Volume : 6, Issue : 9, September - 2017

INCIDENCE OF CANDIDA INFECTION IN ORAL CANCER PATIENTS PRE AND POST RADIOTHERAPY TREATMENT AT A TERTIARY CARE CENTRE IN KANPUR

Ramesh Yadav, R Sujatha, Anil Kumar

Abstract :

<p>&nbsp;<b style="text-align: justify;"><span style="font-size: 12pt; line-height: 150%; font-family: &quot;Times New Roman&quot;, serif;">Aim and Objective:&nbsp; </span></b><span style="text-align: justify; font-size: 12pt; line-height: 150%; font-family: &quot;Times New Roman&quot;, serif;">T</span><span lang="EN-IN" style="text-align: justify; font-size: 12pt; line-height: 150%; font-family: &quot;Times New Roman&quot;, serif;">o find out incidence of Candida infection in oral pre and post cancer patients and to find out most effective antifungal agent for empirical treatment.</span></p> <p class="MsoNormal" style="text-align:justify;line-height:150%"><b><span style="font-size: 12pt; line-height: 150%; font-family: &quot;Times New Roman&quot;, serif;">Material and methods: </span></b><span style="font-size: 12pt; line-height: 150%; font-family: &quot;Times New Roman&quot;, serif;">A total of 60 patients have been selected for this study, who have been diagnosed for oral cancer from January to June 2016 at Rama Medical College Hospital and Research Centre, Kanpur. All isolates were further speculated and tested for antifungal susceptibility according to CLSI guidelines 2016.<o:p></o:p></span></p> <p class="Pa2" style="text-align:justify;line-height:150%"><b><span style="font-family: &quot;Times New Roman&quot;, serif;">Results: </span></b><span style="font-family: &quot;Times New Roman&quot;, serif;">Out of 60 oral cancer patients, 30 samples were collected from patients before radio therapy and 30 samples were collected from patients after radio therapy. Out of 30 samples from pretreatment cases, 14 were found positive for Candida species and from post treatment cases, 19 were observed positive for <i>Candida</i> species.&nbsp; Out of 14 Candida isolates from pretreatment cases, 6 were linked to <i>C. albicans</i>, 3 were connected to <i>C. dubliniensis</i>, 3 were concerned to <i>C. krusei</i> and 2 were belonged to <i>C. parapsilosis</i>. Out of 19 Candida isolates from post treatment, 7 were linked to <i>C. dubliniensis</i>, 4 were concerned to <i>C. albicans</i>, 4 were connected to <i>C. krusei</i> and 4 were related to <i>C. glaata</i>, among patients post treatment. Antifungal susceptibility test result showed Amphoterocin B was most sensitive drug for all <i>Candida</i> species except <i>C. parapsilosis</i> and Fluconazole was most resistant for all <i>Candida </i>species. <o:p></o:p></span></p> <p class="MsoNormal" style="text-align:justify;line-height:150%"><span style="font-size:12.0pt;line-height:150%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">&nbsp;</span></p> <p class="Pa2" style="text-align:justify;line-height:150%"><b><span style="font-family: &quot;Times New Roman&quot;, serif;">Conclusion: </span></b><i><span style="font-family: &quot;Times New Roman&quot;, serif;">Candida albicans</span></i><span style="font-family: &quot;Times New Roman&quot;, serif;"> was predominant isolates in oral cancer patients and most</span><span style="font-family: &quot;Times New Roman&quot;, serif;"> effective antifungal drug was amphoterocin B and least effective antifungal drug was found fluconazole. This study has showed a lot of variation in drug sensitivity, and also has showed irrational use of antifungal drugs. Thus, fungal culture and anti fungal susceptibility tests are necessary for effective treatment. After radiotherapy Candida infection was recorded more common than that of pre radio therapy, it shows radio therapy increases the risk of local Candida infection due to immune-suppression.&nbsp;&nbsp;<o:p></o:p></span></p>