The Effect of Quercus robur Bark on Oral Candidiasis Caused by Candida albicans and Candida glabrata Isolated from a Pediatric Oral Infection as Comparison to Azole Antifungal.

Abstract

Background: The original diversity of Quercus rubra L. (oak) is in eastern America and then distributed to European districts. Oral candidiasis is the most common fungal infection among humans. Azole antifungal drugs can be used to treat Candida infection. Candida albicans and Candida glabrata have emerged as the most common pathogenic yeasts in cases of oral candidiasis.

Aim of the study: This study aimed to explore the genotype Candida spp. and evaluate the antifungal activity of hot water extract of oak bark against C. albicans and C. glabrata as an alternative pharmacotherapy compared to azole antifungal agents.

Materials and methods: The sample was isolated from an 8-year-old child with aggressive oral candidiasis and identified by culturing on sabouraud dextrose agar (SDA) CHROMagar. Genotyping of Candida spp. was performed using the internal transcribed spacer (ITS) region. Standard discs of the antifungal's fluconazole, itraconazole, ketoconazole 10 mg/L for each, amphotericin 100, nystatin 50 mg/L, and hot water oak bark extract were administered to C. albicans and C. glabrata in vitro.

Results: Genotyping of Candida spp. showed that 98% of oral candidiasis cases were C. glabrata which had an 870 bp genotype, while 2% were C. albicans which had a 550 bp genotype based on ITS barcoding region size. The findings that the oak bark extract had high antifungal activity against C. glabrata showed an inhibition zone diameter of 3.067 mm compared to high resistance to antifungals.

Conclusion: Oak extract is considered a successful alternative for the treatment of oral candidiasis infections by antifungals such as azole and nystatin in children.