Oral colonization and anti-fungal susceptibility pattern in patients with hematological malignancy.

BACKGROUND AND PURPOSE

Candidiasis is regarded as one of the most important fungal infections and a cause of disease and mortality in patients with hematological malignancy. Accordingly, antifungal prophylaxis is of significant importance in this regard. This study aimed to identify the epidemiology of colonization and evaluate its antifungal susceptibility pattern in patients with hematological malignancy.

MATERIALS AND METHODS

In this study, the samples were collected from the oral cavity of 100 patients, and colonization was confirmed by fungal culture. strains were also identified by ITS-PCR. antifungal susceptibility tests against fluconazole, amphotericin B, and caspofungin were performed according to CLSI M60.

RESULTS

Demographic characteristics, comorbidities, distribution of species (spp.), and antifungal susceptibility were analyzed in this study. The study participants included 100 patients with a mean age of 15.48%±48.74 years (age range: 17-84 years). Regarding gender distribution, the majority (64%) of the patients were male. In terms of the distribution of underlying hematologic malignancy, 27% of the cases had lymphoma. The most commonly isolated species among patients were complex (49%; n=49), (39%; n=39), and co-colonization of complex and with (10%; n=10). The overall resistance of complex was 5% to fluconazole (n=5) and 2% to amphotericin B (n=2). Furthermore, showed 11% (n=11) resistance to fluconazole and was susceptible to amphotericin B. All spp. isolated from patients who were susceptible to caspofungin.

CONCLUSION

The high rate of colonization of spp., especially the significant increase in the frequency of in patients with blood malignancies and the gradual increase in resistance to fluconazole, necessitate a change in the use of antifungal drugs for the prevention and experimental treatment of hematological malignancy.