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Occurrence of oral Candida colonization and its risk factors among patients with malignancies in China

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Abstract

Objectives

Oral colonization of Candida could lead to later development of oropharyngeal candidiasis or candidemia among the immunocompromised patients. This study aims to describe the occurrence and risk factors of oral Candida colonization in patients with malignancies.

Materials and methods

From October 2012 to March 2013, 78 patients with pulmonary cancer (group I), 101 patients with gastrointestinal tract tumor (group II), 79 patients with hematopoietic system malignant tumor (group III), and 101 healthy controls were consecutively recruited in a hospital in Beijing, China. The oral rinse samples were taken and Candida species were identified; the enzymes activities were tested.

Results

In total, 110 and 27 Candida strains were isolated from 91 patients and 26 controls, respectively. The oral colonization rate with Candida albicans in group III (12.7 %) was significant lower than that in group I (30.8 %), group II (33.7 %), and control group (25.7 %). The oral colonization rates with non-albicans Candida species in group I, group II, and group III were 15.4, 10.9, and 12.7 %, respectively, while only one non-albicans Candida strain was identified in control group. The non-albicans Candida species exhibited a lower virulence than C. albicans. Age was an independent risk factor for Candida colonization in patients with pulmonary cancer and digestive tract malignant tumor, “Teeth brush <1 time/day” was an independent risk factor for Candida colonization in patients with hematopoietic system tumor.

Conclusions

The differences of risk factors for oral Candida colonization in patients with different cancers require different strategies for the prevention and control of Candida infection.

Clinical relevance

Old aged patients with pulmonary cancer and digestive tract malignant tumor are high-risk population for Candida colonization. Increasing frequency of teeth brush might be helpful for preventing Candida colonization.

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Acknowledgments

We thank the staff in Department of the Tumor Therapy Center and Medical Examination Center, The 307th Hospital of PLA, for their help and assistance in recruiting participants and collecting samples. The study was supported by a grant from Beijing Natural Science Foundation, China (No. 7122133), a grant from National “973” Program (No. 2013CB531606), and the National Natural Scientific foundation of China (No. 81102168).

Author contribution

Li Han and Cheng Ge designed the study. Haiyan Sun, Huan Li, and Xuan Zou performed the study. Xiuyun Yin, Haifeng Qin, Rongrui Liu, Changlin Yu, Qihong Li, Kaitao Yu, and Xuelin Han participated in collecting the clinical samples and medical information. Yong Chen and Huan Li collected the data and carried out the statistical analyses. Haiyan Sun and Yong Chen wrote the paper; Jingcai Zou took in charge of reviewing and editing the research manuscript. All of the authors read and approved the final manuscript.

Declaration of interest

The authors have no conflicts of interest to declare.

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    Authors and Affiliations

    1. Department of Stomatology, 307 Hospital, PLA, 8# Dongda Str., 100071, Beijing, China

      Haiyan Sun, Xuan Zou, Qihong Li, Kaitao Yu, Jingcai Zou & Cheng Ge

    2. Center for Hospital Infection Control, Chinese PLA Institute for Disease Control and Prevention, Academy of Military Medical Sciences, 20# Dongda Str., 100071, Beijing, China

      Yong Chen, Xuelin Han & Li Han

    3. Department of Oral Medicine, School of Stomatological, Jiamusi University, Jiamusi, China

      Huan Li

    4. Department of Clinical Laboratory, 307 Hospital, PLA, Beijing, China

      Xiuyun Yin

    5. Department of Digestive Tract Malignant Tumor, 307 Hospital, PLA, Beijing, China

      Haifeng Qin

    6. Department of Pulmonary Cancer, 307 Hospital, PLA, Beijing, China

      Rongrui Liu

    7. Department of Hematopoietic System Tumor, 307 Hospital, PLA, Beijing, China

      Changlin Yu

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    1. Haiyan Sun
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    Correspondence to Cheng Ge or Li Han.

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    Haiyan Sun, Yong Chen and Xuan Zou contributed equally to this work.

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    Sun, H., Chen, Y., Zou, X. et al. Occurrence of oral Candida colonization and its risk factors among patients with malignancies in China. Clin Oral Invest 20, 459–467 (2016). https://doi.org/10.1007/s00784-015-1524-2

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