663. Oral Antifungal Prophylaxis in Patients with Squamous Cell Cancer of the Head and Neck Undergoing Radiotherapy and Its Effect On Oral Candida Colonization
Session: Abstracts: Mycology
Friday, October 22, 2010
Background: Oral antifungal prophylaxis is used for patients at high risk for fungal infections. The effect of prophylactic administration of oral antifungals on oral Candida colonization in patients with squamous cell cancer of the head and neck undergoing radiotherapy was assessed.

Methods: A total of 22 patients with squamous cell cancer of the head and neck receiving nystatin prophylaxis orally during radiotherapy, and 25 healthy controls were enrolled. To investigate oral Candida strain diversity, and changes in Candida counts, oral swabs were collected prior to and during radiotherapy at week 1, 3 and 8. Candida spp. were determined using Candida CHROMagar and emerging colonies were differentiated according to the color of colonies and biochemically by Bio Merieux API Aux test.

Results: Prior to radiotherapy, in the patients group 15 study subjects (68%) were colonized with Candida spp. including C. albicans (n=11), C. glabrata (n=2), C. parapsilosis (n=1) and C. magnoliae (n=1). In the healthy control group, 7 study subjects (36%) were colonized by C. albicans only. The mean Candida colony-forming unit count was significantly higher in the patients group compared to the control group at baseline (P < 0.05). There was no significant difference in Candida colonization between mycological baseline assessment and during radiotherapy at week 1 and 3, but colonization rates decreased, and strain diversity changed at week 8. A total of 14 Candida spp. were isolated from 11 of 22 patients (50%). Candida albicans (n=10) was the most frequently isolated species followed by C. glabrata (n=3), and C. tropicalis (n=1).

Conclusion: Baseline oral Candida colonization was significantly higher in patients with squamous cell cancer of the head and neck and showed also significantly higher strain diversity compared to healthy controls. The prophylactic use of nystatin reduced both Candida colonization rates, and strain diversity during radiotherapy.


Subject Category: M. Mycology including clinical and basic studies of fungal infections

Speakers:
Helmut J.F. Salzer, MD , Section of Infectious Diseases, Division of Pulmonology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
Robert Krause, MD , Section of Infectious diseases, Division of Pulmonology, Department of Internal Medicine,, Medical University of Graz, Austria, Graz, Austria
Sabine Reinisch, MD , Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Graz, Graz, Austria
Harald Kessler, MD , Research Unit Molecular Diagnostics, Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
Karin S. Kapp , University Clinic of Therapeutic Radiology and Oncology, Medical University of Graz, Graz, Austria
Brigitte Santner, MD , Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
Richard Partl, MD , University Clinic of Therapeutic Radiology and Oncology, Medical University of Graz, Graz, Austria
Reinhard B. Raggam, MD , Department of laboratory medicine, Medical University of Graz, Austria, Graz, Austria

Disclosures:

H. J. F. Salzer, None

R. Krause, None

S. Reinisch, None

H. Kessler, None

K. S. Kapp, None

B. Santner, None

R. Partl, None

R. B. Raggam, None

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