In Vitro Antifungal Susceptibility Profiles of Candida albicans Complex Isolated from Patients with Respiratory Infections

  • Somayeh Sharifynia Department of Medical Mycology and Parasitology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
  • Hamid Badali Department of Medical Mycology and Parasitology, Pharmaceutical Sciences Research Center, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.
  • Mina Sharifi Sorkherizi Department of Medical Mycology and Parasitology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
  • Mohammad Reza Shidfar Department of Medical Mycology and Parasitology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
  • Atefe Hadian Department of Medical Mycology and Parasitology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
  • Shadi Shahrokhi Islamic Azad University, Varamin-Pishva Branch, Varamin, Iran.
  • Ghazale Ghandchi Pediatric Infections Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
  • Sassan Rezaie Department of Medical Mycology and Parasitology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
Keywords: In vitro susceptibility, C.albicans complex, Caspofungin

Abstract

Candidiasis, the main opportunistic fungal infection has been increased over the past decades. This study aimed to characterize C.albicans species complex (C.albicans, C.dubliniensis, and C.africana) isolated from patients with respiratory infections by molecular tools and in vitro antifungal susceptibilities by using broth microdilution method according to CLSI M27-A3 guidelines. Totally, 121 respiratory samples were collected from patients with respiratory infections. Of these, 83 strains were germ tube positive and green colonies on chromogenic media, so initially identified as C.albicans species complex and subsequently were classified as C.albicans (89.15%), C.dubliniensis (9.63%), and C.africana (1.2%) based on PCR-RFLP and amplification of hwp1 gene. Minimum inhibitory concentration (MICs) results showed that all tested isolates of C.albicans complex were highly susceptible to triazole drugs. However, caspofungin had highest activity against C.albicans, C.dubliniensis, and C.africana. Our findings indicated the variety of antifungal resistance of Candida strains in different areas. These results may increase the knowledge about the local distribution of the mentioned strains as well as their antifungal susceptibility pattern which play an important role in appropriate therapy.

References

Lemos JdA, Costa CR, Araújo CRd, Hasimoto e Souza LK, Silva MdRR. Susceptibility testing of Candida albicans isolated from oropharyngeal mucosa of HIV+ patients to fluconazole, amphotericin B and Caspofungin: killing kinetics of caspofungin and amphotericin B against fluconazole resistant and susceptible isolates. Braz J Microbiol 2009;40:163-9.

Storm L, Lausch KR, Arendrup MC, Mortensen KL, Petersen E. Vertebral infection with Candida albicans failing caspofungin and fluconazole combination therapy but successfully treated with high dose liposomal amphotericin B and flucytosine. Med Mycol Case Rep 2014;6:6-9.

Afsarian MH, Badali H, Boekhout T, Shokohi T, Katiraee F. Multilocus sequence typing of Candida albicans isolates from a burn intensive care unit in Iran. J Med Microbiol 2015;64:248-53.

Bai FY. Association of genotypes with infection types and antifungal susceptibilities in Candida albicans as revealed by recent molecular typing strategies. Mycology 2014;5:1-9.

Moran GP, Coleman DC, Sullivan DJ. Candida albicans versus Candida dubliniensis: why is C.albicans more pathogenic? Int J Microbiol. 2012;2012:205921.

Ahmad S, Khan Z, Asadzadeh M, Theyyathel A, Chandy R. Performance comparison of phenotypic and molecular methods for detection and differentiation of Candida albicans and Candida dubliniensis. BMC Infect Dis 2012;12:230.

Bosco-Borgeat ME, Taverna CG, Cordoba S, Isla MG, Murisengo OA, Szusz W, et al. Prevalence of Candida dubliniensis fungemia in Argentina: identification by a novel multiplex PCR and comparison of different phenotypic methods. Mycopathologia 2011;172:407-14.

Romeo O, Criseo G. First molecular method for discriminating between Candida Africana, Candida albicans, and Candida dubliniensis by using hwp1 gene. Diagn Microbiol Infect Dis 2008;62:230-3.

Romeo O, Criseo G. Molecular epidemiology of Candida albicans and its closely related yeasts Candida dubliniensis and Candida africana. J Clin Microbiol 2009;47:212-4.

Afsarian MH, Badali H, Shokohi T, Multilocus Sequence Typing: a Molecular Typing Method with High Discriminatory Power for Identification of Candida albicans Strains in Epidemiological Studies. J Mazand Univ Med Sci 2013;23:161-74.

Shokohi T, Bandalizadeh Z, Hedayati MT, Mayahi S. In vitro antifungal susceptibility of Candida species isolated from oropharyngeal lesions of patients with cancer to some antifungal agents. Jundishapur J Microbiol 2011;4:S19-26.

Levallois J, Nadeau-Fredette A-C, Labbé A-C, Laverdière M, Ouimet D, Vallée M. Ten-year experience with fungal peritonitis in peritoneal dialysis patients: antifungal susceptibility patterns in a North-American center. Int J Infect Dis 2012;16:e41-e3.

Clinical and Laboratory Standards Institute. Reference method for broth dilution antifungal susceptibility testing of yeasts; approved standard. 3rd ed. M27–A3. Wayne: CLSI; 2008. (Accessed March 6, 2016, at http://shop.clsi.org/site/Sample_pdf/M27A3_sample.pdf).

Saranya S, Moorthy K, Malar S, Punitha T, Vinodhini R, Bhuvaneshwari M, et al. Prevalence and antifungal susceptibility pattern of Candida albicans from low socio-economic group. Int J Pharm Pharmaceutical Sci 2014;6:158-62.

Fesharaki SH, Haghani I, Mousavi B, Kargar ML, Boroumand M, Anvari MS, et al. Endocarditis due to a co-infection of Candida albicans and Candida tropicalis in a drug abuser. J Med Microb 2013;62:1763-7.

Laal Kargar M, Fooladi-Rad S, Mohammad Davoudi M, Khalilzadeh S, Hassanzad M, Mayahi S, et al. Fungal Colonization in Patients with Cystic Fibrosis. J Mazand Univ Med Sci 2013;23:204-18.

Kumar S, Vyas A, Kumar M, Mehra S. Application of chromagar Candida for identification of clinically important Candida species and their antifungal susceptibility pattern. Int J Biol Med Res 2013;4:3600-6.

Arendrup M, Dzajic E, Jensen R, Johansen HK, Kjaeldgaard P, Knudsen JD, et al. Epidemiological changes with potential implication for antifungal prescription recommendations for fungaemia: data from a nationwide fungaemia surveillance programme. Clin Microbiol Infect 2013;19:E343-53.

Pfaller MA, Messer SA, Woosley LN, Jones RN, Castanheira M. Echinocandin and triazole antifungal susceptibility profiles of opportunistic yeast and mould clinical isolates (2010-2011): Application of new CLSI clinical breakpoints and epidemiological cutoff values to characterize geographic and temporal trends of antifungal resistance. J Clin Microbiol 2013:51:2571-81.

Wiebusch L, Lonchiati D, Rodrigues L, Dantas C, Almeida A, Oliveira K. Profile susceptibility to fluconazole and voriconazole antifungals by species of Candida albicans isolated from urine culture. BMC Proc 2014;8:P34.

Njunda AL, Nsagha DS, Assob JC, Kamga HL, Teyim P. In vitro antifungal susceptibility patterns of Candida albicans from HIV and AIDS patients attending the Nylon Health District Hospital in Douala, Cameroon. J Public Health Africa 2012;3:2.

Wabe NT, Hussein J, Suleman S, Abdella K. In vitro antifungal susceptibility of Candida albicans isolates from oral cavities of patients infected with human immunodeficiency virus in Ethiopia. Retrovirology 2012;9:P44.

Roy R, Sharma G, Barman S, Chanda S. Trend of Candida infection and antifungal resistance in a tertiary care hospital of north east India. Blood 2013;100:19.

Al-mamari A, Al-buryhi M, Al-heggami MA, Al-hag S. Identify and sensitivity to antifungal drugs of Candida species causing vaginitis isolated from vulvovaginal infected patients in Sana’a city. Der Pharma Chemica 2014;6:336-42.

Aher CS. Species distribution, virulence factors and antifungal susceptibility profile of Candida isolated from Oropharyngeal lesions of HIV infected patients. Int J Curr Microbiol App Sci 2014;3:453-60.

Awari A. Species distribution and antifungal susceptibility profile of Candida isolated from urine samples. Int J App Basic Med Res. 2011;18:228-34.

Zhang L, Zhou S, Pan A, Li J, Liu B. Surveillance of antifungal susceptibilities in clinical isolates of Candida species at 36 hospitals in China from 2009 to 2013. Int J Infect Dis 2015;33:1-4.

Yazdanparast SA, Khodavaisy S, Fakhim H, Shokohi T, Haghani I, Nabili M, et al. Molecular Characterization of Highly Susceptible Candida africana from Vulvovaginal Candidiasis. Mycopathologia 2015;180:317-23.

Published
2016-06-08
How to Cite
1.
Sharifynia S, Badali H, Sharifi Sorkherizi M, Shidfar MR, Hadian A, Shahrokhi S, Ghandchi G, Rezaie S. In Vitro Antifungal Susceptibility Profiles of Candida albicans Complex Isolated from Patients with Respiratory Infections. Acta Med Iran. 54(6):376-381.
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Articles