periodontol 2000 1997; 15: 52-54.
67. Jones CG. Chlorhexidine: is it still the gold standard? Periodontol 2000 1997; 15: 55-62.
68. Addy M, Moran J, Newcombe RG. Meta-analyses of studies of 0.2% delmopinol mouth rinse as an adjunct to gingival health and plaque control measures. J Clin Periodontol 2007; 34: 58-65.
69. Flotra L, Gjermo P, Rolla G, Waerhaug J. Side effects of chlorhexidine mouth washes. Scand J Dent Res 1971; 79: 119-25.
70. Yates R, Jenkins S, Newcombe R, Wade W, Moran J, Addy M. A 6-month home usage trial of a 1% chlorhexidine toothpaste (1). Effects on plaque, gingivitis, calculus and toothstaining. J Clin Periodontol 1993; 20: 130-8.
71. Loe H, Schiott CR, Karring G, Karring T. Two years oral use of chlorhexidine in man. I. General design and clinical effects. J Periodontal Res 1976; 11: 135-44.
72. Giuliana G, Pizzo G, Milici ME, Giangreco R. In vitro activities of antimicrobial agents against Candida species. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1999; 87: 44-49.
73. Block SS. Disinfection, Sterilization, and Preservation, 5th edn. Philadelphia, PA: Lippincott Williams & Wilkins, 2001.
74. Traboulsi RS, Mukherjee PK, Ghannoum MA. In vitro activity of inexpensive topical alternatives against Candida spp. isolated from the oral cavity of HIV-infected patients. Int J Antimicrob Agents 2008; 31: 272-6.
75. Addy M, Wright R. Comparison of the in vivo and in vitro antibacterial properties of povidone iodine and chlorhexidine gluconate mouthrinses. J Clin Periodontol 1978; 5: 198-205.
76. Thomas EL. Lactoperoxidase-catalyzed oxidation of thiocyanate: equilibria between oxidized forms of thiocyanate. Biochemistry 1981; 20: 3273-80.
77. Welk A, Meller C, Schubert R, Schwahn C, Kramer A, Below H. Effect of lactoperoxidase on the antimicrobial effectiveness of the thiocyanate hydrogen peroxide combination in a quantitative suspension test. BMC Microbiol 2009; 9: 134.
78. Majerus PM, Courtois PA. Susceptibility of Candida albicans to peroxidase-catalyzed oxidation products of thiocyanate, iodide and bromide. J Biol Buccale 1992; 20: 241-5.
79. 2 system. Oral Microbiol Immunol 1992; 7: 315-20.
80. Flisfisch S, Meyer J, Meurman JH, Waltimo T. Effects of fluorides on Candida albicans. Oral Dis 2008; 14: 296-301.
81. Meurman JH, Kari K, Waltimo T, Kotiranta A, Inkeri J, Samaranayake LP. In vitro antifungal effect of amine fluoride-stannous fluoride combination on oral Candida species. Oral Dis 2006; 12: 45-50.
82. Blinkhorn A, Bartold PM, Cullinan MP et al. Is there a role for triclosan/copolymer toothpaste in the management of periodontal disease? Br Dent J 2009; 207: 117-25.
83. White TC, Agabian N. Candida albicans secreted aspartyl proteinases: isoenzyme pattern is determined by cell type, and levels are determined by environmental factors. J Bacteriol 1995; 177: 5215-21.
84. De Bernardis F, Muhlschlegel FA, Cassone A, Fonzi WA. The pH of the host niche controls gene expression in and virulence of Candida albicans. Infect Immun 1998; 66: 3317-25.
85. Cassone A, De Bernardis F, Mondello F, Ceddia T, Agatensi L. Evidence for a correlation between proteinase secretion and vulvovaginal candidosis. J Infect Dis 1987; 156: 777-83.
86. Fanaki NH, el-Nakeeb MA. Antimicrobial activity of benzydamine, a non-steroid anti-inflammatory agent. J Chemother 1992; 4: 347-52.
87. Kaithwas G, Mukerjee A, Kumar P, Majumdar DK. Linum usitatissimum (linseed/flaxseed) fixed oil: antimicrobial activity and efficacy in bovine mastitis. Inflammopharmacology 2011; 19: 45-52.
88. Meyer-Lueckel H, Tschoppe P, Kielbassa AM. Linseed based saliva substitutes and their effect on mineral dissolution of predemineralized bovine dentin in vitro. J Dent 2006; 34: 751-6.
89. Hammer KA, Carson CF, Riley TV. In vitro activity of Melaleuca alternifolia (tea tree) oil against dermatophytes and other filamentous fungi. J Antimicrob Chemother 2002; 50: 195-9.
90. Brand C, Grimbaldeston MA, Gamble JR, Drew J, Finlay-Jones JJ, Hart PH. Tea tree oil reduces the swelling associated with the efferent phase of a contact hypersensitivity response. Inflamm Res 2002; 51: 236-44.
91. Koh KJ, Pearce AL, Marshman G, Finlay-Jones JJ, Hart PH. Tea tree oil reduces histamine-induced skin inflammation. Br J Dermatol 2002; 147: 1212-7.
92. Carson CF, Mee BJ, Riley TV. Mechanism of action of Melaleuca alternifolia (tea tree) oil on Staphylococcus aureus determined by time-kill, lysis, leakage, and salt tolerance assays and electron microscopy. Antimicrob Agents Chemother 2002; 46: 1914-20.
93. Hammer KA, Carson CF, Riley TV. Antifungal activity of the components of Melaleuca alternifolia (tea tree) oil. J Appl Microbiol 2003; 95: 853-60.
94. Silva Cde B, Guterres SS, Weisheimer V, Schapoval EE. Antifungal activity of the lemongrass oil and citral against Candida spp. Braz J Infect Dis 2008; 12: 63-66.
95. Onawunmi GO. Evaluation of the antimicrobial activity of citral. Lett Appl Microbiol 1989; 9: 105-8.
96. Dutta BK, Karmakar S, Naglot A, Aich JC, Begam M. Anticandidial activity of some essential oils of a mega biodiversity hotspot in India. Mycoses 2007; 50: 121-4.
97. Docampo R, Moreno SN. The metabolism and mode of action of gentian violet. Drug Metab Rev 1990; 3: 161-78.
98. Molan PC. The potential of honey to promote oral wellness. Gen Dent 2001; 49: 584-9.
99. Jull AB, Rodgers A, Walker N. Honey as a topical treatment for wounds. Cochrane Database Syst Rev 2008; 4: CD005083.
100. Bergman A, Yanai J, Weiss J, Bell D, David MP. Acceleration of wound healing by topical application of honey. An animal model. Am J Surg 1983; 145: 374-6.
101. Irish J, Carter DA, Shokohi T, Blair SE. Honey has an antifungal effect against Candida species. Med Mycol 2006; 44: 289-91.
102. Rells GK, Nizell AE. Cariogenicity of honey. J Am Dent Assoc 1973; 87: 29.
103. Shannon IL, Edmonds EJ, Madsen KO. Honey: sugar content and cariogenicity. ASDC J Dent Child 1979; 46: 29-33.
104. Wispelwey B, Pearson RD. Pentamidine: a review. Infect Control Hosp Epidemiol 1991; 12: 375-82.
105. Palmer LB, Albulak K, Fields S, Filkin AM, Simon S, Smaldone GC. Oral clearance and pathogenic oropharyngeal colonization in the elderly. Am J Respir Crit Care Med 2001; 164: 464-8.
106. Umazume M, Ueta E, Osaki T. Reduced inhibition of Candida albicans adhesion by saliva from patients receiving oral cancer therapy. J Clin Microbiol 1995; 33: 432-9.
107. Olsen I. Oral adhesion of yeasts. Acta Odontol Scand 1990; 48: 45-53.
108. Ueta E, Tanida T, Osaki T. A novel bovine lactoferrin peptide, FKCRRWQWRM, suppresses Candida cell growth and activates neutrophils. J Pept Res 2001; 57: 240-9.
109. Edgerton M, Koshlukova SE, Araujo MW, Patel RC, Dong J, Bruenn JA. Salivary histatin 5 and human neutrophil defensin 1 kill Candida albicans via shared pathways. Antimicrob Agents Chemother 2000; 44: 3310-6.
110. Edgerton M, Koshlukova SE, Lo TE, Chrzan BG, Straubinger RM, Raj PA. Candidacidal activity of salivary histatins. Identification of a histatin 5-binding protein on Candida albicans. J Biol Chem 1998; 273: 20438-47.
111. Rydengard V, Shannon O, Lundqvist K et al. Histidine-rich glycoprotein protects from systemic Candida infection. PLoS Pathog 2008; 4: e1000116.
112. Ichikawa T, Yano Y, Fujita Y, Kashiwabara T, Nagao K. The enhancement effect of three sugar alcohols on the fungicidal effect of benzethonium chloride toward Candida albicans. J Dent 2008; 36: 965-8.
113. Pizzo G, Giuliana G, Milici ME, Giangreco R. Effect of dietary carbohydrates on the in vitro epithelial adhesion of Candida albicans, Candida tropicalis, and Candida krusei. New Microbiol 2000; 23: 63-71.