Background
Fungal infections mainly caused by
Candida krusei
are increasing rapidly and represent a serious public health problem in human immunodeficiency virus (HIV)-infected patients. This study aimed to investigate the antifungal susceptibility profile and virulence factors in
C. krusei
isolated from HIV-infected patients.
Methodology
Isolates were identified by biochemical and molecular methods. The antifungal resistance profile was established based on the antifungal susceptibility test performed using the Sensititre YeastOne™ (Thermo Fisher Scientific, Waltham, MA) microdilution technique. The production of phospholipase and proteinase was detected by standard methods. Biofilm formation was performed by the microtiter plate method.
Results
A total of 73 isolates of
C. krusei
were recovered from stool, oral swabs, vaginal swabs, and urine samples. The highest number of
C. krusei
isolates (49, 67.05%)was recovered from stool samples. A total of 32.56% of the
C. krusei
isolates were multidrug-resistant (MDR). The patients living with HIV and not receiving antiretroviral treatment displayed the highest number of
C. krusei
isolates (29, 39.76%), whereas the patients living with HIV on antiretroviral therapy exhibited the lowest number of
C. krusei
isolates (2, 2.72%). All isolates were categorized as strong biofilm producers. Among the production of hydrolytic enzymes, 25 (58.13%) and 24 (55.81%) of
C. krusei
isolates were classified as strong phospholipase and proteinase producers, respectively.
Conclusion
The
C. krusei
isolates obtained in this study were MDR and strongly expressed biofilm formation and both phospholipase and proteinase hydrolytic enzymes. The results show how pathogenic
C. krusei
is in the HIV-infected population and will contribute toward the management of
C.
krusei-
related infections, which may help improve the life quality of people living with HIV.