Candidal carriage, isolation and species variation in patients undergoing radiotherapy and chemotherapy for head and neck tumours

• Published in: Journal of Dr. NTR university of health sciences 2014-01, Vol.3 (1), p.28-34
• Main Authors: Bakki, Shoba, Kantheti, Lalith Prakash, Kuruba, Kiran, Poosarla, Chandrasekhar, Baddam, Venkat Ramana, Mulakaluri, Raja
• Format: Article
• Language: English
• Subjects: Bacterial transformation; Cancer; Care and treatment; Chemotherapy; Complications and side effects; Diagnosis; Immunocompromised host; Medical research; Medicine, Experimental; Radiotherapy; Risk factors; Thrush (Mouth disease)
• ISSN: 2277-8632; 2277-8632
• DOI: 10.4103/2277-8632.128427

Background: Opportunistic fungal infections, mainly candidiasis, is common in immunocompromised patients such as those undergoing chemo or radiatiotherapy and pose a great threat. Hence this study was done, attempting to find out the candidal carrier state and species variation, in such patients. Aims and Objectives: To determine the prevalence and speciation of Candida colonizing in the oral cavity of individuals attending to the cancer clinics in south India. Materials and Methods: Study groups comprised of 50 healthy, asymptomatic individuals as controls (Group I); 50 patients on : chemotherapy (Group - II) and 50 patients undergoing radiotherapy for head and neck cancers (Group - III). Mycological tests for the candidal isolation and speciation were done. Results: A total of 49 cases showed candidal culture positivity (32.67%). Candidal carriage was highest in Group II and Group III (38%). C. albicans was the most prevalent species (30%). The culture positivity and the colony forming unit/ml from the subjects of control group and the study group were highly significant, in pair-wise comparisons. Conclusion: Patients undergoing chemotherapy and radiotherapy for head and neck cancers are at a risk of developing oral candidiasis due to immunosuppression. C. albicans is the predominant isolate, but non-albicans species are also emerging as opportunistic pathogens. All may cause a similar spectrum of disease but differences in disease severity and antifungal susceptibility are noted. Hence, speciation can help to target the treatment of the disease in a much better way.