Molecular discrimination and antifungal susceptibility profile of cryptic Candida albicans complex species isolated from patients in Iran
-
Ashkan Faridi
,
Azam Amanizadeh
,
Seyyed Amin Ayatollahi Mosavi
,
Samira Salari
,
Davood Kalantar-Neyestanaki
,
Somayeh Sharifynia
,
Setareh Agha Kuchak Afshari
Abstract
Background and Objectives: Candida albicans complex species are well known as the main cause of candidiasis, particularly among susceptible individuals. In this study, we report the genetic diversity of Candida spp. and the antifungal susceptibility pattern of the cryptic C. albicans complex isolates in Kerman, Iran.
Materials and Methods: A total of 112 yeast isolates were obtained from different clinical samples, and molecular identification was performed. All C. albicans complex isolates were tested for susceptibility of them to amphotericin B, fluconazole, and itraconazole.
Results: The majority of clinical isolates were C. albicans complex (n=48) followed by C. glabrata complex (n=34), C. parapsilosis complex (n=21), and C. krusei (n=9). Among C. albicans complex, 45 isolates were C. albicans (94%), 2 isolates were C. dubliniensis (4%), and 1 isolate was C. africana (2%). Amphotericin B was the most active antifungal, whereas 8.9% and 6.7% of the isolates were resistant to fluconazole and itraconazole, respectively.
Conclusion: Regarding the high incidence of Candida infections particularly in susceptible populations and the emergence of an infrequent yeast species with elevated MICs, which is indistinguishable with conventional methods, developing accurate molecular methods for laboratory diagnosis should be considered in the clinical setting.
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10. 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: 230-233.
11. Shan Y, Fan S, Liu X, Li J. Prevalence of Candida albicans-closely related yeasts, Candida africana and Candida dubliniensis, in vulvovaginal candidiasis. Med Mycol 2014; 52: 636-640.
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13. Romeo O, De Leo F, Criseo G. Adherence ability of Candida africana: a comparative study with Candida albicans and Candida dubliniensis. Mycoses 2011; 54(4): e57-e61.
14. Bulik CC, Sobel JD, Nailor MD. Susceptibility profile of vaginal isolates of Candida albicans prior to and following fluconazole introduction–impact of two decades. Mycoses 2011; 54: 34-38.
15. Mirhendi H, Makimura K, Khoramizadeh M, Yamaguchi H. A one-enzyme PCR-RFLP assay for identification of six medically important Candida species. Nihon Ishinkin Gakkai Zasshi 2006; 47: 225-229.
16. Deorukhkar SC, Saini S, Mathew S. Non-albicans Candida infection: an emerging threat. Interdiscip Perspect Infect Dis 2014; 2014: 615958.
17. Guinea J. Global trends in the distribution of Candida species causing candidemia. Clin Microbiol Infect 2014; 20 Suppl 6: 5-10.
18. Kaur R, Dhakad MS, Goyal R, Haque A, Mukhopadhyay G. Identification and antifungal susceptibility testing of Candida species: a comparison of Vitek-2 system with conventional and molecular methods. J Glob Infect Dis 2016; 8: 139-146.
19. Nouraei H, Sheykhi S, Zare Shahrabadi Z, Khodadadi H, Zomorodian K, Pakshir K. Comparative analysis of virulence factors of homozygous and heterozygous strains of Candida albicans vaginal isolates. Int J
Microbiol 2020; 2020: 8889224.
20. Sharifynia S, Rezaie S, Mohamadnia A, Mortezaee V, Hadian A, Seyedmousavi S. Genetic diversity and antifungal susceptibility of Candida albicans isolated from Iranian patients. Med Mycol 2019; 57: 127-131.
21. Gharehbolagh SA, Fallah B, Izadi A, Ardestani ZS, Malekifar P, Borman A, et al. Distribution, antifungal susceptibility pattern and intra-Candida albicans species complex prevalence of Candida africana: A systematic review and meta-analysis. PLoS One 2020; 15(8): e0237046.
22. Nikmanesh B, Ahmadikia K, Getso MI, Gharehbolagh SA, Aboutalebian S, Mirhendi H, et al. Candida africana and Candida dubliniensis as causes of pediatric candiduria: A study using HWP1 gene size polymorphism. AIMS Microbiol 2020; 6: 272-279.
23. Shokoohi G, Javidnia J, Mirhendi H, Rasekh-Jahromi A, Rezaei-Matehkolaei A, Ansari S, et al. Molecular identification and antifungal susceptibility profiles of Candida dubliniensis and Candida africana isolated from vulvovaginal candidiasis: A single‐centre experience in Iran. Mycoses 2021; 64: 771-779.
24. Farahyar S, Izadi S, Razmjou E, Falahati M, Roudbary M, Ashrafi-Khozani M, et al. Low prevalence of antifungal resistant Candida africana, in the C. albicans complex causing vulvovaginal candidiasis. Heliyon 2020; 6(3): e03619.
2. Ciurea CN, Kosovski IB, Mare AD, Toma F, Pintea-Simon IA, Man A. Candida and candidiasis—opportunism versus pathogenicity: a review of the virulence traits. Microorganisms 2020; 8: 857.
3. Vitális E, Nagy F, Tóth Z, Forgács L, Bozó A, Kardos G, et al. Candida biofilm production is associated with higher mortality in patients with candidaemia. Mycoses 2020; 63: 352-360.
4. Morgan J, Meltzer MI, Plikaytis BD, Sofair AN, Huie-White S, Wilcox S, et al. Excess mortality, hospital stay, and cost due to candidemia: a case-control study using data from population-based candidemia surveillance. Infect Control Hosp Epidemiol 2005; 26: 540-547.
5. Antinori S, Milazzo L, Sollima S, Galli M, Corbellino M. Candidemia and invasive candidiasis in adults: A narrative review. Eur J Intern Med 2016; 34: 21-28.
6. Fontecha G, Montes K, Ortiz B, Galindo C, Braham S. Identification of cryptic species of four Candida complexes in a culture collection. J Fungi (Basel) 2019;5:117.
7. Criseo G, Scordino F, Romeo O. Current methods for identifying clinically important cryptic Candida species. J Microbiol Methods 2015; 111: 50-56.
8. Tietz HJ, Hopp M, Schmalreck A, Sterry W, Czaika V. Candida africana sp. nov., a new human pathogen or a variant of Candida albicans? Mycoses 2001; 44: 437-445.
9. Asadzadeh M, Ahmad S, Al-Sweih N, Khan Z. Rapid and accurate identification of Candida albicans and Candida dubliniensis by real-time PCR and melting curve analysis. Med Princ Pract 2018; 27: 543-548.
10. 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: 230-233.
11. Shan Y, Fan S, Liu X, Li J. Prevalence of Candida albicans-closely related yeasts, Candida africana and Candida dubliniensis, in vulvovaginal candidiasis. Med Mycol 2014; 52: 636-640.
12. Romeo O, Criseo G. Molecular epidemiology of Candida albicans and its closely related yeasts Candida dubliniensis and Candida africana. J Clin Microbiol 2009; 47: 212-214.
13. Romeo O, De Leo F, Criseo G. Adherence ability of Candida africana: a comparative study with Candida albicans and Candida dubliniensis. Mycoses 2011; 54(4): e57-e61.
14. Bulik CC, Sobel JD, Nailor MD. Susceptibility profile of vaginal isolates of Candida albicans prior to and following fluconazole introduction–impact of two decades. Mycoses 2011; 54: 34-38.
15. Mirhendi H, Makimura K, Khoramizadeh M, Yamaguchi H. A one-enzyme PCR-RFLP assay for identification of six medically important Candida species. Nihon Ishinkin Gakkai Zasshi 2006; 47: 225-229.
16. Deorukhkar SC, Saini S, Mathew S. Non-albicans Candida infection: an emerging threat. Interdiscip Perspect Infect Dis 2014; 2014: 615958.
17. Guinea J. Global trends in the distribution of Candida species causing candidemia. Clin Microbiol Infect 2014; 20 Suppl 6: 5-10.
18. Kaur R, Dhakad MS, Goyal R, Haque A, Mukhopadhyay G. Identification and antifungal susceptibility testing of Candida species: a comparison of Vitek-2 system with conventional and molecular methods. J Glob Infect Dis 2016; 8: 139-146.
19. Nouraei H, Sheykhi S, Zare Shahrabadi Z, Khodadadi H, Zomorodian K, Pakshir K. Comparative analysis of virulence factors of homozygous and heterozygous strains of Candida albicans vaginal isolates. Int J
Microbiol 2020; 2020: 8889224.
20. Sharifynia S, Rezaie S, Mohamadnia A, Mortezaee V, Hadian A, Seyedmousavi S. Genetic diversity and antifungal susceptibility of Candida albicans isolated from Iranian patients. Med Mycol 2019; 57: 127-131.
21. Gharehbolagh SA, Fallah B, Izadi A, Ardestani ZS, Malekifar P, Borman A, et al. Distribution, antifungal susceptibility pattern and intra-Candida albicans species complex prevalence of Candida africana: A systematic review and meta-analysis. PLoS One 2020; 15(8): e0237046.
22. Nikmanesh B, Ahmadikia K, Getso MI, Gharehbolagh SA, Aboutalebian S, Mirhendi H, et al. Candida africana and Candida dubliniensis as causes of pediatric candiduria: A study using HWP1 gene size polymorphism. AIMS Microbiol 2020; 6: 272-279.
23. Shokoohi G, Javidnia J, Mirhendi H, Rasekh-Jahromi A, Rezaei-Matehkolaei A, Ansari S, et al. Molecular identification and antifungal susceptibility profiles of Candida dubliniensis and Candida africana isolated from vulvovaginal candidiasis: A single‐centre experience in Iran. Mycoses 2021; 64: 771-779.
24. Farahyar S, Izadi S, Razmjou E, Falahati M, Roudbary M, Ashrafi-Khozani M, et al. Low prevalence of antifungal resistant Candida africana, in the C. albicans complex causing vulvovaginal candidiasis. Heliyon 2020; 6(3): e03619.
| Files | ||
| Issue | Vol 14 No 3 (2022) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/ijm.v14i3.9795 | |
| Keywords | ||
| Candida albicans; Candidiasis; Polymerase chain reaction; Amphotericin B; Itraconazole; | ||
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Faridi A, Amanizadeh A, Ayatollahi Mosavi SA, Salari S, Kalantar-Neyestanaki D, Sharifynia S, Agha Kuchak Afshari S. Molecular discrimination and antifungal susceptibility profile of cryptic Candida albicans complex species isolated from patients in Iran. Iran J Microbiol. 2022;14(3):423-429.
