Candida adherence and biofilm formation on oral surfaces

Candida albicans is the most common fungal opportunistic pathogen in humans. The AIDS epidemic, improved life-sustaining therapy, and aggressive anticancer therapy have contributed to a rise in the number of severely immunocompromised patients. This has led to an increase in oral and systemic fungal infection. Several factors, such as adherence, persistence, dimorphism, germ tube formation, and/or contact sensing, phenotypic switching, interference with the host defense system, synergism with bacteria, and the production of hydrolases or other metabolites, have been proposed to be virulence factors of this fungus. Among these virulence factors, adherence and persistence are thought to be the most important, since the colonization and subsequent biofilm formation of oral surfaces may serve as a reservoir for disseminated infections, such as aspiration pneumonia and gastrointestinal infection. In the review, we summarized the factors involved in the Candida albicans biofilm formation.