Antifungal Susceptibility Assessment of Candida Isolates from Denture Stomatitis Patients to Azole Drugs

Background: Denture stomatitis is a common inflammatory condition among removable denture wearers, predominantly associated with Candida species colonization. Azole antifungal agents remain the mainstay of therapy; however, emerging resistance threatens clinical outcomes. Methods: A cross-sectional laboratory-based study was conducted on 80 denture stomatitis patients. Oral swabs from palatal mucosa and denture-fitting surfaces were cultured, and Candida species were identified using phenotypic methods and CHROMagar. Antifungal susceptibility to fluconazole, itraconazole, ketoconazole, and voriconazole was evaluated using the CLSI broth microdilution method. Data were analyzed using descriptive statistics and Chi-square tests. Results: Candida species were isolated in 62 of 80 patients (77.5%). Candida albicans was predominant (64.5%), followed by C. tropicalis (17.7%), C. glabrata (12.9%), and C. krusei (4.9%). Overall susceptibility rates were highest for voriconazole (93.5%) and lowest for fluconazole (71.0%). Fluconazole resistance was significantly higher among non- albicans Candida species compared to C. albicans (29.6% vs. 9.8%, P = 0.018). Mean minimum inhibitory concentration (MIC) values were significantly elevated in non- albicans isolates ( P < 0.05). Conclusion: Azole resistance, particularly to fluconazole, is notable among Candida isolates from denture stomatitis patients. Routine antifungal susceptibility testing is recommended to guide effective therapy and prevent treatment failure.