Objective: The incidence of Candida species and the sensitivity to antifungal agents in chemotherapyassociated oral mucositis were determined in an analysis of nosocomial patients with various solid tumours and haematologic malignancies. Methods: Smears were taken from the lesions when oral candidiasis was clinically diagnosed and were plated out in Sabouraud Dextrose Agar (SDA). Candida spp. were identified by assessing germ tube and chlamydospore formation and by examining Api 20C sugar assimilation patterns. For in vitro susceptibility of isolated yeasts to antifungal agents we used a commercial method (the Fungitest panel), which allows susceptibility testing for 5 antifungal drugs at two different concentrations in modified RPMI 1640 (amphotericin B, 5-fluorocytosine, ketoconazole, itraconazole, miconazole and fluconazole). During the study all the patients received antineoplastic chemotherapy. Results: Fifty cases of oral candidiasis were diagnosed from 193 patients (25.8%). Candida albicans was isolated from 28 patients followed by C. tropicalis (14 patients) and C. krusei (4 patients). Fluconazole is frequently used for prophylaxis and treatment of fungal infections in the immuonocompromised patients of our hospital. The findings from in vitro antifungal susceptibility testing confirm that the antifungals tested are effected against C. albicans strains except itraconazole in two isolates and also confirm the innate resistance to fluconazole of the four C. krusei strains isolated. Conclusion: The results of this study denote the need for constant surveillance of the oral mucosa in cancer patients under antineoplastic chemotherapy. The good response of the patients to antimycotic treatment underlines the importance early diagnosis, which is expected to reduce the risk of haematogenous systemic candidiasis.
Full conference title:
16th European Congress of Clinical Microbiology and Infectious Diseases
- ECCMID 16th (2006)