%0 Journal Article
%T Incidence and spectrum of yeast species isolated from the oral cavity of Iranian patients suffering from hematological malignancies
%A Amir Arastehfar
%A Farnaz Daneshnia
%A Ferry Hagen
%A Maryam Roudbary
%A Maryam Salimi
%A Mohammadreza Salehi
%A Pan Weihua
%A Shirin Farahyar
%A Teun Boekhout
%A Wenjie Fang
%J Journal of Oral Microbiology
%D 2019
%R https://doi.org/10.1080/20002297.2019.1601061
%X ABSTRACT Background: Oral candidiasis (OC) has a profound effect on the life quality of immunocompromised patients, such as those undergoing chemotherapy. Objective: Systematic investigation of clinical outcome and microbiological features of yeast isolates recovered from the oral cavity of 150 Iranian patients with hematological malignancies. Design: MALDI-TOF MS, 21-plex PCR, and rDNA sequencing were used for identification. Antifungal susceptibility testing (broth microdilution, CLSI M27-A3/S4) and genotypic diversity of yeast isolates (amplified fragment length polymorphism) were assessed. Results: Nystatin treatment resulted in 70% therapeutic failure and administration of 150 mg fluconazole (FLZ) + nystatin for patients with OC relapse showed 70% clinical failure. Previous history of OC was significantly correlated with FLZ treatment requirement and nystatin failure (P = 0.005, ¦Á < 0.05). Candida albicans (80.3%) and Kluyveromyces marxianus (C. kefyr) (12.7%) were the two most prevalent yeast species isolated. FLZ and AMB exhibited the highest geometric mean values. 21-PCR showed 98.9% agreement with MALDI-TOF MS. K. marxianus isolates had the same genotype, while C. albicans isolates grouped in 15 genotypes. Conclusions: Marked rate of therapeutic failure of nystatin necessitated OC treatment with systemic antifungals. K. marxianus was the second most prevalent yeast and 21-plex PCR could be considered as an inexpensive identification tool
%U https://www.tandfonline.com/doi/full/10.1080/20002297.2019.1601061