Molecular diagnosis and antifungal resistance and biofilm production profiles among Candida species isolated from immunocompromised patients at Menoufia University Hospitals

Abstract

Background: Accurate and rapid identification of Candida species is necessary for proper diagnosis and treatment of candidiasis due to emergences of drug-resistant strains especially among immunocompromised patients. Objectives: Identification of Candida clinical isolates to the species level using different phenotypic and molecular methods. Biofilm-forming ability and antifungal resistance were also studied. Methodology: Sixty-nine Candida strains were isolated from 220 immunocompromised patients. Identification was performed using chromogenic Candida agar, VITEK 2 system and multiplex polymerase chain reaction (PCR). Biofilm formation was detected by the tube method and antifungal susceptibility was tested using the VITEK2 system. Results: The most common source of Candida isolates was from urine (33.3%) and ICUs (56.6%). VITEK 2 system detected 9 spp.: C. albicans (34.8%), C. tropicalis (21.7%), C. famata (8.7%), C. lusitaniae (7.2%), C. cruzi (7.2%), C. ciferri (5.8%), C. dubliniensis (5.8%), C. parapsilosis (5.8 %) and C. glabrata. Candida isolates showed high resistance to flucytocine (49.3%), and high sensitivity to fluconazole, micafungin, voriconazole and caspofungin (88.4%, 81.2% and 81.2 % respectively). Only 30.4% of all Candida isolates were biofilm producers. There was a positive relationship between antifungal resistance and biofilm formation among Candida isolates. Conclusion: C. albicans was the predominant species. Chromogenic Candida agar and VITEK 2 system were valuable tests compared to PCR in speciation of Candida isolates. Antifungal susceptibility was significantly related to biofilm production and its evaluation is important for proper treatment..

Phenotypic identification and antifungal susceptibility patterns of Candida species isolated from various clinical specimens in Suez Canal University Hospitals

“…Bhattacharjee [28] reported higher resistance rates to fluconazole which was 34.38%. Khairat et al [18], Ghonaim et al [29] and El-Ganiny et al [14] also reported higher levels of resistance against fluconazole which were 41.8%, 33.3% and 13.1%, respectively. However, lower fluconazole resistance rates were detected in Taiwan, Egypt, Brazil, and Portugal [10,[30][31][32].…”