The Frequency of Oral Candidiasis in Children and Adolescents with Leukemia in Isfahan Province, Iran

Document Type : Original Article (s)

Authors

1 MSc Student, Department of Mycology and Parasitology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

2 Assistant Professor, Department of Mycology and Parasitology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

3 Associate Professor, Department of Pediatrics, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: Oral candidiasis is one of the most important and common opportunistic fungal infections especially in patients with leukemia, and other kind of cancers. This study aimed to isolate and determine the frequency of common species of Candida in children and adolescents with leukemia in Isfahan province, Iran, in order to provide some ways for prevention and using short-term treatment for them.Methods: In this study, 72 oral samples were obtained from the mouth lesions of the children and adolescents with leukemia hospitalized in Seyed al Shohada hospital in Isfahan city. Two wet sterile swabs were used for sampling, one for direct exam and the second for culturing on CHROMagar candida, and Sabouraud Dextrose agar with chloramphenicol. For more accurate determination of the species, molecular methods such as polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) using Msp1 enzyme were done.Findings: Out of 72 patients with oral lesions, 21 patients (29.2%) had oral candidiasis The frequency of candida species were as 17 cases of Candida albicans (81.0%), 2 cases of Candida glabrata (9.5%), and 1 case of Candida krusei (4.8%) and 1 case of Candida kefyr (4.8%).Conclusion: This study showed that Candida albicans is the most common identified species. Considering that chemotherapy makes the patients susceptible to fungal infections such as candidiasis, early detection of these agents can be useful to control the infection and have a short-term treatment process.

Keywords


  1. Sallberg M. Fungi and fungal infections of the oral cavity. In: Lamont RJ, Hajishengallis G, Jenkinson HF, editors. Oral microbiology and immunology. Washington, DC: ASM Press; 2006.
  2. Williams D, Lewis M. Pathogenesis and treatment of oral candidosis. J Oral Microbiol 2011; 3(1): 5771.
  3. Mulu A, Kassu A, Anagaw B, Moges B, Gelaw A, Alemayehu M, et al. Frequent detection of 'azole' resistant Candida species among late presenting AIDS patients in northwest Ethiopia. BMC Infect Dis 2013; 13: 82.
  4. Belazi M, Velegraki A, Koussidou-Eremondi T, Andreadis D, Hini S, Arsenis G, et al. Oral Candida isolates in patients undergoing radiotherapy for head and neck cancer: prevalence, azole susceptibility profiles and response to antifungal treatment. Oral Microbiol Immunol 2004; 19(6): 347-51.
  5. Dongari-Bagtzoglou A, Dwivedi P, Ioannidou E, Shaqman M, Hull D, Burleson J. Oral Candida infection and colonization in solid organ transplant recipients. Oral Microbiol Immunol 2009; 24(3): 249-54.
  6. Tati S, Davidow P, McCall A, Hwang-Wong E, Rojas IG, Cormack B, et al. Candida glabrata Binding to Candida albicans Hyphae Enables Its Development in Oropharyngeal Candidiasis. PLoS Pathog 2016; 12(3): e1005522.
  7. Epstein JB, Polsky B. Oropharyngeal candidiasis: a review of its clinical spectrum and current therapies. Clin Ther 1998; 20(1): 40-57.
  8. Coronado-Castellote L, Jimenez-Soriano Y. Clinical and microbiological diagnosis of oral candidiasis. J Clin Exp Dent 2013; 5(5): e279-e286.
  9. Samaranayake LP, Keung LW, Jin L. Oral mucosal fungal infections. Periodontol 2000 2009; 49: 39-59.
  10. Gonzalez GH, Gonzalez ME, Zambrano O, Lozano CM, Rodriguez d, V, Robertis S, et al. Oral Candidiasis in children and adolescents with cancer. Identification of Candida spp. Med Oral Patol Oral Cir Bucal 2007; 12(6): E419-E423.
  11. Deliverska EG, Krasteva A. Oral signs of leukemia and dental management – literature data and case report. J of IMAB. 2013; 19(4):388-91.
  12. Berger A, Portenoy RK, Weissman DE, editors. Principles and practice of supportive oncology. Philadelphia, PA: Lippincott–Raven; 1998. p. 237.
  13. Childers NK, Stinnett EA, Wheeler P, Wright JT, Castleberry RP, Dasanayake AP. Oral complications in children with cancer. Oral Surg Oral Med Oral Pathol 1993; 75(1): 41-7.
  14. Epstein JB, Freilich MM, Le ND. Risk factors for oropharyngeal candidiasis in patients who receive radiation therapy for malignant conditions of the head and neck. Oral Surg Oral Med Oral Pathol 1993; 76(2): 169-74.
  15. Nicolatou-Galitis O, Athanassiadou P, Kouloulias V, Sotiropoulou-Lontou A, Dardoufas K, Polychronopoulou A, et al. Herpes simplex virus-1 (HSV-1) infection in radiation-induced oral mucositis. Support Care Cancer 2006; 14(7): 753-62.
  16. Nicolatou-Galitis O, Velegraki A, Sotiropoulou-Lontou A, Dardoufas K, Kouloulias V, Kyprianou K, et al. Effect of fluconazole antifungal prophylaxis on oral mucositis in head and neck cancer patients receiving radiotherapy. Support Care Cancer 2006; 14(1): 44-51.
  17. Safdar A, Chaturvedi V, Cross EW, Park S, Bernard EM, Armstrong D, et al. Prospective study of Candida species in patients at a comprehensive cancer center. Antimicrob Agents Chemother 2001; 45(7): 2129-33.
  18. Lass-Florl C, Gunsilius E, Gastl G, Englisch M, Koch G, Ulmer H, et al. Fungal colonization in neutropenic patients: a randomized study comparing itraconazole solution and amphotericin B solution. Ann Hematol 2003; 82(9): 565-9.
  19. Silva GA, Bernardi TL, Schaker PODC, Menegotto M, Valente P. Rapid yeast DNA extraction by boiling and freeze-thawing without using chemical reagents and DNA purification. Braz Arch Biol Techn 2012; 55(2): 319-27.
  20. Yapar N. Epidemiology and risk factors for invasive candidiasis. Ther Clin Risk Manag 2014; 10: 95-105.
  21. Schelenz S, Abdallah S, Gray G, Stubbings H, Gow I, Baker P, et al. Epidemiology of oral yeast colonization and infection in patients with hematological malignancies, head neck and solid tumors. J Oral Pathol Med 2011; 40(1): 83-9.
  22. Lone MS, Bashir G, Bali N, Sajad S, Aejaz S, Bashir H, et al. Oral Candida colonization and infection in cancer patients and their antifungal susceptibility in a tertiary care hospital. Int J Adv Res 2014; 2(5): 541-50.
  23. Badiei P, Hadadi P, Zareifar S, Jafarian H. Prevalence of fungal infections in children with hematologic disorders and determination of anti-fungal susceptibility in isolated species. J Kerman Univ Med Sci 2015; 22(4): 410-23. [In Persian].
  24. Hasan AH, AL-Jubouri MH. Isolation of candida Spp. from patients with different types of leukemia who suffered oral candidiasis due to their weekend immune system. J Pharm Chem Biol Sci 2015; 3(1): 79-83.
  25. Maheronnaghsh M, Tolouei S, Dehghan P, Chadeganipour M, Yazdi M. Identification of Candida species in patients with oral lesion undergoing chemotherapy along with minimum inhibitory concentration to fluconazole. Adv Biomed Res 2016; 5: 132.