Molecular identification and antifungal susceptibility of Candia tropicalis and Candida parapsilosis isolated from cancer patients

Abstract

Candida species cause  systemic Candidiasis in immunocompromised cancer patients. Currently, a large proportion of bloodstream infections are due to non-Candida albicans Candida spp. (Candida species other than C. albicans), with Candida tropicalis and Candida parapsilosis being the most isolated Candida species from cancer patients. In this study, 52 Candida isolates collected from cancer patient at the Apeksha Hospital, Maharagama, Sri Lanka. Molecular identification of isolated Candida samples employed a multiplex PCR technique utilizing specific primer pairs for two strains of both Candida tropicalis and Candida parapsilosis. Furthermore, to determine the susceptibility of the identified isolates, antifungal susceptibility testing was conducted using the disk diffusion method on Mueller-Hinton agar medium. Six antifungal drugs, including Fluconazole, Itraconazole, Clotrimazole, Miconazole, Ketoconazole, and Amphotericin B, were utilized in the susceptibility testing. In this study 38% was identified as Candida tropicalis II  while, 31% was  identified  as  Candida parapsilosis II. According to this study Fluconazole was the most susceptible drug against both species and Amphotericin B was the least susceptible drug. Ketoconazole, Clotrimazole, Itraconazole and Miconazole showed varying degrees of susceptibility patterns. The study concludes that multiplex PCR is a better approach for the identification of both Candida tropicalis and Candida parapsilosis for clinical and diagnostic purposes and Fluconazole is the best antifungal drug against Candida parapsilosis, while caution is advised when using Amphotericin B as a treatment option since its’ low susceptible rates.