Abstract
INTRODUCTION: The aim of this study was to evaluate some virulence factors in Candida albicans isolates from patients with onychomycosis and determine the correlation between these factors and the antifungal resistance profile. METHODS: Seventy species of C. albicans were confirmed using polymerase chain reaction amplification of the HWP1 gene. According to the Clinical & Laboratory Standards Institute guidelines, the susceptibility profile of four antifungal agents was investigated, and the production of aspartyl protease, phospholipase, haemolysin, and biofilm was determined. The correlation between these profiles was also investigated.RESULTS: The isolates indicated different levels of resistance and production of virulence factors. Significant correlations were observed between the minimum inhibitory concentration (MIC) of fluconazole/itraconazole and biofilm production, between phospholipase production and fluconazole/itraconazole MIC, and between fluconazole MIC and hemolytic activity in C. albicans isolates. The results also showed significant correlations between phospholipase activity and biofilm production.CONCLUSIONS: Our findings will contribute to a better understanding of the pathogenesis of C. albicans and characterize the relationship between virulence factors and antifungal resistance, which may suggest new therapeutic strategies considering the possible involvement of the virulence mechanism in the effectiveness of treatment.
Highlights
The aim of this study was to evaluate some virulence factors in Candida albicans isolates from patients with onychomycosis and determine the correlation between these factors and the antifungal resistance profile
The results showed significant correlations between phospholipase activity and biofilm production in C. albicans isolates (P = 0.004, rs = 0.339)
The increasing resistance of C. albicans to antifungals possibly indicates the relationship between the antifungal resistance mechanisms and production of biofilms and extracellular enzymes[3,10]
Summary
The aim of this study was to evaluate some virulence factors in Candida albicans isolates from patients with onychomycosis and determine the correlation between these factors and the antifungal resistance profile. According to the Clinical & Laboratory Standards Institute guidelines, the susceptibility profile of four antifungal agents was investigated, and the production of aspartyl protease, phospholipase, haemolysin, and biofilm was determined. The correlation between these profiles was investigated. As Candida virulence factors, can improve the potential of fungal organisms to colonize and penetrate into the host tissue and disrupt the immune system[4] Phospholipase production is another major virulence factor of C. albicans, which binds the fungus to the target tissue and generates a pathway to enter the tissue following the hydrolysis of phospholipids and degradation of cell membranes[5]. Haemolysin, as another extracellular enzyme, contributes to the invasion of yeasts through absorption of iron[6].
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