Bacterial Pneumonia and Oral Candidiasis Are Strongly Related

Bacterial pneumonia is significantly associated with oral candidiasis, according to a recent study.

To reach this conclusion, the researchers analyzed data on 228 elderly patients with a mean age of 81.3 years. These patients had all undergone oral examination while hospitalized with several systemic diseases in a community‐based acute care hospital from May 2014 to October 2016.

“Patients with clinical signs and symptoms of oral candidiasis, including presence of whitish plaques on the oral surfaces, oral mucosal redness with/without sore mouth, chronic inflammation of oral mucosa restricted to the denture‐bearing areas, and xerostomia, were diagnosed as having oral candidiasis using a candida testing kit,” the researchers wrote. 

While conventional criteria were used to classify oral candidiasis, the presence of characteristic clinical symptoms were used to diagnose candida‐associated lesions.

In all, 44 of the patients had oral candidiasis. Of these patients, 31 had had a medical history of bacterial pneumonia. 

After performing a multiple logistic regression analysis, the researchers determined that bacterial pneumonia has a statistically strong relationship with oral candidiasis.

Having poor oral hygiene (n=40) or severe dry mouth (n=16) were also significantly associated with oral candidiasis.

According to the researchers, the risk factors for oral candidiasis and bacterial pneumonia are similar and include being older than aged 65 years, as well as having diabetes mellitus, dysphagia, malfunctions, or a nonambulatory condition.

“Poor oral and denture hygiene and dry mouth are also critical factors associated with oral candidiasis and bacterial pneumonia. Professional oral health care (POHC) treatment reduces the number of [Candida albicans] and bacterial pathogens in the oral cavity that cause aspiration pneumonia,” the researchers concluded. “Maintaining a clean and adequately moistened intraoral environment by POHC could be helpful in preventing the occurrence of oral candidiasis and bacterial pneumonia.”

—Colleen Murphy


Nakajima M, Umezaki Y, Takeda S, et al. Association between oral candidiasis and bacterial pneumonia: a retrospective study. Oral Dis. 2020;26(1):234-237. doi:10.1111/odi.13216