Oral candidiasis in patients undergoing cancer chemotherapy

Introduction: Some types of cancer are often treated with chemotherapeutic drugs which indirectly affect the oral cavity, thus making the patient vulnerable to infections such as oral candidiasis. Oral infection by Candida albicans has been found to be fostered by oncological conditions, but other Candida species have not been sufficiently analyzed in such a context. Objective: Identify Candida spp. in the oral cavity of patients undergoing cancer chemotherapy. Methods: A descriptive cross-sectional study was conducted of 60 samples of an equal number of patients selected by convenience sampling at an Oncological Institute in Barranquilla, Colombia, following diagnostic clinical examination for oral candidiasis. Swab samples were taken from the infected surfaces to perform direct examination – Gram staining and Sabouraud dextrose agar culture with chloramphenicol incubated at 37ºC for 48 h and then cultured in CHROMagar® Candida medium – for identification of various species. Analysis was based on correlation and descriptive statistics. Results: Of the total patients evaluated 55% were female and aged over 60 years. Breast cancer prevailed with 30%. The chemotherapy applied in all cases was 5-fluorouracil combined with cyclophosphamide. Atrophic candidiasis of the tongue was the most common clinical type with 37%, followed by pseudomembranous candidiasis of the tongue with 33%. Of the samples examined, 90% contained some sort of Candida, growth of a single species and mixed cultures with more than one Candida species. C. albicans represented 13.3% and non-albicans spp. another 13.3%. None of the oncological diagnostic analyses had a statistically significant association to Candida species. Conclusions: The species C. albicans was the most commonly found in oral candidiasis among cancer patients, with a predominance of non-albicans Candida spp. (C. glabrata, C. tropicalis) mixed cultures, a fact not generally related to this condition.