Oral Candida colonization and infection in cancer patients and their antifungal susceptibility in a tertiary care hospital

Oral candidiasis is a common fungal infection affecting cancer patients. Although most cases are due to C. albicans, non-albicans strains have increasingly been implicated in causing this disease. The aim of this study was to investigate the epidemiology of oral yeast colonization and infection amongst cancer patients and their antifungal susceptibility. A total of 150 cancer patients and 150 healthy controls were included in the study. Cases included patients with solid, head and neck or hematological malignancy. Oral examination was done and oral swabs taken from all the participants for yeast culture, identification and susceptibility testing to fluconazole and voriconazole. Amongst the cancer group, 75 (50%) had solid organ malignancy, 45 (30%) had hematological malignancy and 30 (20%) had head & neck malignancy. Total colonization was prevalent in 50% and oral candidiasis in 30% of all cancer patients. Highest rate of total colonization and candidiasis was seen in head and neck cancer patients (77% and 63% respectively) and in patients receiving chemotherapy and radiotherapy together (72.97% and 56.75% respectively). Age ? 60 years and recent oral fungal infection were associated with Candida carriage. C. albicans was the most common species (74.39%) causing colonization and candidiasis with 100% susceptibility to the two azoles. Overall sensitivity of Candida spp. to fluconazole and voriconazole was 92.68% and 100% respectively.