Antifungal susceptibility of non-albicans Candida spp. isolated from raw milk and human blood in Alborz and Tehran provinces

  • Zahra Namvar Depatment of Microbiology, School of Biological Sciences, Islamic Azad University, North Tehran Branch, Tehran, Iran
  • Abbas Akhavan Sepahy Depatment of Microbiology, School of Biological Sciences, Islamic Azad University, North Tehran Branch, Tehran, Iran
  • Robab Rafiei Tabatabaei Depatment of Microbiology, School of Biological Sciences, Islamic Azad University, North Tehran Branch, Tehran, Iran
  • Sassan Rezaie Depatment of Medical Mycology and Parasitology, Division of Molecular Biology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
Keywords: Candida parapsilosis; Candida glabrata; Candida krusei; Candida tropicalis; Antifungal; Raw milk


Background and Objectives: Recent reports indicate high prevalence of fungal infections due to non-albicans Candida spp. which are present in various environments such as raw milk. The quality of milk for fungal normal flora was investigated in this study.
Materials and Methods: A total of 262 milk samples were collected directly from milk collection tanks indesignated dairy farms and cultured in SDA media. By further analysis of grown yeasts, 69 non-albicans Candida strains were identified. Antifungal susceptibility of the isolated species, were evaluated against amphotericin B, itraconazole, fluconazole and flucytosine. Fifty two non-albicans clinical samples isolated from human blood have been evaluated along.
Results: Antifungal susceptibility evaluation in non-albicans strains isolated from milk revealed Candida glabrata and Candida tropicalis to be 100% sensitive to flucytosine and fluconazole. Candida krusei showed 94% and 80% sensitivity to flucytosine and fluconazole respectively. Candida parapsilosis indicated 72.72% sensitivity to fluconazole.
Conclusion: Evaluation of non-albicans Candida species in raw milk and antifungal susceptibility patterns of these isolatescompare with non-albicansisolates from human blood, may help physicians to choose an appropriate medication for diseases needing long-term treatment, especially for diseases caused by local strains.


1. Neviani E, Bottari B, Lazzi C, Gatti M. New developments in the study of the microbiota of raw-milk, long-ripened cheeses by molecular methods: the case of Grana Padano and Parmigiano Reggiano. Front Microbiol 2013;4:36.
2. Reiss E, Tanaka K, Bruker G, Chazalet V, Coleman D, Debeaupuis J, et al. Molecular diagnosis and epidemiology of fungal infections. Med Mycol 1998;36 Suppl 1:249-257.
3. Martin GS, Mannino DM, Eaton S, Moss M. The epidemiology of sepsis in the United States from 1979 through 2000. N Engl J Med 2003;348:1546-1554.
4. Kullberg BJ, Arendrup MC. Invasive Candidiasis. N Engl J Med 2015: 373: 1445-1456.
5. Mendes J, Gonçalves C, Ferreira G, Esteves I, Freitas C, Villarreal J, et al. Antifungal susceptibility profile of diferent yeasts isolates from wild animals, cow’s milk with subclinical mastitis and hospital environment. Braz J Biol 2018;78:68-75.
6. de Aguiar Cordeiro R, Pereira de Alencar L, Nogueira Brilhante RS, de Souza Collares Maia Castelo-Branco D, Cordeiro Teixeira CE, de Brito Macedo R, et al. Antifungal susceptibility of emerging opportunistic yeasts and yeast-like fungi from Rhea americana. Can J Microbiol 2013;59:577-580.
7. Baghdadi E, Khodavaisy S, Rezaie S, Abolghasem S, Kiasat N, Salehi Z, et al. Antifungal susceptibility patterns of Candida species recovered from endotracheal tube in an intensive care unit. Adv Med 2016;2016:9242031.
8. Mohammadi R, Mirhendi H, Rezaei-Matehkolaei A, Ghahri M, Shidfar MR, Jalalizand N, et al. Molecular identification and distribution profile of Candida species isolated from Iranian patients. Med Mycol 2013;51:657-663.
9. Borghi E, Iatta R, Sciota R, Biassoni C, Cuna T, Montagna MT, et al. Comparative evaluation of the Vitek 2 yeast susceptibility test and CLSI broth microdilution reference method for testing antifungal susceptibility of invasive fungal isolates in Italy: the GISIA3 study. J Clin Microbiol 2010;48:3153-3157.
10. Fernandes T, SilvaS, Henriques M. Candida tropicalis biofilm's matrix—involvement on its resistance to amphotericin B. Diagn Microbiol Infect Dis 2015;83:165-169.
11. Bruder-Nascimento A, Camargo CH, Mondelli AL, Sugizaki MF, Sadatsune T, Bagagli E. Candida species biofilm and Candida albicans ALS3 polymorphisms in clinical isolates. Braz J Microbiol 2014;45:1371-1377.
12. Álvarez-Pérez S, García ME, Peláez T, Martínez-Nevado E, Blanco JL. Antifungal susceptibility testing of ascomycetous yeasts isolated from animals. Antimicrob Agents Chemother 2016; 60: 5026-5028.
13. Silva S, Henriques M, Martins A, Oliveira R, Williams D, Azeredo J. Biofilms of non-Candida albicans Candida species: quantification, structure and matrix composition. Med Mycol 2009;47:681-689.
14. Chagas-Neto TC, Chaves GM, Melo AS, Colombo AL. Bloodstream infections due to Trichosporon spp.: species distribution, Trichosporon asahii genotypes determined on the basis of ribosomal DNA intergenic spacer 1 sequencing, and antifungal susceptibility testing. J Clin Microbiol 2009;47:1074-1081.
15. Hazirolan G, Canton E, Sahin S, Arikan-Akdagli S. Head-to-head comparison of inhibitory and cidal activities of fluconazole, itraconazole, voriconazole, posaconazole and isavuconazole against clinical isolates of Trichosporon asahii determined by three methods: MIC, minimum fungicidal concentration and time-kill curves. Antimicrob Agents Chemother 2013:57:4841-4847.
16. Kludze-Forson M, Eschenauer GA, Kubin CJ, Della-Latta P, Lam SW. The impact of delaying the initiation of appropriate antifungal treatment for Candida bloodstream infection. Med Mycol 2010;48:436-439.
17. Smith KD, Achan B, Hullsiek KH, McDonald TR, Okagaki LH, Alhadab AA, et al. Increased antifungal drug resistance in clinical isolates of Cryptococcus neoformans in Uganda. Antimicrob Agents Chemother 2015;59:7197-204.
18. Milici ME, Maida CM, Spreghini E, Ravazzolo B, Oliveri S, Scalise G, et al. Comparison between disk diffusion and microdilution methods for determining susceptibility of clinical fungal isolates to caspofungin. J Clin Microbiol 2007;45:3529-3533.
19. Thompson III GR, Wiederhold NP, Sutton DA, Fothergill A, Patterson TF. In vitro activity of isavuconazole against Trichosporon, Rhodotorula, Geotrichum, Saccharomyces and Pichia species. J Antimicrob Chemother 2009;64:79-83.
20. Du J, Wang X, Luo H, Wang Y, Liu X, Zhou X. Epidemiological investigation of non-albicans Candida species recovered from mycotic mastitis of cows in Yinchuan, Ningxia of China. BMC Vet Res 2018;14:251.
How to Cite
Namvar Z, Akhavan Sepahy A, Rafiei Tabatabaei R, Rezaie S. Antifungal susceptibility of non-albicans Candida spp. isolated from raw milk and human blood in Alborz and Tehran provinces. Iran J Microbiol. 11(6):520-526.
Original Article(s)