Non-Candida albicans Candida Species: Virulence Factors and Species Identification in India

Abstract

Background and Purpose: The predominant cause of candidiasis was Candida albicans which has recently changed to non-Candida albicans Candida (NCAC) (i.e., Candida spp. other than the C. albicans). The NCAC spp., earlier considered non-pathogenic or minimally virulent, are now considered a primary cause of morbidity and mortality in immunocompromised individuals. Given the NCAC spp.has become more common in clinical cases, this study aimed to determine the prevalence of NCAC spp. in different clinical specimens and assess a few of their virulence factors.
 Materials and Methods: Routine samples for bacterial culture and sensitivity that showed colony characteristics, like Candida on Blood Agar and microscopic features resembling Candida spp., were processed further. Candida isolates underwent tests for chlamydospore formation and biochemical tests, including sugar fermentation and sugar assimilation tests. These were grown at 42oC, and their colony color was identified using HiCrome™ Candida Differential Agar (HiMedia Laboratories Pvt. Ltd., Mumbai,India), HiCandidaTM Identification Kit (HiMedia Laboratories Pvt. Ltd., Mumbai, India),and VITEK-2® Compact (Biomérieux, France). Virulence factors, such as adherence to buccal epithelial cells (ABEC), biofilm formation, hemolytic activity, and production of coagulase enzyme were also tested.
 Results: Mean age of the patients was 38.46 years with a male-female ratio of 1.36:1. In total, 137 Candida isolates were recovered; 45.3%, 19.7%, and 13.9% of the isolates were isolated from urine, vaginal swabs, and oropharyngeal swabs, respectively. Moreover, 55(40.1%) isolates were those of C. albicans and 82 (59.9%) isolates belonged to NCAC spp.,with C. tropicalis (23.4%) contributing highest among NCAC species. Furthermore, C. albicans (3; 50%) was the most common spp. in cases of candidemia. Haemolysin production (85.5%) and ABEC (78.2%) were the major virulence factors in C. albicans. C.tropicalis (59.4%) and C. dubliniensis (50%) showed maximum ABEC. Biofilm forming capacity was higher in C. tropicalis (78.1%) than C. albicans (67%).
 Conclusion: Results of this study suggest varied prevalence and virulence based on geographical locations, even within a subcontinent. It clearly indicates the emergence of the NCAC spp. and their predominance in different body fluids. Identification of Candida to the spp. level should become a routine in all laboratories.

Candida species isolated from clinical samples in a tertiary hospital in Honduras: Where is Candida auris?

“…Our results coincide with two available studies on the epidemiology of Candida in Honduras [ 20 , 25 ] in which C. albicans is described as the predominant yeast in urine and sputum. Similarly, our results are also similar to those previously reported elsewhere [ 32 , 34 , 35 ]. The clinical significance of yeasts in urine and sputum is still not entirely clear, as it could indicate contamination, commensalism, colonization, or even a localized infection that could later evolve into a disseminated infection [ 20 , 36 ].…”

Candida spp. Associated With COVID-19 And Its Susceptibility To Some Antifungals

“…positive reaction, -: negative reaction, *: strain variation The results of this test were the same as those of Hedayati, et al [37] in which the data showed that Candida species were accurately identified using the HiCandida identification kit, which is also conforms to Singh, et al [38] who stated that Identification was accomplished with the support of diagnostic by using this kit.…”

Mycological Profile of Candida tropicalis and its Virulence Factors from Candidemia Patients at A Tertiary Care Facility

“…However, a lot of research publications discuss the development of virulence among NAC species. [38][39][40] The demonstration of virulence factors shows that 43 (61.43%) isolates showed phospholipase activity and 25 isolates of C.tropicalis showed maximum phospholipase activity. These results were correlated with the study findings of Sachin C et al which showed that 60.9% of isolates demonstrated phospholipase activity and 76% and phospholipase activity was predominantly produced by 19 isolates of C. tropicalis.…”