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Open Access 01-12-2023 | Amphotericin B | Research

Identification and susceptibility testing of oral candidiasis in advanced cancer patients

Authors: Ragnhild Elisabeth Monsen, Anne Karin Kristoffersen, Caryl L. Gay, Bente Brokstad Herlofson, Katrine Gahre Fjeld, Lene Hystad Hove, Hilde Nordgarden, Anita Tollisen, Anners Lerdal, Morten Enersen

Published in: BMC Oral Health | Issue 1/2023

Abstract

Background

Patients with advanced cancer are prone to develop different opportunistic oral infection due to anti-cancer treatment or the malignancies themselves. Studies of oral fungal samples show an increased prevalence of non-Candida albicans species in mixed oral infections with Candida albicans. Non-C. albicans and C. albicans are associated with varying degrees of resistance to azoles, which may have implications for treatment. This study aimed to assess the diversity and antifungal susceptibility of Candida species detected in the oral cavity.

Methods

An observational study with microbiological analysis was conducted. Clinical fungal isolates were collected from patients in a hospice unit in 2014–2016. Isolates were re-grown on chromID® Candida plates in 2020. Single colony of each species was re-cultivated and prepared for biochemical identification with a VITEK2® system and verified by gene sequencing. Etest was performed on RPMI agar, and the antifungals fluconazole, amphotericin B, anidulafungin and nystatin were applied.

Results

Fifty-six isolates from 45 patients were identified. Seven different Candida species and one Saccharomyces species were detected. The results of biochemical identification were confirmed with sequencing analysis. Thirty-six patients had mono infection, and nine out of 45 patients had 2–3 different species detected. Of C. albicans strains, 39 out of 40 were susceptible to fluconazole. Two non-C. albicans species were resistant to fluconazole, one to amphotericin B and three to anidulafungin.

Conclusion

C. albicans was the predominant species, with a high susceptibility to antifungal agents. Different Candida species occur in both mono and mixed infections. Identification and susceptibility testing may therefore lead to more effective treatment and may prevent the development of resistance among patients with advanced cancer.

Trail registration

The study Oral Health in Advanced Cancer was registered at ClinicalTrials.gov (#NCT02067572) in 20/02/2014.

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Title: Identification and susceptibility testing of oral candidiasis in advanced cancer patients
Authors: Ragnhild Elisabeth Monsen
Anne Karin Kristoffersen
Caryl L. Gay
Bente Brokstad Herlofson
Katrine Gahre Fjeld
Lene Hystad Hove
Hilde Nordgarden
Anita Tollisen
Anners Lerdal
Morten Enersen
Publication date: 01-12-2023
Publisher: BioMed Central
Keywords: Amphotericin B
Candidiasis
Candidiasis
Fluconazole
Nystatin
Published in: BMC Oral Health / Issue 1/2023
Electronic ISSN: 1472-6831
DOI: https://doi.org/10.1186/s12903-023-02950-y

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Identification and susceptibility testing of oral candidiasis in advanced cancer patients

Abstract

Background

Methods

Results

Conclusion

Trail registration

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

Trail registration

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