口腔念珠菌定植率在健康儿童及成年人中可达40%-70%,在有龋齿的儿童及佩戴义齿的老年人中这一比例更高。[12]Daniluk T, Tokajuk G, Stokowska W, et al. Occurrence rate of oral Candida albicans in denture wearer patients. Adv Med Sci. 2006;51:77-80.http://www.ncbi.nlm.nih.gov/pubmed/17458064?tool=bestpractice.com[13]Abu-Elteen KH, Abu-Alteen RM. The prevalence of Candida albicans populations in the mouths of complete denture wearers. New Microbiol. 1998;21:41-48.http://www.ncbi.nlm.nih.gov/pubmed/9497928?tool=bestpractice.com[14]Lyon JP, da Costa SC, Totti VM, et al. Predisposing conditions for Candida spp. carriage in the oral cavity of denture wearers and individuals with natural teeth. Can J Microbiol. 2006;52:462-467.http://www.ncbi.nlm.nih.gov/pubmed/16699571?tool=bestpractice.com[15]Rozkiewicz D, Daniluk T, Zaremba ML,et al. Oral Candida albicans carriage in healthy preschool and school children. Adv Med Sci. 2006;51:187-190.http://www.ncbi.nlm.nih.gov/pubmed/17458089?tool=bestpractice.com念珠菌携带率亦随肿瘤放疗、糖尿病、HIV感染等因素的存在而升高。[16]Stokman MA, Spijkervet FK, Burlage FR,et al. Oral mucositis and selective elimination of oral flora in head and neck cancer patients receiving radiotherapy: a double-blind randomised clinical trial. Br J Cancer. 2003;88:1012-1016.http://www.ncbi.nlm.nih.gov/pubmed/12671696?tool=bestpractice.com[17]Tapper-Jones LM, Aldred MJ, Walker DM, et al. Candidal infections and populations of Candida albicans in mouths of diabetics. J Clin Pathol. 1981;34:706-711.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC493798/pdf/jclinpath00488-0012.pdfhttp://www.ncbi.nlm.nih.gov/pubmed/7021599?tool=bestpractice.com[18]Campisi G, Pizzo G, Milici ME, et al. Candidal carriage in the oral cavity of human immunodeficiency virus-infected subjects. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002;93:281-286.http://www.ncbi.nlm.nih.gov/pubmed/11925537?tool=bestpractice.com[19]Erkose G, Erturan Z. Oral Candida colonization of human immunodeficiency virus infected subjects in Turkey and its relation with viral load and CD4+ T-lymphocyte count. Mycoses. 2007;50:485-490.http://www.ncbi.nlm.nih.gov/pubmed/17944711?tool=bestpractice.com念珠菌定植在免疫低下人群中可导致机会性黏膜感染、播散或多系统器官累及。在化疗、放疗及HIV感染中,念珠菌感染比例可分别高达50%、70%及90%。[20]Soysa NS, Samaranayake LP, Ellopola AN. Cytotoxic drugs, radiotherapy and oral candidiasis. Oral Oncol. 2004;40:971-978.http://www.ncbi.nlm.nih.gov/pubmed/15509487?tool=bestpractice.com[21]Reichart PA. Oral manifestations in HIV infection: fungal and bacterial infections, Kaposi's sarcoma. Med Microbiol Immunol. 2003;192:165-169.http://www.ncbi.nlm.nih.gov/pubmed/12684760?tool=bestpractice.com
在肿瘤患者放疗、化疗过程中,常使用抗真菌药物来预防机会性感染。[22]Ship JA, Vissink A, Challacombe SJ. Use of prophylactic antifungals in the immunocompromised host. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007;103:S6.e1-e14.http://www.ncbi.nlm.nih.gov/pubmed/17379157?tool=bestpractice.com此外,高效抗逆转录病毒方案的使用也使得HIV感染人群口腔念珠菌病及其他难治性感染疾病发生率降低。[23]Patton LL, McKaig R, Stauss R, et al. Changing prevalence of oral manifestations of human immuno-deficiency virus in the era of protease inhibitor therapy. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2000;89:299-304.http://www.ncbi.nlm.nih.gov/pubmed/10710453?tool=bestpractice.com[24]Centers for Disease Control and Prevention; National Institutes of Health; HIV Medicine Association of the Infectious Diseases Society of America. Guidelines for prevention and treatment of opportunistic infections in HIV-infected adults and adolescents. April 2015. https://aidsinfo.nih.gov/ (last accessed 26 March 2017).https://aidsinfo.nih.gov/contentfiles/lvguidelines/Adult_OI.pdf这些抗反转录病毒治疗的收益作用主要来自于免疫系统的恢复及口咽念珠菌定植的减少,或者对念珠菌的直接抑制作用。[25]Gottfredsson M, Cox GM, Indridason OS, et al. Association of plasma levels of human immunodeficiency virus type 1 RNA and oropharyngeal Candida colonization. J Infect Dis. 1999 Aug;180(2):534-7.http://jid.oxfordjournals.org/content/180/2/534.fullhttp://www.ncbi.nlm.nih.gov/pubmed/10395877?tool=bestpractice.com[26]Korting, HC, Schaller M, Eder G, et al. Effects of the human immunodeficiency virus (HIV) proteinase inhibitors saquinavir and indinavir on in vitro activities of secreted aspartyl proteinases of Candida albicans isolates from HIV-infected patients. Antimicrob Agents Chemother. 1999;43:2038-2042.http://aac.asm.org/cgi/content/full/43/8/2038http://www.ncbi.nlm.nih.gov/pubmed/10428932?tool=bestpractice.com[27]de Repentigny L, Lewandowski D, Jolicoeur. Immunopathogenesis of oropharyngeal candidiasis in human immunodeficiency virus infection. Clin Microbiol Rev. 2004;17:729-759.http://cmr.asm.org/cgi/content/full/17/4/729http://www.ncbi.nlm.nih.gov/pubmed/15489345?tool=bestpractice.com