Oral Candida Speciation using HiCrome Agar with Antifungal Susceptibility Patterns in Patients with Malignancy Undergoing Treatment

Abstract

Background: Oral candidiasis is a frequent opportunistic fungal infection in patients with malignancy undergoing chemotherapy and radiotherapy. Species identification and antifungal susceptibility testing are crucial to effective management. The aim of the study was to identify oral Candida species using HiCrome Candida agar and evaluate antifungal susceptibility patterns among patients with malignancy undergoing treatment. Methods: A cross-sectional study was conducted among patients with malignancy receiving chemotherapy and/or radiotherapy. Saliva samples were cultured on Sabouraud dextrose agar and presumptively identified using HiCrome Candida agar. Antifungal susceptibility testing was performed using the disk diffusion method. Results: Candida albicans was the predominant species identified by HiCrome agar (50%), followed by Candida parapsilosis, Candida tropicalis, Candida krusei, Candida glabrata and Candida guilliermondii among cancer patients. Amphotericin B and Nystatin showed 100% susceptibility by all Candida species, whereas Itraconazole exhibited lowest susceptibility among all the azole compounds. Conclusion: Although HiCrome agar is used as a cost effective, presumptive identification of Candida species, it is unable to differentiate other species of Candida. Other conventional methods or molecular methods are recommended for the accurate species identification. The study emphasises the importance of AST as drug resistance is commonly seen in Candida species.

Keywords: Oral candidiasis, Candida, HiCrome agar, antifungal susceptibility, AST, malignancy.