Oral Candida colonization in xerostomic postradiotherapy head and neck cancer patients

• Published in: Oral diseases Vol. 25; no. 7; pp. 1798 - 1808
• Main Authors: Tarapan, Supanat, Matangkasombut, Oranart, Trachootham, Dunyaporn, Sattabanasuk, Vanthana, Talungchit, Sineepat, Paemuang, Wannaporn, Phonyiam, Tawaree, Chokchaitam, Orapin, Mungkung, On‐ong, Lam‐ubol, Aroonwan
• Format: Journal Article
• Language: English
• Published: Denmark Wiley Subscription Services, Inc 01.10.2019
• Subjects: Adult; Aged; Candida; Candida - drug effects; Candida - growth & development; Candida - radiation effects; Candida albicans - drug effects; Candida albicans - growth & development; Candidiasis, Oral - diagnosis; Candidiasis, Oral - epidemiology; Colonization; Colony Count, Microbial; Dentures; Female; Females; Head & neck cancer; head and neck cancer; Head and Neck Neoplasms - radiotherapy; Humans; hyposalivation; Middle Aged; Mouth; Mouth - microbiology; Mouth - radiation effects; non‐albicans; pH effects; Polymerase chain reaction; Population studies; Prosthetics; Risk factors; Saliva - metabolism; Saliva - microbiology; Saliva - radiation effects; Salivary Glands - radiation effects; Secretory Rate - radiation effects; Species; xerostomia; Xerostomia - etiology; Xerostomia - radiotherapy; xerostomia; head and neck cancer; non-albicans; Candida; hyposalivation
• ISSN: 1354-523X; 1601-0825; 1601-0825
• DOI: 10.1111/odi.13151

Objectives To evaluate (a) oral colonization of Candida species, especially for non‐albicans Candida species (NACS), in xerostomic postradiotherapy head and neck cancer patients and (b) risk factors affecting their colonization. Materials and methods Subjective and objective dry mouth scores, stimulated salivary flow rates, pH and buffering capacity were measured in 72 xerostomic postradiotherapy head and neck cancer patients. Candida counts and species identification were performed using oral rinse samples cultured in Candida Chromagar, followed by polymerase chain reaction and API 20C AUX system. Results Candida colonization was observed in 87.5% of subjects, with 80.6% and 48.6% of study population colonized by C. albicans and NACS, respectively. NACS was associated with high objective dry mouth scores, denture use, and females (p = .006, .009, and .036, respectively). In addition, Candida glabrata was detected more in females (p = .018) and denture wearers (p = .026), while Candida tropicalis was associated with high objective dry mouth scores (p = .022) and females (p = .027). Quantity of Candida colonization correlated positively with objective dry mouth scores (r = 0.599, p < .001) and negatively with salivary flow rates (r = −0.258, p = .041) and pH (r = −0.290, p = .022). Conclusion NACS colonization was common in xerostomic head and neck cancer patients. Increased signs of dry mouth, female and dental prostheses may promote NACS colonization.