Abstract
Virulence factors and antifungal resistance features of Candida albicans considering a growing health problem worldwide. This study made to show the expression of both virulence and azole resistance genes at 100 clinical isolates of Candida we used a model of infection of human vaginal epithelial cells with C. albicans strains isolated from Egyptian women with vulvovaginal candidiasis (VVC). The detection and expression of virulence genes and azole resistance genes were performed using PCR technic. All isolates were susceptible to ketoconazole (KTC), 3 isolates (3%) only were resist to both nystatin (NY) and amphotericin B (AMB) ,all isolates found resist to griseofulvin (AGF) 10 µg, eighty five isolates (85%)were resist to flucytosine (AFY), four isolates (4%)were resist to miconazole (MCL), seventy one isolates (71%) were resist to voriconazole (VO), thirty three isolates (33 %) were resist to itraconazole (ITC), forty one isolates and twenty seven isolates (27%)were resist to 100 µg fluconazole (flu). All isolated strains expressed SAP4-SAP6 (100%) and almost all expressed SAP1-SAP3 (91%) In this study, fluconazole resistance was identified in 27% of the strains, whereas (27%) had positive ERG11 gene, (27%) were positive MDR1 gene and (14%) were positive CDR1 gene. The results indicate that the strains that infect Egyptian patients suffering from VVC are highly virulent and virtually all are insensitive to fluconazole.
Highlights
Candida albicans is a domain fungal species of the human microbiota and asymptomatically colonizes healthy people
C. albicans is the prevalent cause of invasion the fungal infections [2] and represents a serious challenge with increasing the medical and the economic importance due to the high mortality rates and increased costs of care and duration of hospitalization [3], [4].Clinical strains of C. albicans have many virulence genes that directly influence the pathogenesis of vulvovaginal candidiasis (VVC), including genes responsible for phenotypic switching [5], HWP1
Three isolates (3%) were resist to amphotericin B (AMB) 20 μg, eighty five isolates (85%) were resist to flucytosine (AFY) 1 μg, four isolates (4%) were resist to miconazole (MCL) 10 μg, seventy one isolates (71%) were resist to voriconazole (VO) 1 μg, thirty seven isolates (37%) were resist to 8 μg itraconazole, thirty three isolates (33%) were resist to 50 μg itraconazole, forty one isolates (41%) were resist to 25 μg fluconazole and twenty seven isolates (27%)were resist to 100 μg fluconazole, (Table 5)
Summary
Candida albicans is a domain fungal species of the human microbiota and asymptomatically colonizes healthy people. It is an opportunistic microorganism which can cause fatal bloodstream infections [1]. The raising of C. albicans resistant to antifungal agents, spicially to azoles, is a serious health problem and hampers the treatment of VVC. Many mechanisms responsible for azoles resistance include overexpression of CDR1 and CDR2 from the ABC transporter family and MDR1 which encodes a multidrug efflux pump.
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