Non Candida albicans Candida (NCAC) of oral cavity in head and neck cancer patients under cancer therapy: Prevalance, species identification and antimycotic sensitivity pattern

Introduction: Cancer patients remain at risk for developing serious infections due to oropharyngeal Candida colonisation as the incidence of Candidiasis continues to rise after chemotherapy (CT), Radiochemotherapy (RCT) or Radiotherapy (RT) for head and neck cancer. So, accurate and rapid identification of candida species is very important in clinical laboratory. Objective: To study the prevalance, species identification and antimycotic sensitivity pattern of Candida spp. of oral cavity in patients of head & neck cancer undergoing chemotherapy (CT) & Radiochemotherapy (RCT) and compare with control group. Materials and Methods: This is prospective cross sectional and case control analysis including 110 patient in study group; chemotherapy (CT)-55 patient, Radiochemotherapy (RCT)-55 patients and 50 healthy individuals as control. Candida isolates identified by standrad methods using morphological, biochemical & chromogenic property of different Candida spp. and antimycotic sensitivity applied by disc diffusion method. Results: Prevalence of Candida spp. colonization seen in 50% patients of study and 20% in control group (p value- 0.004) ; patients on RCT (63.6%) have higher prevelance as compare to CT (36.4%), (p 0.007). C. tropicalis was most common (38%) species followed by C. albicans (11%) & C. glabrata (11%); most of isolates were sensitive to Amphotericin B and Nystatin and least sensitive to Fluconazole. Conclusion: High prevalence of Candidal carriage and the species variation and changing pattern of antifungal susceptibility of Candida spp in patients undergoing chemotherapy and radiation therapy require isolation and speciation of the causative Candida sp. and prophylaxis is needed to prevent infection among these patients.