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

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 caspofungin 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 Candida species and their antifungal susceptibility is useful for deciding on antifungal prophylaxis and selecting the empirical therapy of cancer patients.

Design, Synthesis, and In Vitro and In Vivo Evaluation of Novel Fluconazole-Based Compounds with Promising Antifungal Activities

“…Since drug resistance emerges in many of the Candida species and restricts clinicians’ therapeutic choices, we investigated the antifungal effects of the most active compounds 8b and 8c against a series of seven FLC-resistant clinical Candida isolates ( R 1 – R 7 ). − The results were presented as planktonic minimum inhibitory (PMIC) values in Table . Compounds 8b and 8c effectively inhibited the growth of all of the resistance forms of Candida isolates at the concentrations of 0.25–2 μg/mL, significantly lower than that of FLC (MIC ≥ 64 μg/mL).…”

“…albicans; R 7 : C. glabrata) from archived isolates (Refs − ). R 1 – R 7 strains were provided by the Department of Medical Parasitology and Mycology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.…”

“…Antibiofilm Assay. For biofilm formation, two fluconazoleresistant clinical C. albicans isolates (R 1 −R 2 ) from the laboratory archive 27 were first cultured on Sabouraud dextrose agar media (SDA, Difco) at 37 °C for 48 h. 31 After incubation, a full loop of each colony was inoculated in Sabouraud dextrose broth (SDB) and then incubated for 72 h at 37 °C. Centrifugation (3000g, 5 min) was carried out for cell harvest, washed two times with sterile phosphate-buffered saline (PBS), and suspended in 10 mL of RPMI 1640 medium (Sigma-Aldrich, St. Louis).…”

Oral Candidal Colonization in Patients with Different Prosthetic Appliances

“…Oral candidiasis poses a particular problem among cancer patients and patients on chemotherapy and radiotherapy. These are the main predisposing factors that compromise the immune system and put the patient at risk for oropharyngeal candidiasis [ 10 ]. Colonization with Candida spp.…”

Does Prolonged Exposure of Environmental Fungi to Ultraviolet Irradiation Change the Pattern of Drug Resistance?

“…Currently, various fungal species (spp.) cause life-threatening infections in immunocompromised patients, whose population is on a growing trend given the increase in cancer, AIDS, and organ transplantation cases (3). Aspergillosis consists of an extensive range of pulmonary diseases, such as invasive aspergillosis, allergic bronchopulmonary aspergillosis, and type I respiratory hypersensitivity reactions (4).…”