Incidence and spectrum of yeast species isolated from the oral cavity of Iranian patients suffering from hematological malignancies.
Amir ArastehfarFarnaz DaneshniaShirin FarahyarWenjie FangMaryam SalimiMohammadreza SalehiFerry HagenPan WeihuaMaryam RoudbaryTeun BoekhoutPublished in: Journal of oral microbiology (2019)
Background: Oral candidiasis (OC) has a profound effect on the life quality of immunocompromised patients, such as those undergoing chemotherapy. Objective: Systematic investigation of clinical outcome and microbiological features of yeast isolates recovered from the oral cavity of 150 Iranian patients with hematological malignancies. Design: MALDI-TOF MS, 21-plex PCR, and rDNA sequencing were used for identification. Antifungal susceptibility testing (broth microdilution, CLSI M27-A3/S4) and genotypic diversity of yeast isolates (amplified fragment length polymorphism) were assessed. Results: Nystatin treatment resulted in 70% therapeutic failure and administration of 150 mg fluconazole (FLZ) + nystatin for patients with OC relapse showed 70% clinical failure. Previous history of OC was significantly correlated with FLZ treatment requirement and nystatin failure (P = 0.005, α < 0.05). Candida albicans (80.3%) and Kluyveromyces marxianus (C. kefyr) (12.7%) were the two most prevalent yeast species isolated. FLZ and AMB exhibited the highest geometric mean values. 21-PCR showed 98.9% agreement with MALDI-TOF MS. K. marxianus isolates had the same genotype, while C. albicans isolates grouped in 15 genotypes. Conclusions: Marked rate of therapeutic failure of nystatin necessitated OC treatment with systemic antifungals. K. marxianus was the second most prevalent yeast and 21-plex PCR could be considered as an inexpensive identification tool.
Keyphrases
- candida albicans
- end stage renal disease
- saccharomyces cerevisiae
- newly diagnosed
- biofilm formation
- genetic diversity
- ejection fraction
- mass spectrometry
- chronic kidney disease
- peritoneal dialysis
- prognostic factors
- cell wall
- cystic fibrosis
- intensive care unit
- patient reported outcomes
- pseudomonas aeruginosa
- single cell
- intellectual disability
- squamous cell carcinoma
- bioinformatics analysis
- extracorporeal membrane oxygenation
- free survival