title: First experience of Candida non-albicans isolates with high antibiotic resistance pattern caused oropharyngeal candidiasis among cancer patients.
abstract: OBJECTIVE
  In cancer patients, Candida species can cause a variety of diseases particularly oropharyngeal candidiasis which is a common infection. In this study, an attempt has been made to determine susceptibility pattern of four antifungal agents against the Candida species isolated from cancer patients with oropharyngeal candidiasis.
  
  
  METHODS
  Samples were taken from 50 cancer patients with oropharyngeal candidiasis by the physician, and isolation and identification of Candida spp. was done based on standard procedures. Antifungal resistance pattern was carried out according to CLSI guidelines, and 18s ribosomal RNA among Candida spp. was identified using multiplex polymerase chain reaction.
  
  
  RESULTS
  Of the 50 patients, 18 (36%) were females and 32 (64%) were males; mean age was 38.4 years. Leukemia and lymphoma were the most frequent cancer types in the studied group, accounting for 17 (34%) and 12 (24%), respectively. A total of 29 Candida spp. were isolated from 29 cancer patients, of which 17 were C. albicans and 12 were C. non-albicans. All the Candida spp. were confirmed having 18s ribosomal RNA. Among all the Candida spp., C. non-albicans showed higher resistance pattern to amphotericin B (MIC 07 μg/ml) and ketoconazole (MIC = 05 μg/ml).
  
  
  CONCLUSIONS
  In conclusion, oropharyngeal Candidiasis is a serious infection among cancer patients. The isolated Candida spp. were resistant to common antifungal agents, which may lead to longer hospital stay, more expensive/toxic drugs and higher mortality. Therefore, interval surveillance is necessary in developing institutional guidelines.
authors.forename: Enayatollah
authors.initials: E
authors.lastname: Kalantar
authors.forename: Seyed Mahmoud Amin
authors.initials: SM
authors.lastname: Marashi
authors.forename: Helen
authors.initials: H
authors.lastname: Pormazaheri
authors.forename: Ellaheh
authors.initials: E
authors.lastname: Mahmoudi
authors.forename: Shiva
authors.initials: S
authors.lastname: Hatami
authors.forename: Maryam Agha
authors.initials: MA
authors.lastname: Barari
authors.forename: Mohammad Hadi
authors.initials: MH
authors.lastname: Naseh
authors.affiliation: Department of Oncology, Shahid Madani Hospital, Alborz University of Medical Sciences, Karaj, Iran.
authors.forename: Mojan
authors.initials: M
authors.lastname: Asadi
mesh_terms: D000293:Adolescent; D000328:Adult; D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D002175:Candida / Q000187:drug effects / Q000302:isolation & purification*; D002180:Candidiasis, Oral / Q000188:drug therapy / Q000382:microbiology*; D025141:Drug Resistance, Fungal; D005260:Female; D006801:Humans; D007654:Ketoconazole / Q000627:therapeutic use; D008297:Male; D009369:Neoplasms / Q000382:microbiology*; D055815:Young Adult
chemical_list: D000935:Antifungal Agents; D000666:Amphotericin B; D007654:Ketoconazole