CLINICAL AND MICROBIOLOGICAL PROFILE OF CANDIDA ISOLATES FROM ORAL CANDIDIASIS IN PATIENTS UNDERGOING RADIOTHERAPY FOR HEAD AND NECK MALIGNANCY

Mridula Madiyal; Krishna Sharan; Indira Bairy; Prakash Peralam Yegneswaran; Mamidipudi Srinivasa Vidyasagar

doi:10.22159/ajpcr.2016.v9s3.14870

Authors

Mridula Madiyal Assistant Professor, Department of microbiology, Kasturba Medical College Manipal, Manipal University.
Krishna Sharan Associate Professor, Department of Radiotherapy and Oncology, Kasturba Medical College, Manipal, Manipal University.
Indira Bairy Professor & Head, Department of Microbiology, Melaka Manipal Medical College, Manipal University.
Prakash Peralam Yegneswaran Associate Professor, Department of Microbiology, Kasturba Medical College, Manipal, Manipal University.
Mamidipudi Srinivasa Vidyasagar Professor Department of Radiotherapy and Oncology Kasturba Medical College, Manipal Manipal University.

DOI:

https://doi.org/10.22159/ajpcr.2016.v9s3.14870

Abstract

ABSTRACT
Objective: To study the clinico-microbiological profile of oral candidiasis in head and neck squamous cell cancer (HNSCC) patients undergoing
curative radiotherapy (cRT).
Methods: Patients undergoing cRT and developing oral candidiasis were enrolled. Clinical features such as pain and xerostomia were recorded.
Candida isolates from lesions were speciated using CHROMagar (Himedia Inc.), and antifungal susceptibility was determined using microbroth
dilution (MBD). Patients were followed up to study the clinical course of infection.
Results: Of the 100 patients undergoing cRT, 79 developed oral candidiasis. Median duration to development of infection was 4 weeks (range:
1-6.5 weeks). Mucositis was observed in 76 (96.2%) and xerostomia in 53 (67.1%) patients; 61 patients (77.2%) had symptoms attributable to
candidiasis. However, there was no correlation between severity of infection and mucositis (p=0.84) or xerostomia (p=0.51). Candida albicans was the
most frequent (47 patients, 59.4%) isolate, followed by Candida tropicalis (23 patients; 29.1%). All isolates were sensitive to nystatin, but fluconazole
resistance/dose-dependent susceptibility was noted in 26 (32.9%) isolates. Both Candida krusei and two of four Candida glabrata isolate exhibited
fluconazole resistance. All patients received treatment for Candidiasis. On follow-up, 1 month after cRT, oral candidiasis resolved with gradual
recovery of mucositis in all patients.
Conclusion: Candida albicans was the most common cause of oral Candidiasis in HNSCC cRT, and all isolates were susceptible to nystatin in-vitro.
All lesions resolved with recovery from mucositis. In addition, as no patient developed systemic candidiasis, it appears that oral candidiasis though
troublesome is curable with treatment.
Keywords: Radiation mucositis, CHROMagar, Microbroth dilution, Antifungal susceptibility.

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Author Biographies

Mridula Madiyal, Assistant Professor, Department of microbiology, Kasturba Medical College Manipal, Manipal University.

Assistant Professor, Department of Microbiology

Krishna Sharan, Associate Professor, Department of Radiotherapy and Oncology, Kasturba Medical College, Manipal, Manipal University.

Associate Professor
Department of Radiotherapy and Oncology

Indira Bairy, Professor & Head, Department of Microbiology, Melaka Manipal Medical College, Manipal University.

Professor & Head,
Department of Microbiology,
Melaka Manipal Medical College,
Manipal University.

Prakash Peralam Yegneswaran, Associate Professor, Department of Microbiology, Kasturba Medical College, Manipal, Manipal University.

Associate Professor
Department of Microbiology.

Mamidipudi Srinivasa Vidyasagar, Professor Department of Radiotherapy and Oncology Kasturba Medical College, Manipal Manipal University.

Professor ,
Department of Radiotherapy and Oncology.

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