DNA identification of the pathogen of candidal aspiration pneumonia induced in the course of oral cancer therapy

Abstract

Aspiration of oropharyngeal bacteria and fungi is occasionally suspected in patients with pneumonia. A patient with oral carcinoma underwent chemoradioimmunotherapy and, about 4 weeks from the start of the therapy, the patient suffered from severe oral mucositis induced by chemoradiotherapy, and candidal pneumonia was subsequently induced. The candidal pneumonia was insufficiently improved by potent antifungal drugs, taking a lethal course. Randomly amplified polymorphic DNA analysis and DNA sequence examination of strains isolated from the oral cavity 1 week before the onset of pneumonia and autopsied lung revealed the identity of both strains as Candida albicans, and the DNA analysis supported aspiration of oral Candida. These results indicate that the pathogen of the pneumonia, C. albicans, was aspirated from the oral cavity and that oral Candida is easily aspirated and becomes the pathogen of pneumonia.

Effect of lactoperoxidase on the antimicrobial effectiveness of the thiocyanate hydrogen peroxide combination in a quantitative suspension test

“…albicans can be isolated from the mouth of most individuals, but the fungus causes oral disease such as oral mucositis in primarily immunocompromised individuals [45-47]. Further, Candida albicans is seen as a reservoir for pneumonia [48] and intestinal related diseases [49]. …”

Molecular investigation of a fungemia outbreak due to Candida parapsilosis in an intensive care unit

“…As such, more in-depth subsequent epidemiological analyses are required to more accurately clarify whether there are simply genetic similarities in a characteristic cloned population among these isolates or whether hospital procedures help disseminate the agents among these patients through cross-infections. DNA sequencing is such method that can be used for both in the identification of species and the demonstration of clonal spread [22]. In our study, C. parapsilosis isolates obtained from the patients were identified as the same strain by direct DNA sequence analysis.…”

Aspiration pneumonia: With special reference to pathological and epidemiological aspects, a review of the literature

“…It was revealed the identity of both strains as Candida albicans. The DNA analyses therefore suggest that oral Candida was aspirated and multiplied in the lungs, and this result suggests the importance of oral hygiene for AP [59].…”