Detection of antifungal drug-resistant and ERG11 gene mutations among clinical isolates of Candida species isolated from Khartoum, Sudan.

Abstract

Background: Candida species are one of the most important opportunistic fungal pathogens that cause both superficial and systemic infections, especially in immunocompromised individuals. Considering the sharp increase in the rate of Candida infections, and resistance to commonly used antifungal agents in the last decades; this study was conducted to determine the rate of resistance among clinical isolates of Candida species, and to characterize some of the resistant genes among resistant isolates collected in Khartoum. Methods: This is a cross-sectional laboratory-based study included 100 pre-screened Candida species isolates from Khartoum state hospitals. Chromogenic media was used for Candida isolation and/or identification. The standard disc diffusion method was performed to investigate the susceptibility to fluconazole, itraconazole, and amphotericin. Following genomic DNA extraction, the entire ERG11 gene was amplified from some C. albicans resistant isolates, sequenced, and further analyzed. Results: Out of 100 clinical isolates collected, 51% were C. albicans, followed by C. glabrata (31%), C. krusie (8%), C. tropicals (5%), and C. dupliniens (5%). Resistance rate was 23% for fluconazole, 4% for itraconazole, while there were no amphotericin resistant isolates detected. C. albicans ERG11 gene sequence reveals 15 different mutations. Among these, three (D116E, E266D, and V488I) were missense mutations; however, these substitutions do not contribute to fluconazole resistance. Conclusion: C. albicans was found to be the most common species. Resistance against fluconazole was observed most frequently; however, mutations in ERG11 are unlikely to be the reason behind fluconazole resistance among these isolates.

Potential Anti-fungal Activity of Lactobacilli Probiotic Against Fluconazole Resistant Candida albicans Clinical Isolates

“…All C. albicans isolates exhibited 100% sensitivity to amphotericin B. This result is analogous to studies conducted by other authors 35,36 . Despite the fact that polyenes have been used for a long time, resistance to amphotericin B is rare, because it has fungicidal activity as it binds to ergosterol that present in the fungal membrane, resulting in pore formation and hence disrupting membrane structure and function 46 .…”

“…They reported 59.6% and 57.4% prevalence rate of C. albicans isolates respectively. Also, Mohammed et al stated that C. albicans was the predominant isolated species (51%) 36 .…”

“…Kaur et al found that 36.3% of C. albicans isolated from different samples were FLZ resistant 39 . Mohamed et al reported 23% FLZ resistance in C. albicans isolates 36 .…”

Six-Year Retrospective Analysis of Epidemiology, Risk Factors, and Antifungal Susceptibilities of Candidiasis from a Tertiary Care Hospital in South China

“…The lower susceptibilities of candidemia-causing NCA isolates might be due to prescribers’ persisting use of empirical prophylactic treatments ( 6 ). Additionally, this study shows that NCA was more prone to becoming resistant than C. albicans ( 60 ). Based on our findings, we recommend conducting additional research to determine the appropriate use of azole drugs as empirical therapy ( 21 , 61 ).…”