Oral Candida colonization in xerostomic postradiotherapy head and neck cancer patients

Abstract

Objectives To evaluate (a) oral colonization of Candida species, especially for non‐albicans Candida species (NACS), in xerostomic postradiotherapy head and neck cancer patients and (b) risk factors affecting their colonization. Materials and methods Subjective and objective dry mouth scores, stimulated salivary flow rates, pH and buffering capacity were measured in 72 xerostomic postradiotherapy head and neck cancer patients. Candida counts and species identification were performed using oral rinse samples cultured in Candida Chromagar, followed by polymerase chain reaction and API 20C AUX system. Results Candida colonization was observed in 87.5% of subjects, with 80.6% and 48.6% of study population colonized by C. albicans and NACS, respectively. NACS was associated with high objective dry mouth scores, denture use, and females (p = .006, .009, and .036, respectively). In addition, Candida glabrata was detected more in females (p = .018) and denture wearers (p = .026), while Candida tropicalis was associated with high objective dry mouth scores (p = .022) and females (p = .027). Quantity of Candida colonization correlated positively with objective dry mouth scores (r = 0.599, p < .001) and negatively with salivary flow rates (r = −0.258, p = .041) and pH (r = −0.290, p = .022). Conclusion NACS colonization was common in xerostomic head and neck cancer patients. Increased signs of dry mouth, female and dental prostheses may promote NACS colonization.

Hyposalivation, oral health, and Candida colonization in independent dentate elders

“…We also observed significant negative correlations between salivary flow rates and the quantity of Candida in the oral cavity (Fig 1A and 1B). These are consistent with previous reports that decreased salivary flow rate is a risk factor for Candida colonization [17,32,39,41,42]. Of note, patients with higher Candida counts were shown to have higher risk for candidiasis [22,43,44].…”

“…Interestingly, we observed a significant association between denture use and NACS colonization ( Table 5, p = 0.017) This is consistent with our previous study in xerostomic post-radiotherapy Head and Neck cancer patients [17]. The use of denture was associated with a higher Candida colonization rate in mexican elderly women, with many isolates showing resistance to fluconazole [47].…”

“…These conditions are prevalent in the elders and may contribute to risk of Candida infection. Furthermore, we previously found that denture use was associated with higher colonization of non-albicans Candida species (NACS) in xerostomic post-radiation therapy patients [17]. The NACS, such as Candida tropicalis, Candida glabrata, Candida dubliniensis, Candida krusei, and Candida parapsilosis, can cause infections that are more difficult to treat and may be resistant to antifungal drugs.…”

Radiotherapy and Management in Maxillofacial Prosthodontic: Part 1- Before Radiotherapy

“…La dysgueusie peut aggraver la dysphagie (contribuant à la perte de poids) et altère la qualité de vie des patients atteints [28]. Candidose Post-Radique : le risque de survenue des infections opportunistes surtout la candidose (Prévalence de la colonisation par les candida augmentée) augmente chez les patients irradiés [29].Le tableau clinique de la candidose est représenté par différents aspects cliniques notamment la candidose pseudomembraneuse , la candidose érythémateuse et la chéilite angulaire [12].Elle entraine la douleur, un changement de goût (goût métallique), une anorexie et peut évoluer vers l'oesophage aboutissant à une dysphagie [15]. Le diagnostic reste pratiquement difficile vue la similitude de la manifestation clinique avec la mucite radio-induite [12].…”

Efficacy of gel-based artificial saliva on Candida colonization and saliva properties in xerostomic post-radiotherapy head and neck cancer patients: a randomized controlled trial

“…The quantity and quality of saliva in head and neck cancer patients are dramatically declined after completion of radiotherapy. Their salivary flow rate, pH, and buffering capacity are abnormally low [3,4]. Consequently, the patients usually suffer from dry mouth symptoms (xerostomia) as well as poor oral conditions [2,5,6].…”