Abstract
Background: Candida infection is considered one of the most dangerous infections in intensive care unit patients (ICU). Resistance to azoles is a major challenging condition in treating candida infections. Mutations or overexpression of the ERG 11 gene may contribute to azoles resistance. Methods: This prospective study evaluated 300 clinical samples including sputum, blood, urine, wound swabs, and pus obtained from different ICU patients. Different candida species were identified phenotypically by conventional methods and biochemical analysis by API 20 C kit (api® Candida) and confirmed by VITEK 2 compact system using identification yeast ID-YST cards. Antifungal susceptibility testing was performed using the VITEK 2 compact system followed by detection of ERG11-2 gene overexpression by RT-PCR in azoles resistant candida species. Results: A total of 165 candida species were detected from 300 clinical samples. C. albicans was identified in 59.4%. Most of C. albicans and non albicans were isolated from sputum samples. Only 17% of the overall isolated Candida species were resistant to fluconazole while 5% were resistant to voriconazole. Overexpression of the ERG11 gene was detected only in 10 isolates. Conclusion: Increased ERG11 gene expression may be one of the leading causes of azoles resistance among candida species in ICU patients.
Highlights
Candida species are the main leading cause of fungal infections that are usually associated with wide range of infections either mild mucocutaneous candidiasis or severe invasive candidiasis with high morbidity and mortality rate [1].Multiple risk factors like prolonged use of broad-spectrum antibiotics, immunosuppression, and the use of invasive devices are associated with high incidence of Candida infections in intensive care unit (ICU) patients [2].Most cases of candidiasis are caused by Candida albicans (C. albicans)
A total of 165 candida species were isolated from 300 clinical samples
Candida albicans was identified in 98 samples (59.4%), non-albicans species were isolated in 67 samples (40.6%), most cases of Candida infection were detected in older age patients between 51 to 60 years old, more females were reported in cases with Candida infection representing 57% and 66% of C. albicans and non-albicans infection respectively
Summary
Candida species are the main leading cause of fungal infections that are usually associated with wide range of infections either mild mucocutaneous candidiasis or severe invasive candidiasis with high morbidity and mortality rate [1].Multiple risk factors like prolonged use of broad-spectrum antibiotics, immunosuppression, and the use of invasive devices are associated with high incidence of Candida infections in intensive care unit (ICU) patients [2].Most cases of candidiasis are caused by Candida albicans (C. albicans). Multiple risk factors like prolonged use of broad-spectrum antibiotics, immunosuppression, and the use of invasive devices are associated with high incidence of Candida infections in intensive care unit (ICU) patients [2]. Candida infection is considered one of the most dangerous infections in intensive care unit patients (ICU). Resistance to azoles is a major challenging condition in treating candida infections. Mutations or overexpression of the ERG11 gene may contribute to azoles resistance. Antifungal susceptibility testing was performed using the VITEK 2 compact system followed by detection of ERG11-2 gene overexpression by RT-PCR in azoles resistant candida species. Conclusion: Increased ERG11 gene expression may be one of the leading causes of azoles resistance among candida species in ICU patients
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
