Opportunistic Microorganisms in Oral Cavity According to Treatment Status in Head and Neck Cancer Patients DC14-DC17
Dr. Priyanka Soni,
291, Purohiton Ka Vas, Village and Post-Boosi, Via-Somesar, District Pali-306401, Rajasthan, India.
Introduction: Cancer patients receiving chemotherapy and/ or radiation therapy are prone to many predisposing factors like immunosuppression, imbalance in the oral flora, hyposalivation and local tissue damage. Therefore, considered to be at higher risk for oral bacterial and fungal infection than the general population.
Aim: To study oropharyngeal flora in head and neck cancer patients under treatment and to correlate their incidence according with Chemotherapy cycles and Radiochemotherapy.
Materials and Methods: Total 110 patients were selected for study, those were further divided into two groups, group I under Chemotherapy (CT) – 55 patients and group II under Radiochemotherapy (RCT) – 55 patients and 50 healthy individuals were taken as control. Saliva sample was collected from control and study group and inoculated on Blood agar, MacConkey agar and Sabouraud’s Dextrose Agar (SDA). The identification of bacterial and fungal isolates was done by standard microbiological methods and result was calculated according to cycles of Chemotherapy and Radiochemotherapy combined. Significant differences between patients were tested using the Chi-square test or Fisher’s exact test. A p-value less than 0.05 was considered as statistically significant.
Result: There were 149 culture isolates from 110 patient in which Gram Negative Bacilli (GNB) found in 63.6%, Candida spp. in 50%, Staphylococcus aureus in 8% and Normal commensal of oral cavity in 13.6% patients in study group and this was higher than control group and this difference was statistically significant in relation to all isolates individually. Relatively more microorganism were isolated during RCT (56%) in compare to CT alone (44%), among GNB- Pseudomonas (27.7%,32.3%) and Klebsiella (25%,29.4%) were most frequently isolated during CT, RCT respectively. Candida spp. were more commonly isolated from patient on RCT (63.6%) than CT (36.3%) when compared to control group (20%) among which C. tropicalis was more prevalent species. Both GNB & Candida spp. were more commonly isolated in later chemotherapy cycles (CT4, CT5 CT6).
Conclusion: Colonisation of Gram negative bacilli & Candida spp. is directly related to number of chemotherapy cycles and combined cancer therapy. Hence, prophylactic medication for these two organisms should be incorporated along with cancer therapy.