Z Jahanshiri1, S Manifar2, H Moosa3, F Asghari-Paskiabi3, H Mahmoodzadeh4, M Shams-Ghahfarokhi5, M Razzaghi-Abyaneh3. 1. Department of Mycology, Pasteur Institute of Iran, 12, Farvardin street, Tehran 13164, Iran. Electronic address: z_jahanshiri@pastuer.ac.ir. 2. Department of Oral Medicine, School of Dentistry, Tehran University of Medical Sciences, Cancer Institute of Tehran, Imam Khomeini Hospital Complex, Tehran, Iran. 3. Department of Mycology, Pasteur Institute of Iran, 12, Farvardin street, Tehran 13164, Iran. 4. Department of General Surgery, Tehran University of Medical Sciences, Cancer Institute of Tehran, Imam Khomeini Hospital Complex, Tehran, Iran. 5. Department of Mycology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
Abstract
OBJECTIVE: Oropharyngeal candidiasis (OPC) is the most frequent opportunistic fungal infection in head and neck cancer patients. This study was done to identify the Candida species, which cause OPC, and to evaluate their antifungal susceptibility pattern and pathogenic characteristics in Iranian head and neck cancer patients treated by radiotherapy. MATERIAL AND METHODS: The oral clinical samples were determined by culturing on CHROMagar, carbohydrate assimilation and ITS sequencing methods. Biofilm formation, phospholipase and proteinase activity and antifungal susceptibility were examined too. RESULTS: Among 54 patients with confirmed OPC, 39 (72.22%) patients were male and 15 (27.77%) were female. The most frequently Candida species from a total of 60 isolates was C. albicans (53.3%), followed by C. tropicalis (21.66%), C. glabrata (15%), C. kefyr (5%) and C. dubliniensis (1.66%). All the isolates were high-producers of biofilm. All of Candida isolates were proteinase positive and 47 isolates (81.04%) represented phospholipase activity. The maximum and minimum rates of antifungal resistance belonged to ketoconazole (93.75% of C. albicans and 89.28% of Candida non-albicans) and fluconazole (62.50% and 42.85% of C. albicans and Candida non-albicans), respectively. The most effective antifungal against all candida isolates was fluconazole. CONCLUSION: Our data can estimate abundance of OPC in male and female head and neck cancer patients and is helpful to use effective strategies for antifungal treatment, prophylaxis, and preventive therapies in these patients.
OBJECTIVE: Oropharyngeal candidiasis (OPC) is the most frequent opportunistic fungal infection in head and neck cancerpatients. This study was done to identify the Candida species, which cause OPC, and to evaluate their antifungal susceptibility pattern and pathogenic characteristics in Iranian head and neck cancerpatients treated by radiotherapy. MATERIAL AND METHODS: The oral clinical samples were determined by culturing on CHROMagar, carbohydrate assimilation and ITS sequencing methods. Biofilm formation, phospholipase and proteinase activity and antifungal susceptibility were examined too. RESULTS: Among 54 patients with confirmed OPC, 39 (72.22%) patients were male and 15 (27.77%) were female. The most frequently Candida species from a total of 60 isolates was C. albicans (53.3%), followed by C. tropicalis (21.66%), C. glabrata (15%), C. kefyr (5%) and C. dubliniensis (1.66%). All the isolates were high-producers of biofilm. All of Candida isolates were proteinase positive and 47 isolates (81.04%) represented phospholipase activity. The maximum and minimum rates of antifungal resistance belonged to ketoconazole (93.75% of C. albicans and 89.28% of Candida non-albicans) and fluconazole (62.50% and 42.85% of C. albicans and Candida non-albicans), respectively. The most effective antifungal against all candida isolates was fluconazole. CONCLUSION: Our data can estimate abundance of OPC in male and female head and neck cancerpatients and is helpful to use effective strategies for antifungal treatment, prophylaxis, and preventive therapies in these patients.