The antifungal effect of Salvadora persica and Euclea natalensis on Candida isolates from Libyan patients with type 2 Diabetes mellitus.

Philosophiae Doctor - PhD (Medical BioScience)Improved oral hygiene plays a vital role on quality of health and well-being of diabetic patients. Poor oral health leads to an increased incidence of oral diseases, particularly oral candidiasis. The emergence and global spread of azole- resistant Candida species has necessitated the need for novel, cost effective antifungals to stop further spread of resistant Candida infections. This project is the first documented investigation of Candida species prevalence in Libyan type 2 diabetes mellitus (T2DM) patients and investigated the antifungal effect of Salvadora persica and Euclea natalensis on azole-resistant Candida isolates. In this study, 182 Candida isolates from the oral mucosa of T2DM patients were identified using presumptive species identification by chromogenic media followed by confirmation using API ID 32 C, YST Vitek 2 and phenotype microarrays. Their drug susceptibility profiles were tested using the disc diffusion and the AST Vitek 2 compact system. High-pressure liquid chromatography and nuclear magnetic resonance were employed to separate, isolate and purify the bioactive compounds and fractions of the plant extracts which were then tested for their antifungal activity. The results showed that both Salvadora persica and Euclea natalensis promise to provide beneficial alternatives to conventional drugs in treating oral candidiasis in diabetic patients