![]() ![]() The PCR condition was defined similarly to the ITS region amplification condition. africana was differentiated using the hyphal wall protein 1 ( HWP1) gene with primers CR-f 5’-GCTACCACTTCAGAATCATCATC-3’ and CR-r 5’-GCACCTTCAGTCGTAGAGACG-3’. Amplification of the HWPI Gene for Differentiating C. The PCR products were subjected to sequencing using the ITS1 and ITS4 primers by employing the Big Dye Terminator cycle sequencing kit (Bioneer, Korea).ģ.5. The PCR products were subjected to the sequencing for the precise identification of isolates. The contents of the PCR mixture were according to a method previously described ( 7). The ITS regions of the rDNA gene of isolates were amplified by universal fungal primers, ITS1 (5’-TCCGTAGGTGAACCTGCGG-3’) and ITS4 (5’-CCTCCGCTTATTGATATGC-3’) ( 8). PCR Sequencing of ITS Regions for NAC Identification The final solution (DNA template) was kept at - 20☌ until use as a template for PCR.ģ.4. ![]() The DNA was extracted from 24 h fresh colony cultures of all 120 isolates, using the method previously described ( 7). For preliminary species identification, white colonies in positive cultures were inoculated on the CHROMagar candida Candida medium (CHROMagar, Paris, France). Oropharyngeal candidiasis was confirmed by the existence of budding yeast cells and pseudohyphae in the direct microscopic examination and positive culture of oral swabs. One swab was used for microscopic examination (potassium hydroxide (KOH) 10% preparation and methylene blue staining) and the other one for fungal culture on Sabouraud Dextrose Agar (SDA, Merck, Germany) with chloramphenicol (50 µg/mL) (Merck, Germany). Two sterile swabs were used to collect samples from the oral cavity. Sample Collection and Initial Identification of Isolates The patients received antifungal prophylaxis before and during chemotherapy.ģ.2. The study was conducted in the bone marrow, hematology, oncology, and transplant wards of Taleghani Hospital in Tehran, Iran. Oropharyngeal candidiasis occurred in 120 of them. In this study, 138 patients with hematological malignancies were admitted from October 2018 to September 2019 in Iran. isolated from patients with oral candidiasis in patients with hematological malignancies. The present study was designed to identify and evaluate the antifungal susceptibility patterns of Candida spp. Microbiological and clinical evaluations should be emphasized in cancer patients. The antifungal susceptibility patterns of Candida albicans and non albicans Candida are different. Recent data suggest an increased incidence of non albicans Candida (NAC) ( 6). with invasion to the mucosa may spread the infection to the bloodstream, leading to disseminated disease ( 5). ![]() are normal commensals in humans and may be associated with certain virulence factors ( 4) If not treated rapidly, especially in patients on chemotherapy, the colonization of Candida spp. ![]() The incidence of oropharyngeal candidiasis, as reported in several studies, ranges from 6 to 53% among cancer patients on chemotherapy ( 3). One of the most important predisposing factors to fungal infections, especially in malignancies, is chemotherapy. The development of this infection may lead to esophagitis and life-threatening systemic infection ( 2). The disease generates irritating infections accompanied by several symptoms like angular cheilitis, thrush (pseudomembranous), and erythematous ( 1). Oropharyngeal candidiasis is a fungal infection in the mouth caused by Candida spp. Oral Candidiasis Hematologic Malignancy Candida albicans 1. albicans and non albicans Candida species and their antifungal susceptibility is useful for deciding on antifungal prophylaxis and selecting the empirical therapy of cancer patients. Local information about the increasing resistance to fluconazole in both C. ![]()
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