Genetic relatedness and antifungal susceptibility pattern of Candida spp. recovered from the oral cancer patients

Abstract

Introduction: Oral candidiasis is the most common opportunistic infection of the oral cancer patients. Identification of Candida isolates and its susceptibility to antifungal agents will be helpful in the therapeutic management. Aim and Objective: To study the Genetic relatedness and antifungal susceptibility pattern of Candida isolates recovered from the oral cancer patients. Material and Methods: The present study was conducted in the Department of Microbiology at Santosh Medical College, Ghaziabad, U.P. & VarunArjun Medical College & Rohilkhand Hospital, Shahjahanpur, Uttar Pradesh. A total of 377 oropharyngeal cancer patients were selected for the study. The study was conducted from 2019 to 2021. Oropharyngeal swab was cultured by semi-quantitative method on Sabouraud dextrose agar (SDA) and Hi-Chrome agar and followed by identification and Antifungal susceptibility test. The Molecular characterization of Candida albicans and non albicans Candida isolates was performed by DNA extraction and PCR. Results: Out of the 377 oropharyngeal cancer cases, 292 (78.8%) were males and 85 (21.2%) females. The male: female ratio was 3.4:1. Of the 377 oral cancer cases, 152 (40.3%) cases were culture positive for Candida species. 191 isolates were recovered from oral cavity of the cancer patients with oral candidiasis. Isolates included Candida albicans (n = 42, 22.0%), Candida tropicalis (n = 36, 18.8%), Candida parapsilosis (n = 34, 17.9%), Candida dubliniensis (n= 30, 15.7%), Candida krusei (n= 30, 15.7%), Candida glabrata (n = 19, 9. 9%). 142 (74.3%) isolates were susceptible to miconazole followed by Ketoconazole 112 (58.6%), and of and Itraconazole 111 (58.1 %). Conclusion: The decreased effectiveness of antifungal drugs is a serious issue, especially in cancer patients. Hence, addition to emphasis on topical use of Miconazole application in the first stage of oral candidiasis in patients, using alternative systemic drugs such as Ketoconazole and Itraconazole may prove fruitful.