Prevalence of Candida Species in oral cavity during radiation therapy in Oral cancer patients

Abstract

Background: It is observed that during the course of radiotherapy many patients of oral cancer develop many changes in the oral cavity due to effects of radiation. There is increase in candida infection in oral cavity which may be attributed to radiation induced xerostomia. Reduced salivary production can predispose patients to oral candidiasis as salivary constituents inhibit the overgrowth of candida, as radiation reduces the amount and characteristics of saliva secretion leading to candida overgrowth. There is an increased rate of candida infection associated with neutropenia also.Objective and hypothesis: The objective of this study was to investigate the prevalence of candida species in oral cavity of patients of oral cancer during the course of radiotherapy. Methods: We collected samples using two swabs from 40 patients of oral cancer who developed oral lesions suggestive of candidiasis, while undergoing radiotherapy treatment.Results: In this study Candida species isolated from oral cavity lesions clinically diagnosed as Candidiasis from the patients undergoing radiotherapy were Candida albicans - 28 (70%) was the predominant species isolated followed by Candida dubliniensis 4 (10%), C. tropicalis was isolated in 3 (7.5%) of the samples, C. krusei - 2 (5%), C. guilliaermondii, C. parapsilosis, C. glabrata were found in 1 (2.5%) patient each.Conclusion:Oropharyngeal candidiasis is a common fungal infection in patients undergoing radiation treatment. Clinical signs and symptoms and microbiological studies will help us in early diagnosis. There are several practical considerations which patients can take to reduce the risk of such infections.