Biomedical and Biotechnology Research Journal (BBRJ)

ORIGINAL ARTICLE
Year
: 2020  |  Volume : 4  |  Issue : 1  |  Page : 65--68

To study the isolation and identification of fungi from oral cancer after radiotherapy


Vibha Khatri1, Harish Kumar2, Veer Bahadur Singh3, Gautam Kumar Meghwanshi1,  
1 Department of Microbiology, MGS University, Bikaner, Rajasthan, India
2 Department of Emergency Medicine, S P Medical College, Bikaner, Rajasthan, India
3 Department of Medicine, S P Medical College, Bikaner, Rajasthan, India

Correspondence Address:
Miss. Vibha Khatri
Department of Microbiology, MGS University, B-3 Shastri Nagar, Bikaner - 334 001, Rajasthan
India

Abstract

Background: Cancer, known medically as a malignant neoplasm, is a broad group of diseases involving unregulated cell growth. In oral cavity infection, the oral microflora may be subsequently replaced by potentially pathogenic microorganisms such as candela species (from 72% to 92%). Hence, because of a weakened line of defense in oral cancer patients, the present prospective cohort study was carried out with the aim of isolation and identification of fungal colonization from oral cavity from radiotherapy. Radiotherapy and both radio-chemotheray treated patients. Methods: The proposed study was carried out on clinical samples in the Department of Microbiology in S. P. Medical College, Bikaner, Rajasthan. Isolates from clinical samples were collected from Acharya Tulsi Regional Cancer Hospital, Bikaner, Rajasthan. Samples of the lesion from the tongue and mouth were obtained with a sterile cotton swab. The sample was cultured on Sabouraud's dextrose agar and typical yeast colonies were determined after 72 h. After, staining isolates were subjected to biochemical identification. Results: A total of fifty isolates were taken for the study. Out of these fifty isolates, 45 (90%) were male, whereas 5 (10%) were female. In this study, about 90% of oral and pharyngeal cancer in men and around 10% in women can be estimated. Out of fifty, the highest isolates obtained were Candida albicans (15, 30%), followed by Candida glabrata (11, 22%) and Candida tropicalis (8, 16%), and the lowest number was of Candida krusei (6, 12%). In this purposed study, out of fifty patients, C. albicans can be isolated in 15 patients that is a higher value. Conclusion: C. albicans is the most commonly implicated organism in the mouth after radiotherapy and radio chemotherapy. It is clear that C. albicans is the most commonly found fungi to cause secondary infection.



How to cite this article:
Khatri V, Kumar H, Singh VB, Meghwanshi GK. To study the isolation and identification of fungi from oral cancer after radiotherapy.Biomed Biotechnol Res J 2020;4:65-68


How to cite this URL:
Khatri V, Kumar H, Singh VB, Meghwanshi GK. To study the isolation and identification of fungi from oral cancer after radiotherapy. Biomed Biotechnol Res J [serial online] 2020 [cited 2021 Aug 2 ];4:65-68
Available from: https://www.bmbtrj.org/text.asp?2020/4/1/65/280877


Full Text



 Introduction



Cancer, known medically as a malignant neoplasm, is a broad group of diseases involving unregulated cell growth. There is no definition that describes all the cancers. They are large family of diseases which form a subset of neoplasm, which show some features that suggest of malignancy. Oral cancer, subtypes of head-and-neck cancer, is any cancerous tissue growth located in the oral cavity.[1]

In oral cavity infection, the oral microflora may be subsequently replaced by potentially pathogenic microorganisms such as candela species (from 72% to 92%); Candida carriage was reported commonly in cancer patients, with Candida albicans being the predominant species in patients who undergo radiotherapy for head and neck.[2],[3],[4],[5],[6]

Hence, because of a weakened line of defense in oral cancer patients, the present prospective cohort study was carried out with the aim of isolation and identification of fungal colonization from oral cavity from radiotherapy. Radiotherapy and both radio-chemotheray treated patients.

Certain fungal organisms, notably C. albicans, are commensally inhabitants of the oral cavity in a large proportion of individuals. Under normal conditions, these fungal organisms of the normal oral flora do not cause disease. However, changes in the oral and/or systemic environment can result in an overgrowth of these fungal spp., leading to clinical oral fungal infection. These changes include:[7]

Immunosuppression – induced by drugs or diseaseImbalance in the oral flora – secondary to antibiotic therapyHyposalivation – induce by drugs, disease, or radiation therapyLocal tissue damage – mucositis secondary to chemotherapy and/or radiation therapy.

Oral candidiasis accounts for the vast majority of oral fungal infections and can have a number of clinical presentation, including [8]

Pseudomembranous candidiasis (thrush): present as white curd-like pseudomembranes, which can be removed with some pressure, leading behind an erythematous mucosaChronic hyperplastic candidiasis: presents as a hyperkeratosis white patch, with or without hyperplasia of epithelial tissue, which cannot be removed by scrapingErythematous candidiasis: presents as erythema, fissuring, and crusting of the commissures (angles) of the lips.

Oral candidiasis is candidiasis that occurs in the mouth. That is, oral candidiasis is a mycosis (yeast) fungal infections of Candida spp. on the mucosal membranes of the mouth.

C. albicans is the most commonly implicated organism in this condition. C. albicans is carried in the mouth of about 0% of the world's population as a normal component of the oral microbiota.[9]

Three main clinical appearances of candidiasis are generally recognized: pseudomembranous, erythematous (atrophic), and hyperplastic.[10] Most often affected individuals display one clear type or another, but sometimes, there can be more than one clinical variant in the same person.[11]

 Methods



The proposed study was carried out on clinical samples in the department of microbiology in S. P. Medical College, Bikaner, Rajasthan. Isolates from clinical samples were collected from Acharya Tulsi Regional Cancer Hospital, Bikaner, Rajasthan. Samples of the lesion from the tongue and mouth were obtained with a sterile cotton swab. The sample was cultured on Sabouraud's dextrose agar (SDA), and typical yeast colonies were determined after 72 h [Table 1].{Table 1}

After, staining isolates were subjected to biochemical identification.

Procedure

With an inoculation needle, half of the single colony is transferred in 0.5 ml of serum to the test tubeIncubate at 37°C for a maximum of 1½ h.

Results

Strains of C. albicans produce germ tubes from their yeast cells constitute a positive test.

Carbohydrate fermentation test [Table 2]{Table 2}

Media and reagents

Indicator broth medium

Peptone 1.0 g

Sodium chloride 0.5 g

Beef extract 0.5 g

Bromocresol purple 0.10 ml

Carbohydrate solution 0.3 ml 20%

Procedure

With a sterile loop, take few isolated colonies from SDA plate in 2.0 ml sterile saline in a test tubeDurham's tube is placed in an inverted position in screw-capped test tubes filled with 5–6 ml indicator broth mediumTake 0.2 ml of culture suspension in indicator broth medium with sugarsIncubate the tubes at 30°C or 37°C for 2–10 daysResult: the presence of bubbles in Durham's tube indicates the fermentation of sugars.

 Results



The proposed study was carried out on oral swab samples obtained from Cancer Hospital and Research Center, Bikaner, Rajasthan. The samples were processed according to the routine diagnostic guidelines.

In our study, 45 (90%) were male and 5 (10%) were female from the total isolates patients [Table 3] and [Graph 1].{Table 3}[INLINE:1]

In our study, out of fifty patients, 10 (20%) patients are betel chewing, 39 (78%) patients were smoker (bidi/cigarette), 4 (8%) patients were tobacco chewing, and rest (12, 24%) patients were drinker [Table 4] and [Graph 2].{Table 4}[INLINE:2]

In our study, out of fifty, the highest isolates obtained were C. albicans (15, 30%), followed by Candida glabrata (11, 22%) and Candida tropicalis (8, 16%), and the lowest number was of C. krusei (6, 12%) [Table 5], [Graph 3] and [Figure 1], [Figure 2], [Figure 3].{Table 5}{Figure 1}{Figure 2}{Figure 3}[INLINE:3]

 Discussion



According to the International Agency for Research on Cancer (IARC) carcinogenic cause to human including tobacco, alcohol, chewing betel etc.[12]

The IARC classified tobacco smoking as cause of oral cavity, tonsil pharynx, and nasopharynx cancer.[12]

Smoking tobacco causes 70% of oral and pharyngeal cancer in men and around 55% in women in the UK.[13]

In this study, about 90% of oral and pharyngeal cancer in men and around 10% in women can be estimated.

The proposed study was conducted on fifty patients, in which 78% of patients would be smoker, and 8% of patients would be tobacco chewer.

The IARC classifies alcohol as a cause of oral cavity tonsil and pharynx cancer.[12],[13] According to the IARC, drinking causes around 37% of oral and pharyngeal cancer in the UK.[14]

Among this study, out of fifty patients, 12 were found to be drinker and around 24% of patients are drinker.

A study shows that oral candidiasis is candidiasis that occurs in the mouth. That is, oral candidiasis is a mycosis (yeast/fungal infection) of Candida species on the mucous membrane of the mouth.[9]

C. albicans is the most commonly implicated organism in this condition. C. albicans is carried in the mouth of about 50% of the world's population as a normal component of the oral microbiota.[9]

In this proposed study, out of fifty patients, C. albicans can be isolated in 15 patients that is a higher value. Other species of Candida would be isolated from the patient. By this, it is clear that C. albicans is most commonly found fungi to cause secondary infection.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

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