Incidence of Candida Species Biofilms in Pediatric Cancer Patients Undergoing Chemotherapy Treatment

Karzan Abdulmuhsin Mohammad; Raya Kh. Yashooa; Suhad Asad Mustafa

doi:10.59786/bmtj.114

Authors

Karzan Abdulmuhsin Mohammad General Directorate of Scientific Research Center, Salahaddin University-Erbil, Erbil, 44001, Iraq https://orcid.org/0000-0003-1631-5675
Raya Kh. Yashooa General Directorate of Scientific Research Center, Salahaddin University-Erbil, Erbil, 44001, Iraq https://orcid.org/0000-0002-9886-9868
Suhad Asad Mustafa General Directorate of Scientific Research Center, Salahaddin University-Erbil, Erbil, 44001, Iraq https://orcid.org/0000-0002-6774-2979

DOI:

https://doi.org/10.59786/bmtj.114

Keywords:

Oral candidiasis, Fungal, Candida sp., Biofilms, Cancer

Abstract

The oral thrush due to biofilms of Candida species is a common infection for the oral cavity of cancer patients undergoing chemotherapy, leading to oral infections. These biofilms, composed of Candida organisms, pose challenges in terms of diagnosis and treatment due to their increased resistance and ability to persist in the oral environment. This study aimed to determine the frequency of Candida species biofilm colonization in the oral cavity of pediatric cancer patients receiving chemotherapy. By examining the incidence of Candida sp. biofilms, this research provides valuable insights into the oral health challenges specific to children with cancer, emphasizing the need for targeted preventive and management strategies to address these infections effectively. In this study, a total of 100 oral cavity swabs were collected, with 50 swabs obtained from cancer patients undergoing chemotherapy and suspected to have oral candidiasis, and the other 50 swabs collected from non-cancer healthy individuals serving as control. All swabs were cultured on Sabouraud Dextrose agar (SDA) media, followed by microscopic examination of positive samples. The API identification candida system was utilized for the identification of Candida species, along with the implementation of biochemical tests to further study the characteristics of the identified species.The findings demonstrated that out of the 50 cancer patients, approximately 47% (23 patients) exhibited positive yeast growth on SDA agar. Among the 50 non-cancer control cases, approximately 30% (15 cases) showed positive growth on SDA agar. Furthermore, using the API candida system, we confirmed the presence of candida species in 25 cases. Candida albicans was identified as the most prevalent species, followed by Candida parapsilosis, Candida krusei, and Saccharomyces cerevisiae, which were detected less frequently.
In conclusion, there were a significant increase in Candida species among cancer patients undergoing chemotherapy treatment in comparison to non-cancer control individuals. This finding highlights the impact of chemotherapy on the prevalence of Candida infections in cancer patients, emphasizing the need for heightened attention and appropriate management strategies in this vulnerable population.

Downloads

Download data is not yet available.

References

Al-Dwairi Z, Darwazeh A, Shukri L. Isolation of candida species from the oral cavity and fingertips of complete and partial dentures wearers. J Dent Health Oral Disord Ther. 2014;1(3):00015.

Aldossary MA, Almansour N, Abdulraheem B. Isolation and identification of Candida species from the oral cavity of cancer patients undergoing chemotherapy in Basrah, Iraq. Journal of Biology Agriculture and Healthcare. 2016;6(18):22-30.

Jayachandran AL, Katragadda R, Thyagarajan R, et al. Oral Candidiasis among cancer patients attending a tertiary Care Hospital in Chennai, South India: an evaluation of Clinicomycological association and antifungal susceptibility pattern. Canadian Journal of Infectious Diseases and Medical Microbiology. 2016;2016

de Sousa L, Santos VL, de Souza Monteiro A, et al. Isolation and identification of Candida species in patients with orogastric cancer: susceptibility to antifungal drugs, attributes of virulence in vitro and immune response phenotype. BMC Infect Dis. Feb 23 2016;16:86. doi:10.1186/s12879-016-1431-4

Kang J, He Y, Hetzl D, et al. A candid assessment of the link between oral Candida containing biofilms and oral cancer. Advances in Microbiology. 2016;6(02):115.

Millsop JW, Fazel N. Oral candidiasis. Clin Dermatol. 2016;34(4):487-494.

Epstein JB. Antifungal therapy in oropharyngeal mycotic infections. Oral Surg Oral Med Oral Pathol. 1990;69(1):32-41.

Guida R. Candidiasis of the oropharynx and esophagus. Ear Nose Throat J. 1988;67(11):832-840.

Odds FC. Candida and candidosis: a review and bibliography. Bailliere Tindall; 1988.

Vila T, Sultan AS, Montelongo-Jauregui D, Jabra-Rizk MA. Oral Candidiasis: A Disease of Opportunity. Journal of Fungi. 2020;6(1):15.

Singh A, Verma R, Murari A, Agrawal A. Oral candidiasis: An overview. J Oral Maxillofac Pathol. Sep 2014;18(Suppl 1):S81-5. doi:10.4103/0973-029x.141325

Akpan A, Morgan R. Oral candidiasis. Postgrad Med J. 2002;78(922):455-459.

Ghannoum M, Radwan S. Candida adherence to epithelial cells, vol 1 CRC Press. Inc, Boca Raton, FL[Google Scholar]. 1990;

Abu-Elteen K, Abu-Alteen R. The prevalence of Candida albicans populations in the mouths of complete denture wearers. The new microbiologica. 1998;21(1):41-48.

Rautemaa R, Ramage G. Oral candidosis–clinical challenges of a biofilm disease. Critical reviews in microbiology. 2011;37(4):328-336.

Williams D, Lewis M. Pathogenesis and treatment of oral candidosis. J Oral Microbiol. 2011;3(1):5771.

Naglik JR, Moyes DL, Wächtler B, Hube B. Candida albicans interactions with epithelial cells and mucosal immunity. Microb Infect. 2011;13(12-13):963-976.

Southern P, Horbul J, Maher D, Davis DA. C. albicans colonization of human mucosal surfaces. PLoS One. 2008;3(4):e2067.

Fidel Jr P. Candida-host interactions in HIV disease: implications for oropharyngeal candidiasis. Advances in dental research. 2011;23(1):45-49.

Lewis M, Williams D. Diagnosis and management of oral candidosis. Br Dent J. 2017;223(9):675-681.

Ramage G, Mowat E, Jones B, Williams C, Lopez-Ribot J. Our current understanding of fungal biofilms. Critical reviews in microbiology. 2009;35(4):340-355.

Davis SL, Vazquez JA, McKinnon PS. Epidemiology, risk factors, and outcomes of Candida albicans versus non-albicans candidemia in nonneutropenic patients. Ann Pharmacother. 2007;41(4):568-573.

Naglik JR, Challacombe SJ, Hube B. Candida albicans secreted aspartyl proteinases in virulence and pathogenesis. Microbiology and molecular biology reviews. 2003;67(3):400-428.

Naglik JR, Moyes D, Makwana J, et al. Quantitative expression of the Candida albicans secreted aspartyl proteinase gene family in human oral and vaginal candidiasis. Microbiology. 2008;154(11):3266-3280.

Kantheti LPC, Reddy B, Ravikumar S, Anuradha C, Chandrasekhar P, Rajeswari MR. Isolation, identification, and carriage of candidal species in PHLAs and their correlation with immunological status in cases with and without HAART. J Oral Maxillofac Pathol. 2012;16(1):38.

Rajendran R. Shafer's textbook of oral pathology. Elsevier India; 2009.

Caira M, Candoni A, Verga L, et al. Pre-chemotherapy risk factors for invasive fungal diseases: prospective analysis of 1,192 patients with newly diagnosed acute myeloid leukemia (SEIFEM 2010-a multicenter study). Haematologica. 2015;100(2):284.

Singh S, Fatima Z, Hameed S. Predisposing factors endorsing Candida infections. Infez Med. 2015;23(3):211-223.

Teoh F, Pavelka N. How chemotherapy increases the risk of systemic candidiasis in cancer patients: current paradigm and future directions. Pathogens. 2016;5(1):6.

Magare JD, Awasthi R. Evaluating the prevalence of Candida species in the oral cavity of immunocompromised patients. Int J Sci Res Maret. 2014;3(3):180-3.

González Gravina H, González de Morán E, Zambrano O, et al. Oral Candidiasis in children and adolescents with cancer: Identification of Candida spp. Medicina Oral, Patología Oral y Cirugía Bucal (Internet). 2007;12(6):419-423.

Bashir H, Ahmad J. Oral Candida colonization and infection in cancer patients and their antifungal susceptibility in a tertiary care hospital. Int J Adv Res. 2014;2:541-50.

Ramírez‐Carmona W, Fernandes GLP, Díaz‐Fabregat B, et al. Effectiveness of fluconazole as antifungal prophylaxis in cancer patients undergoing chemotherapy, radiotherapy, or immunotherapy: systematic review and meta‐analysis. APMIS. 2023;