Incidence and spectrum of yeast species isolated from the oral cavity of Iranian patients suffering from hematological malignancies

摘要

ABSTRACT 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.