IN-VITRO ANTI-Candida POTENTIAL OF SELECTED SRI LANKAN MEDICINAL PLANTS AGAINST Candida SPECIES ISOLATED FROM  CANCER PATIENTS’ ORAL MICROBIOTA

Oral candidiasis is a common opportunistic infection among immunocompromised individuals, particularly cancer patients undergoing chemotherapy and radiotherapy. The increasing prevalence of antifungal resistance among Candida species further complicates clinical management, highlighting the urgent need for alternative therapeutic approaches. This study aimed to identify Candida species colonizing the oral cavities of cancer patients and healthy individuals in Sri Lanka, assess their antifungal susceptibility patterns, evaluate the anticandidal properties of selected medicinal plants traditionally used in Sri Lankan indigenous medicine, and rationalize their  ethnopharmacological use as potential antifungal remedies against oral candidiasis prevalent in cancer patients. Oral swabs and rinse samples were collected from 170 cancer patients and 170 healthy individuals. Candida isolates were identified using morphological and biochemical methods, and antifungal  susceptibility was determined using the disk diffusion method. The study revealed a significantly higher prevalence of oral Candida colonization among cancer patients (60.59%) compared to healthy controls (44.71%), with Candida albicans being the predominant species. Alarmingly, high resistance rates to fluconazole and voriconazole were observed among clinical isolates, underscoring the threat of emerging antifungal resistance. Selected plant extracts exhibited strong in vitro anticandidal activity, with Aegle marmelos fruit and leaves, Lowsonia inermis leaves, and Cinnamomum zeylanicum leaves showing the most potent  effects. Phytochemical screening confirmed the presence of bioactive compounds such as phenolics and flavonoids. A novel herbal mouthwash developed from these extracts demonstrated significant anticandidal efficacy comparable to commercial formulations. The study emphasizes the critical necessity for regular antifungal resistance monitoring and  supports the potential of plant-based therapies as safer, effective alternatives. Future studies should include sophisticated and more accurate molecular identification of Candida species, toxicity testing using oral epithelial cell lines, and clinical trials to validate the efficacy and safety of plant derived antifungal formulations.