Naslov
Oral candidiasis and effectiveness of miconazole treatment in patients receiving radiation for head and neck cancer in University Hospital Centre Split, Croatia

Autori
Novak, Anita ; Ježina Bušelić, Marina ; Goić- Barišić, Ivana ; Tonkić, Marija ; Rubić, Zana ; Radić, Marina ; Ognjenović Mirošević, Marina ; Prentić-Bakić, Samra

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, znanstveni

Izvornik
ESCMID Library / - , 2015

Skup
European Congress of Clinical Microbiology and Infectious Diseases

Mjesto i datum
Kopenhagen, Danska, 25.04.2015. - 28.04.2015

Vrsta sudjelovanja
Poster

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
candidiasis ; miconazole ; treatment ; cancer

Sažetak
Objectives: To assess the occurrence of mucositis and oral candidiasis, as well as their impact on quality of life in patients receiving radiotherapy for head and neck cancer (HNC) and to evaluate the effectiveness of miconazole treatment in this patients. Methods: The study included all patients eligible to receive radiotherapy for HNC in period between July 2011 and February 2012 in University Hospital Centre Split. Patients were examined and the samples were obtained prior the irradiation, during the radiotherapy and three weeks after the irradiation had been finished. Salivation was measured by collecting saliva for 10 minutes. Samples for mycological analysis were proceeded according to ESCMID guidelines. Minimum inhibitory concentrations (MICs) for fluconazole, flucytosine, voriconazole and amphotericin B were determined using the EUCAST and CLSI protocols. Mucositis was evaluated according to WHO criteria, while quality of life was evaluated according to the Washington Quality of Life Questionnaire. Results: In seven months period, 40 patients were consecutively enrolled in the study. The amount of saliva was significantly decreased (from 0.375 ml/min to 0.250 ml/min, P<0.001), while the frequency of mucositis increased during the radiotherapy (P<0.001). At the 4th week of treatment 95% (38/40) of all patients had mucositis in comparison with 22.5% (9/40) before the radiotherapy. 18 patients (45%) without clinical signs and symtoms of oral candidiasis had positive mycolocical samples before the radiotherapy. Candida albicans was isolated from 66.7% (12/18) of positive samples and non-C. albicans from 33.3% (6/18) of positive samples (2 strains were C. parapsilosis while 4 strains were C. krusei). In the 4th week of radiotherapy 24 patients (60%) had positive mycological findings. Among them, 75% (18/24) patients had C. albicans, while 8.3% (2/24) had C. parapsilosis and 16.7% (4/24) had C. krusei. All patients with clinical picture of oral candidiasis and positive mycological results received miconazole. Three weeks after the radiotherapy was finished, 30% of patients (12/40) had positive findings (8 isolates were C. albicans and 4 isolates were C. krusei). That was significantly lower in comparison with the baseline founding. All isolates were susceptible to all tested antifungal drugs (except the resistance of C. krusei to fluconazole). The most frequent changes in quality of life according to patients' self- reports were dry mouth (80%), anxiety (72.5%), fatigue (65%), difficulty swallowing (60%), dysgeusia (37.5%) and pain (37.5%). Conclusions: Radiotherapy for HNC affects salivary gland function and increase the susceptibility of the oral mucosa to colonization by Candida species. Candida albicans continues to be the most common species involved and miconazole is still the first-line therapy for oral candidiasis in patients undergoing radiotherapy in our hospital. However, periodic epidemiological studies should be carried out to determine susceptibility profiles of different isolated Candida species.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

POVEZANOST RADA