Non-albicans Candida in oral cancer patients

Candida infections may complicate the treatment and prognosis of oral cancer patients. Non-albicans Candida (NAC) was shown to be rare in elderly outpatients in Helsinki (Meurman et al. Gerodontology 2011;28:246). These strains often are virulent and resistant to commonly used antifungal drugs (Seneviratne et al. Mycopathologia 2011;172:389). We therefore set out to study the prevalence of NAC in oral cancer patients with the hypothesis that among them the carriage percentage is higher than in outpatients. 

Method:

Open convenient sample study on 71 patients (40 men, 31 women, mean age 68 years) with oral squamous cell cancer referred for treatment to the Helsinki University Central Hospital.  Yeast samples were taken according to Rautemaa et al. (J Med Microbiol 2006;55:1447) and immediately transported for conventional cultivation. Non-albicans strains were identified from C. albicans by using chromagar and latex-agglutination and API -tests. The patients’ salivary flow rate was also measured.  Medical and dental hospital records were available for analyses conducted using descriptive statistics.

Result:

Of the patients 18% of men and 26% of women were NAC positive, while C. albicans was detected in 59% of the samples.  The identified NAC strains were C. dubliniensis (10%), C. glabrata (4%), C. tropicalis (3%), C. parapsilosis (3%) and C. guilliermondii (1%).

Conclusion:

Non-albicans Candida was found to be fairly prevalent in oral cancer patients as expected. Further studies are needed to assess their importance in the prognosis of the patients.