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Research Arcle
Journal of Communicable Diseases (P-ISSN: 0019-5138 & E-ISSN: 2581-351X)
Copyright (c) 2024: Author(s). Published by Indian Society for Malaria and Other Communicable Diseases
Journal of Communicable Diseases
Volume 56, Issue 2 - 2024, Pg. No. 53-61
Peer Reviewed & Open Access Journal
Corresponding Author:
Bareq N Al-Nuaimi, Al-Iraqia University, College
of Medicine, Department of Microbiology.
E-mail Id:
Bareq.n.tareq@aliraqia.edu.iq
Orcid Id:
How to cite this arcle:
Al-Ameri A D, zghair A S, Al-Nuaimi N B , Adbdul
of Susceptibility of Candida species to Six
J Commun
Date of Submission: 2024-04-16
Date of Acceptance: 2024-06-24
INFO ABSTRACT
Evaluation of Susceptibility of Candida species
to Six Antifungal Drugs in Iraqi Specimens
Dhiey A Al-Aameri1, 2, Bareq N Al-Nuaimi3,4,
4,mah 3
Al-Iraqia University, College of Medicine, Department of Microbiology.
Mustansiriyah University, College of Medicine, Department of Microbiology.
DOI: httpsdoi.org
Introducon: Candida
CDC, about 7% of Candida
Candida
Objecve:Candida
Methods:
standards.
Results:Candida
albicans glabratadubliniensistropicalis
krusei parapsilosisugosa, C. lusitaniae,
and C. kyfer
Conclusion:
albicans
glabrata
had a 7% non-WT rate against AMB. C. tropicalis and C. parapsilosis
Keywords: Candida
54
Al-Ameri A D et al.
J. Commun. Dis. 2024; 56(2)
ISSN: 0019-5138
DOI: hps://doi.org/10.24321/0019.5138.202432
Introduction
The most prevalent fungi that cause fungaemia are of the
genus Candida
Candida
in severity from mild to lethal. Candida causes a range
of invasive life-threatening illnesses, from bloodstream
vulvovaginal, genitourinary, and oropharyngeal. Invasive
increases the length of hospitality. C. albicans is considered
a prevalent species causing candidiasis. Although, lately,
an epidemiological change for non-albicans Candida spp.
for azoles and echinocandin.
Unfortunately,
main divisions are used for human treatment. Based on
are currently used to treat candidiasis are categorised
Several combined factors have contributed to the clinical
The rising
and no vaccines invented against Candida. The increased
candidiasis incidence leads to increased drug usage, and
7
usage to treat Candida, as they are cheap, show reduced
toxicity, and are available for oral usage. One of the biggest
handicaps to achieving clinical success with azole is the
resistance among species of Candida and Aspergillus.
Due to prolonged azole usage worldwide, Candida species
resistant to azoles have increased, as the MICs level is
rising and failure of clinical treatment. Candida species
Despite that azole and echinocandins are pioneers in
Candida species have progressed
resistance against them.
The echinocandin drugs are
used for yeasts that show resistance to azoles, especially C.
glabrata. Prolonged exposure to echinocandin
reduced Candida
levels with failure of occasional treatment have been
Candida, especially C. glabrata.
Despite the growing resistance against the echinocandin
class, the rate of echinocandin resistance among Candida
with a wide range spectrum, used for systemic fungal
usage.
epidemiology. Some studies showed that the frequently
Candida
are uncommon species of Candida, including C. glabrata,
C. guilliermondii, and C. lusitaniae.
Candida species isolates in vitro.
resistance among Candida species during treatment. Nearly
Candida species intrinsically show resistance to
In the current study, isolates of Candida were tested
against six antifungal drugs, which are fluconazole,
itraconazole, voriconazole, amphotericin B, caspofungin,
determined. Also, the highly resistant species of Candida
against the studied drugs were revealed.
Materials and Methods
Sampling
samples included sputum, bronch-alveolar lavage, vaginal
55
Al-Ameri A D et al.
J. Commun. Dis. 2024; 56(2)
ISSN: 0019-5138
DOI: hps://doi.org/10.24321/0019.5138.202432
Antifungal Susceptibility Test
All isolates were submitted for identification and
flucytosine, amphotericin, caspofungin, fluconazole,
itraconazole, and voriconazole, using the ID&AST System
Reading Susceptibility Test Results
Statistical Analysis
variables on the study parameters. In this study, a chi-
square test was employed to compare the percentage
Results
The present study results showed that most candidiasis
Table 1.Divisions of Candida spp. in Different
Clinical Specimens Including Sex Groups
Site of Sample n (%) Male Female
specimen
---
Urine
Mouth
-
between sex groups
Table 2.Samples Distribution According to Age
Groups
Age Groups (Years) n (%)
Total
Chi-square
Total
p value
Incidence of Candida species
Candida-infected
C. albicans, C. glabrata, and C. dubliniensis. C. tropicalis, C.
krusei, C. parasilosis, C. rugosa, C. lusitaniae, and C. kyfer
The epidemiology of C. albicans
glabrata dubliniensis tropicalis
krusei parapsilosis
C. rugosa, C. lusitaniae, and C. kefyr
Candida Species Number of Isolates (%)
C. albicans
C. glabrata
C. dubliniensis
C. tropicalis
C. krusei
Table 3.Divisions of Candida Species
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Al-Ameri A D et al.
J. Commun. Dis. 2024; 56(2)
ISSN: 0019-5138
DOI: hps://doi.org/10.24321/0019.5138.202432
Antifungal Susceptibility Proling Results
This study tested Candida isolates
C. parasilosis
Other Candida species
rugosa, C. lusitaniae, C.
kyfer
Total
Chi-square
Table 4.Susceptibility of Candida Species Against the Six Studied Antifungals
Anfungal Drugs (n, %)
Species Paern FLC ITR VRC AMB CAS 5-FC
C. albicans
I
-
-
-
-
-
-
-
C. glabrata
I
-
-
-
-
-
-
-
-
-
-
C.
dubliniensis
I
-
-
-
-
-
-
-
C. tropicalis
I
-
-
-
-
-
-
-
-
-
C. krusei
I
-
-
-
-
-
-
-
-
-
-
-
C.
parapsilosis
I
-
-
-
-
-
-
-
-
-
-
-
-
Others
I
-
-
-
-
-
-
-
-
-
All isolates
I
-
-
-
showed that Candida
57
Al-Ameri A D et al.
J. Commun. Dis. 2024; 56(2)
ISSN: 0019-5138
DOI: hps://doi.org/10.24321/0019.5138.202432
Candida albicans Susceptibility Proling
Albicans
showed a WT phenotype, while only four samples revealed
Candida glabrata Susceptibility Proling
glabrata showed no resistance against the drug,
Candida dubliniensis Susceptibility Proling
For
isolates showed the WT phenotype and only one showed
C. tropicalis Susceptibility Proling
samples were resistant. For AMB, six samples presented
C. krusei Susceptibility Proling
Less Common Candida spp. Susceptibility Proling
C. lusitaniae
two cultures of C. parapsilosis were included in the current
kefyr was the only
isolate included in the current study. C. kefyr showed a
According to MIC, the
Table 5.Antifungal Susceptibility Prole of 100 Candida Isolates
No. of Isolates at Each Determined MIC Value (µg/mL)
Drug
>
MIC
GM
MIC
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Al-Ameri A D et al.
J. Commun. Dis. 2024; 56(2)
ISSN: 0019-5138
DOI: hps://doi.org/10.24321/0019.5138.202432
C. albicans
- - - - 7 - - -
- -- - - - - - -
- - - - - - - - - -
AMB - - - - - - - - -
CAS - - - - - - - - - - - -
- - - - - 7 - -
C. glabrata
- - - - - -
- - 7 - - -
- - - - - - - - -
AMB - - - - -
CAS - - - - - - - - -
- - - - - - -
C. dubliniensis
- - - - 7 -- - -
- - - - - - -
-- - - - - - - -
AMB - - - - - - - -
CAS - - - - - - - - - -
- - - - - - - -
C. tropicalis
- - - - - - - -
- - - - - - - - -
- - - - - - - - -
AMB - - - - - - -
CAS - - - - - - - - - -
- - - - - - - - -
- - - - - - - - -
- - - -- - - - -
- - - - - - - -
AMB - - - - - - - -
CAS - - - - - - - - -
- - - - - - -
59
Al-Ameri A D et al.
J. Commun. Dis. 2024; 56(2)
ISSN: 0019-5138
DOI: hps://doi.org/10.24321/0019.5138.202432
Others
- - - - - - - -
- - - - - - -
-- - - - - - -
AMB - - - - - - - -
CAS - - - - - - - - -
- - - - - - -
Discussion
Epidemiologically, our results show diversity in Candida
albicans together with C. glabrata
There was a
spectrum change from Candida albicans to non-Albican
Candida
al.
C. tropicalis, C. krusei, and C. parapsilosis. There were
This is due to the rise in the epidemiology of C. dubliniensis
during recent years.
population-based surveillance projects have greatly
In the current study, we suggested the in vitro
Candida
Candida
of Candida albicans, and other species in the study except C.
Candida krusei. As we
Candida species in Iraq. This
C. albicans remained
dubliniensis
C. tropicalisglabrata
For C. albicans
In our study, C. tropicalis together with C. parapsilosis
tropicalis, six isolates
tropicalis and
C. parapsilosis were reported as the Candida species
with the maximum elevated MIC values in the region
other than C. albicans. We reported that C. glabrata
twenty sample cultures of the species demonstrated an
in Kuwait.dubliniensis, two
dubliniensis
the Khalifa et al. study in Japan, except for CAS, which
Conclusion
In conclusion, we have documented the Candida isolates
60
Al-Ameri A D et al.
J. Commun. Dis. 2024; 56(2)
ISSN: 0019-5138
DOI: hps://doi.org/10.24321/0019.5138.202432
[PubMed] [Google
Scholar]
synthesis by poacic acid and caspofungin. Cell Surf.
[PubMed] [Google Scholar]
resistance in pathogenic fungi. Clin Infect Dis.
PubMed] [Google Scholar]
PubMed]
[Google Scholar]
[PubMed] [Google Scholar]
Candida strains.
[PubMed] [Google Scholar]
PubMed] [Google Scholar]
Amphotericin B and other polyenes-discovery, clinical
PubMed] [Google Scholar]
for Candida
PubMed] [Google Scholar]
PubMed] [Google
Scholar]
Morace G, Perdoni F, Borghi E. Antifungal drug
resistance in Candida
[PubMed] [Google Scholar]
PubMed]
[Google Scholar]
Perea S, Patterson TF. Antifungal resistance in
caspofungin. C. albicans
glabrata
AMB. Also, C. tropicalis together with C. parapsilosis are
especially for C. albicans, C. tropicalis, C. glabrata, and C.
parapsilosis.
Further studies and follow-ups are important in Iraq to
Source of Funding: None
Conict of Interest: None
References
candidemia in adults and children hospitalized in the
PubMed] [Google Scholar]
PubMed]
[Google Scholar]
for common and uncommon opportunistic fungi
PubMed] [Google Scholar]
[PubMed] [Google Scholar]
PubMed] [Google Scholar]
Candida
auris
Candida species. Clin Microbiol Newsl.
PubMed] [Google Scholar]
7.
Shor E, Perlin DS. Coping with stress and the emergence
PubMed] [Google Scholar]
Candida albicans isolated
61
Al-Ameri A D et al.
J. Commun. Dis. 2024; 56(2)
ISSN: 0019-5138
DOI: hps://doi.org/10.24321/0019.5138.202432
PubMed] [Google
Scholar]
Barchiesi F, Arzeni D, Caselli F, Scalise G. Primary
resistance to flucytosine among clinical isolates
of Candida spp. J Antimicrob Chemother.
PubMed] [Google Scholar]
candidemia in a medical center in middle Taiwan.
[PubMed] [Google Scholar]
Candida isolates
PubMed] [Google Scholar]
Candida
glabrata species complex, Candida krusei, Candida
parapsilosis species complex and Candida tropicalis
PubMed] [Google Scholar]
clinical Candida glabrata
PubMed]
[Google Scholar]
Candida
dubliniensis
[PubMed] [Google Scholar]
resistance, and genotyping of Candida krusei recovered
PubMed] [Google
Scholar]
Kashani SM, Karimimoghadam Z, Wang K, Imanieh
[PubMed] [Google Scholar]
Al-Nuaimi BN, Abdul-Ghani MN, Al-Asadi AB, Al-
IraqGoogle Scholar]
Candida spp. as
PubMed] [Google Scholar]
cutoff values for characterization of geographic
PubMed] [Google
Scholar]
susceptibility testing of Candida spp. by use of
PubMed] [Google Scholar]
Candida
PubMed] [Google Scholar]
epidemiology of Candida species in the Middle East
[PubMed] [Google Scholar]
of Candida species, including Candida dubliniensis,
[PubMed] [Google Scholar]
G. Candida species isolated from clinical samples
Candida
PubMed]
[Google Scholar]
Candida albicans and C. dubliniensis
PubMed]
[Google Scholar]\
PubMed] [Google Scholar]
echinocandin MIC values among Candida glabrata
[PubMed] [Google Scholar]
