Abstract
The very nature of infectious diseases has undergone profound changes in the past few decades. Fungi once considered as nonpathogenic or less virulent are now recognized as a primary cause of morbidity and mortality in immunocompromised and severely ill patients. Candida spp. are among the most common fungal pathogens. Candida albicans was the predominant cause of candidiasis. However, a shift toward non-albicans Candida species has been recently observed. These non-albicans Candida species demonstrate reduced susceptibility to commonly used antifungal drugs. In the present study, we investigated the prevalence of non-albicans Candida spp. among Candida isolates from various clinical specimens and analysed their virulence factors and antifungal susceptibility profile. A total of 523 Candida spp. were isolated from various clinical specimens. Non-albicans Candida species were the predominant pathogens isolated. Non-albicans Candida species also demonstrated the production of virulence factors once attributed to Candida albicans. Non-albicans Candida demonstrated high resistance to azole group of antifungal agents. Therefore, it can be concluded that non-albicans Candida species have emerged as an important cause of infections. Their isolation from clinical specimen can no longer be ignored as a nonpathogenic isolate nor can it be dismissed as a contaminant.
Highlights
Over the last few years, the incidence of mycotic infections has progressively increased
Out of 9 C. dubliniensis, 7 were isolated from oropharyngeal swabs collected from HIV infected patients with oropharyngeal candidiasis (OPC), whereas 2 were isolated from vaginal swabs collected from HIV noninfected clinically suspected cases of vulvovaginal candidiasis (VVC)
C. glabrata was the major isolate from cases of candidemia followed by C. tropicalis and C. albicans (Table 1)
Summary
Over the last few years, the incidence of mycotic infections has progressively increased. Candida spp. are among the most common fungal pathogens. They are capable of initiating infections in both immunocompetent individuals and immunocompromised hosts, but the incidence of infections is more in immunocompromised individuals; candidiasis, is rightly called the “disease of diseased” [2]. Candida spp., though commensal organisms that normally colonize mucosal surfaces in an asymptomatic manner, can become one of the most significant causes of disabling and lethal infection [3]. Candida spp. are responsible for various clinical manifestations ranging from mucocutaneous overgrowth to life threatening disseminated infections like candidemia [4]
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