Parvin Dehghan
Isfahan University of Medical Sciences Isfahan, Iran
Title: Identification of Candida species in patients with oral lesion undergoing chemotherapy along with minimum inhibitory concentration (MIC) to fluconazole
Biography
Biography: Parvin Dehghan
Abstract
Introduction: In the past two decades, various species of Candida, especially Candida albicans was known as the most important etiological agent of fungal infections. Oral candidiasis is the most common fungal infection in patients undergoing chemotherapy. The purpose of this study was to identify Candida species in patients with various types of cancer and testing antifungal susceptibility of clinical isolates.
Materials & Methods: Isolated yeasts were identified on the basis of colony morphology and pigmentation on CHROMagar Candida and also by PCR- RFLP method. The ITS1-5.8SrDNA-ITS2 region was amplified using universal primers and subsequently products were digested with the restriction enzyme MspI. The minimum inhibitory concentration (MIC) and minimum fungicidal concentration (MFC) of each species to fluconazole was compared.
Results: Among 385 patients with various types of cancer who were hospitalized in Seyed Al-Shohada, Isfahan, Iran. Fifty five (14.3%) showed oral lesions. Oral candidiasis confirmed in 36 cases by direct examination and culture. Candida albicans and non-albicans represented in 26 (72.2%) and 10 (27.8%) of the isolates respectively. Non-albicans species were Candida glabrata (n: 5), Candida kefyr (n: 3), Candida krusei (n: 1) and Candida stellatoidea (n: 1). Thirteen (76.5%) of Candia-albicans and 4 (23.5%) non-albicans isolates were resistant to fluconazole. The majority of isolated candida in patients with gastrointestinal cancers 7 (87.5%) and lymphoma 4 (66/6%) were identified as resistant C. albicans.
Conclusion: Data were shown that C. albicans is the most commonly identified species in oral candidiasis and majority of fluconazole resistant C. albicans were found in patients with gastrointestinal cancer and lymphoma. Therefore we recommend an alternative drug instead of fluconazole as a first line of treatment for these type of cancers and administration of fluconazole in patients undergoing chemotherapy should be prescribed in accordance with the type of cancer.