Signs and symptoms of oral candidiasis associated with health factors and resistant Candida infections in a Northern Ontario patient cohort
Bibliographic record
Abstract
Background: Oral candidiasis is a common fungal infection that disproportionately affects older adults, immunosuppressed individuals, and patients undergoing cancer treatment. Despite its prevalence, diagnosis and treatment remain challenging due to the diverse symptom presentation and potential for antifungal resistance. Objective: infections, with a specific focus on identifying features associated with antifungal treatment failure. A secondary objective was to assess whether underlying medical conditions, including frailty and comorbidities, influence infection susceptibility or resolution following therapy. Methods: A cohort of 57 patients aged 65 years and older (mean age 74) was enrolled through oncology and hospitalist clinics in Northern Ontario. The majority (65%) were actively receiving cancer treatment. Participants underwent clinical assessment for oral candidiasis signs and symptoms, and fungal swabs were taken at baseline and two-week follow-up. Fungal species identification and treatment outcomes were recorded. Results: tended to persist, consistent with known antifungal resistance. Symptomatically, pseudomembranous candidiasis-characterized by white plaques, coated tongue, and taste disturbance-was more likely to resolve, while erythematous features such as angular cheilitis and oral redness were associated with persistent infection. Although 45% of patients were classified as moderately to severely frail, frailty status was not significantly associated with infection persistence or resistance. Conclusion: These findings underscore the clinical variability of oral candidiasis and highlight the need for rapid molecular diagnostic tools at the point of care to distinguish infection types and guide appropriate therapy, particularly in older and medically complex populations.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".