Quantity of <i>Candida</i> Colonies in Saliva: A Diagnostic Evaluation for Oral Candidiasis

Objective: To investigate the relationship between the quantity of Candida colonies in saliva and oral candidiasis (OC), as well as to identify the threshold for distinguishing oral candidiasis from healthy carriage. Methods: A diagnostic test was conducted in 197 patients with different oral problems. The diagnosis of OC was established based on clinical features. Whole saliva samples from the subjects were cultured for Candida species. Receiver operating characteristic (ROC) curve analysis was used in this study. Results: OC patients had significantly more Candida colony-forming units per millilitre saliva (795 cfu/ml) than asymptomatic carriers (40 cfu/ml; P 0.05). Among different types of candidiasis, the quantity of Candida colonies differed. The number of Candida colonies in pseudomembranous type was significantly higher than that in the erythematous type (P 0.05). Candida albicans was the predominant species of Candida. The cut-off point with the best fit for OC diagnosis was calculated to be 266 cfu/ml. The sensitivity and specificity were 0.720 and 0.825, respectively. Analysis of the ROC curve indicated that Candida colonies had a high diagnostic value for OC, as demonstrated by the area under the curve (AUC = 0.873). Conclusion: Based on this study, the value of 270 cfu/ml was considered a threshold for distinguishing OC from carriage. Keywords: quantity, candidiasis, Candida, saliva, diagnosis