Oral Candidiasis in Hematological Malignancy Patients: Identification and Antifungal Susceptibility Patterns of Isolates Publisher



Mardani M¹ ; Abolghasemi S¹ ; Darvishnia D¹ ; Lotfali E² ; Ghasemi R³ ; Rabiei MM³ ; Fattahi A⁴ Show Affiliations
Source: Jundishapur Journal of Microbiology Published:2020

Abstract

Background: Oropharyngeal candidiasis is a fungal infection in the mouth caused by Candida species. Oropharyngeal candidiasis is a major problem among hematologic malignancy patients. Objectives: The present study was designed to identify and evaluate antifungal susceptibility patterns of Candida spp. isolated from hematological malignancy patients with oral candidiasis. Methods: Samples were collected from the oral cavity of 138 patients and confirmed for oropharyngeal candidiasis by microscopic examination and fungal culture. Isolated Candida strains were identified by ITS-PCR. Hyphal wall protein 1 (HWP1) was amplified to differentiate the Candida albicans complex. In-vitro antifungal susceptibility tests against fluconazole, amphotericin B, and caspo-fungin were performed according to CLSI M27-A3/S4. Results: The study enrolled 120 patients, including 74 (61.66%) females and 46 (38.33%) males. The mean age of affliction by fungal infections was 42 ± 8 years. Patients with acute myeloid leukemia (44%) comprised the majority of cases. The most commonly isolated species among patients were C. albicans (n = 110; 91.6%), C. glabrata (n = 8; 6.6%), and C. africana (n = 2; 2.8%). The overall resistance of C. albicans was 2.7% to fluconazole, and 1.8% to amphotericin B. Candida glabrata showed 12.5% resistance to amphotericin B. All Candida spp. isolates from patients were susceptible to caspofungin. Conclusions: Local information about the increasing resistance to fluconazole in both C. albicans and non-albicans species and their antifungal susceptibility is useful for deciding on antifungal prophylaxis and selecting the empirical therapy of cancer patients. © 2020, Author(s).