Antifungal susceptibility patterns and virulence factors of clinical Candida spp. isolates

Abstract

Objective. The global emergence of antifungal resistance among Candida spp. is a growing threat to public health. Candida infections may resist antifungal drugs actions resulting in their therapeutic deficiency. Considering the increase rate of Candida infections and resistance to antifungal agents in the last decades, this study was conducted to evaluate the in vitro expression of different virulence factors among clinical isolates of Candida species, as well as to assay their susceptibility patterns against antifungal agents. Material and methods. Chromogenic media was used for Candida isolation. A total of 127 Candida isolates were identified by conventional methods, Vitek 2 system. The antifungal susceptibility test was carried out by Vitek-2 system. Candida species were tested for virulence factors such as extracellular enzymes and biofilm formation by the standard phenotypic methods. Results. C. albicans continues to remain one of the most common opportunistic pathogenic fungi in humans. The authors highlighted the importance of research on understanding the mechanisms of antifungal resistance and its pathogenicity. The study demonstrates that C. albicans isolates were the most virulent and produce the highest number of extracellular enzymes: hemolysin, phospholipase, protease, esterase and catalase. The study showed the most effective antifungal agent was fucitozin (98.4%), while 29.4% isolates were resistant to fluconazole and 11.8% to voriconazole. Conclusion. C. albicans were the most virulent and produce the highest number of extracellular enzymes compared to non-albicans Candida isolates. The study showed the most effective antifungal agent was fucitozin. In conclusion, more locally relevant studies should be carried out to monitoring of the distribution and susceptibility profile.