A study of changes in the oral fungal flora of patients on radiotherapy for head and neck malignancies and their correlation with funguria and fungemia

Raj, Shraddha; Sharma, Dheeraj; Mate, Pooja Uttam; Capoor,; Bhowmik, K.T.

doi:10.4103/ijc.ijc_155_17

Cited by 8 publications

(6 citation statements)

References 14 publications

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“…A study by Raj et al in 42 H&N cancer patients showed a 57.14% incidence of Candida infection. 7 The common species found in this study was Candida tropicalis (28.57%) and Candida albicans (14.28%) followed by Candida parapsilosis (14.28%). In our study, the most common Candida species isolated was Candida albicans at (18.66%) followed by Candida tropicalis (5.66%) and Candida glabrata at (2%).…”

Section: Discussionmentioning

confidence: 52%

Salivary IgA as a Surrogate Biomarker for Microbial Infections in Postoperative Patients Receiving Chemo-Radio-Therapy for Head and Neck Cancer

et al. 2023

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Objective Radiotherapy (RT) and chemotherapy (CT) are important treatment options in patients with head and neck cancers. A common complication of this is microbial colonization or infection of mucosal surfaces. These infections may commonly be due to bacteria or yeasts. Salivary proteins with their buffering activity and immunoglobulin, especially immunoglobulin A (IgA), protect oral tissue, mucosal surfaces, and teeth from various microorganisms. This study characterizes the common microorganisms encountered and evaluates the role of salivary IgA in predicting microbial infections in this group of patients with mucositis. Methods A total of 150 adult head and neck cancer patients on CTRT were evaluated at baseline and at the end of 3 and 6 weeks, respectively. Oral swabs collected from buccal mucosa were processed in the microbiology laboratory for the presence of microorganisms. Saliva was processed for IgA level estimation on Siemens Dimension Automated biochemistry analyzer. Results Pseudomonas aeruginosa and Klebsiella pneumoniae were the most common organisms found in our patients, followed by Escherichia coli and group A beta-hemolytic Streptococci. A significant increase (p = 0.0203) in the incidence of bacterial infection was observed in post-CTRT patients (61%) compared to pre-CTRT patients (49.33%). There was significant increase in levels of salivary IgA (p = 0.003) in patients with bacterial and fungal infection (n = 135/267) when compared to those in samples showing no growth (n = 66/183). Conclusion A significant increase in the incidence of bacterial infection in post-CTRT patients was observed in this study. This study also indicated that postoperative head and neck cancer patients with oral mucositis that developed an infection were associated with high salivary IgA levels, and it may serve as a surrogate biomarker of infection in these patients.

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Section: Discussionmentioning

confidence: 52%

Salivary IgA as a Surrogate Biomarker for Microbial Infections in Postoperative Patients Receiving Chemo-Radio-Therapy for Head and Neck Cancer

et al. 2023

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“…Diminution of its protective role in patients on chemotherapy with oral mucositis contributes to both local infection and penetration of microorganisms from mouth to blood, which was observed in almost 50 % of patients on chemotherapy having bacteremia (20). Candida albicans and Candida glabrata from the oral cavity were also found in the blood in patients with oral mucositis (21).…”

Section: Resultsmentioning

confidence: 99%

Efficacy and safety of local lysozyme treatment in patients with oral mucositis after chemotherapy and radiotherapy

et al. 2019

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This observational clinical study was composed of two substudies: a non-comparative one (n = 166), testing only lysozyme-based compounds (LBCs), and a comparative substudy (n = 275), testing both LBCs and bicarbonate-based local compounds (BBCs) on the healing of oral mucositis during radio- or chemotherapy. The density of ulcerations has decreased significantly after the treatment with lysozyme in both substudies. The density of ulcerations in the radiotherapy group was lower in patients treated with LBCs compared to patients treated with BBCs (p < 0.001). In the chemotherapy group, reduction of ulceration density was similar with both LBCs and BBCs. The LBCs reduced pain intensity during the intake of solid food and speech more than BBCs in both patient cohorts (p < 0.05). In the radiotherapy cohort, pain intensity when consuming liquid foods was reduced more with LBCs than with BBCs (p < 0.05). No adverse events were recorded. This study demonstrates the advantages of treating oral mucositis during radiotherapy or chemo-therapy with LBCs.

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“…24 The RT induces changes in the oral microbiota and this is significantly different when associated with the mutational changes of the cancer, 1,5,22,23,26 changing progressively with tumor progression. 23,27 In the treatments of RT with or without adjuvant CT, there is an increase of bacteria from some groups including Proteobacteria, Spirochaetes, 2,28 xx • OM was more frequent in patients undergoing RT. Bacteria and yeast were found in the study.…”

Section: Discussionmentioning

confidence: 99%

Oral microbiota versus oral mucositis during cancer treatment: a review

Ribeiro¹,

Ferigatto²,

César³

et al. 2020

hu rev

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Introduction: Oral microbiota has been implicated on oral mucositis (OM) that occurs during cancer therapy, however without consensus. Objective: This study, aimed to establish, through a review, the association between oral microbiota and OM at head and neck cancer therapy (HNCT). Material and methods: The search of PubMed was performed considering 2008-2018 period, and the descriptors “oral mucositis” and “oral microbiota” in subheadings etiology and microbiology into the Medical Subject Heading (MeSH) “Head and Neck Neoplasms”. The conducting question was “Is there an oral dysbiosis during HNCT associated with OM?”. Results: 22 articles were selected under two steps of data extraction: articles that evaluated de oral microbiota during HNCT (n=13), and articles that also focused in OM (n=9). Conclusion: The evidence presented in the literature suggests associations of oral microbiota dysbiosis with the progression and worsening of radiation-induced OM. However, to define a microbial core for the disease, future standardized studies are required.

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A study of changes in the oral fungal flora of patients on radiotherapy for head and neck malignancies and their correlation with funguria and fungemia

Abstract: Prophylactic antifungal therapy in patients undergoing RT for head and neck malignancy is particularly important to prevent intraoral colonization and infection by Candida. Screening of such patients on RT for fungal infections can prevent fatal mold infections.

Cited by 8 publications

References 14 publications

Salivary IgA as a Surrogate Biomarker for Microbial Infections in Postoperative Patients Receiving Chemo-Radio-Therapy for Head and Neck Cancer

Salivary IgA as a Surrogate Biomarker for Microbial Infections in Postoperative Patients Receiving Chemo-Radio-Therapy for Head and Neck Cancer

Efficacy and safety of local lysozyme treatment in patients with oral mucositis after chemotherapy and radiotherapy

Oral microbiota versus oral mucositis during cancer treatment: a review

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