ISSN: 0973-7510

E-ISSN: 2581-690X

Research Article | Open Access
Neethu Babu1,2, Chitralekha Saikumar3 and C. Jomon Raphael4
1Department of Microbiology, Amala Institute of Medical Sciences, Amala Nagar, Thrissur, Kerala, India.
2Department of Microbiology, Bharath Institute of Higher Education and Research, Chennai, Tamil Nadu, India.
3Department of Microbiology, Sree Balaji Medical College and Hospital, Chennai, Tamil Nadu, India.
4Department of Radiation Oncology, Amala Institute of Medical Sciences, Amala Nagar, Thrissur, Kerala, India.
Article Number: 8794 | © The Author(s). 2023
J Pure Appl Microbiol. 2023;17(4):2415-2423.
Received: 19 June 2023 | Accepted: 01 November 2023 | Published online: 29 November 2023
Issue online: December 2023

The objective of the current study was to quantify the adherence property of Candida species causing infections in head and neck cancer patients on radiation therapy (RT) or chemoradiotherapy (CRT). Additionally, the study aimed to establish a correlation between adherence properties and patients’ hemograms. A prospective cohort study was done on head and neck cancer (HNC) patients with oropharyngeal candidiasis. All patients received radiation doses ranging from 60 to 70 Gy using Intensity Modulated Radiation Therapy. Inoperable patients received concurrent chemotherapy with cisplatin 40mg/m2 once weekly during the course of RT. Swabs were collected from patients with signs and symptoms of candidiasis and microbiological confirmation and speciation were done according to standard protocol. An in vitro adherence test was done. Hemogram of all the patients at the start of infection was compared with the adherence. Candidiasis was detected in 58(35.3%) out of a total of 164 patients (Age 36-85). Candida albicans was the most prevalent 39(67.2%) species isolated. C.albicans showed the highest adherence which was statistically significant. The hemogram at the start of treatment and with C. albicans infection showed a statistically significant decrease in the absolute lymphocyte count (p-value 0.0001), RBC count (p-value 0.004) and haemoglobin level (p-value 0.003). Less adherence was seen with non-albicans Candida infection when compared to C.albicans (Odds 0.894, 95% CI -0.818-0.977), significant at 5 % (0.013). C. albicans showed significant adherence, which indicates the severity of infection. The occurrence of oral candidiasis is strongly associated with low lymphocyte count and severity of mucositis. Absolute lymphocyte count needs to be monitored in HNC patients who are undergoing RT or CRT.


Candida albicans, Candidiasis, Chemo Radiotherapy

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© The Author(s) 2023. Open Access. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License which permits unrestricted use, sharing, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.