307661

Assessment of the accuracy of identification of clinical <i>Candida</i> species with reduced fluconazole susceptibility by rapid methods and their relative expression of major ef

Article

Last updated: 04 Jan 2025

Subjects

-

Tags

Antimicrobial resistance

Abstract

Background: Candida infections are commonly treated with fluconazole. Efflux pumps are one of the mechanisms for fluconazole resistance. This study assessed the accuracy of identification of Candida species with reduced fluconazole susceptibility and their relative expression of major efflux pump genes. Methods: Candida species (n=111) were collected from clinical samples, identified by Brilliance Candida Agar (BCA) and germ tube test, then tested for fluconazole susceptibility by disk diffusion. Confirmation of identification and susceptibility to fluconazole was done by Phoenix BD and broth microdilution methods, and the accuracy of preliminary methods was calculated. qPCR was performed to evaluate the gene expression of common efflux pump genes. Results: The most predominant were C. albicans (32%) and C. tropicalis (29%). Accuracy of BCA identification was 84% for both species. Reduced fluconazole susceptibility was detected in 8.3% of C. albicans and 40.6% of C. tropicalis. Accuracy of disk diffusion was 100% for C. albicans and 62% for C. tropicalis. qPCR showed upregulation of CDR2 efflux pump among non-susceptible C. albicans (1.99 ± 1.04), though not statistically significant. CDR1 expression was at a basal level for C. albicans (0.9 ± 0.25) and C. tropicalis (0.69 ± 0.76). MDR-1 was significantly downregulated in non-susceptible C. tropicalis (0.30 ± 0.63, p= 0.025). Conclusion: Brilliance Candida Agar  identification requires verification. The disk diffusion method is of higher accuracy with C. albicans than with C. tropicalis. Overexpression of CDR1 and CDR2 in C. albicans, and CDR1 and MDR1 in C. tropicalis were not the main reasons behind reduced susceptibility to fluconazole.

DOI

10.21608/mid.2023.220044.1553

Keywords

C. albicans, C. tropicalis, CDR1,CDR2 and MDR1, Fluconazole resistance

Authors

First Name

Aliaa

Last Name

Aboulela

MiddleName

Gamaleldin

Affiliation

Microbiology Department, Medical Research Institute, Alexandria University, Egypt

Email

aliaagamaleldin@alexu.edu.eg

City

Alexandria

Orcid

0000-0002-2923-1027

First Name

Samah

Last Name

Idris

MiddleName

Nasr

Affiliation

Microbiology Department, Medical Research Institute, Alexandria University, Egypt

Email

samah.naser93@gmail.com

City

Alexandria

Orcid

-

First Name

Dalia

Last Name

Metwally

MiddleName

El Sayed

Affiliation

Microbiology Department, Medical Research Institute, Alexandria University

Email

dalia.metwally@alexu.edu.eg

City

Alexandria

Orcid

0000-0002-1810-8218

First Name

Rasha

Last Name

Emad

MiddleName

-

Affiliation

Alexandria Main University Hospital, Alexandria, Egypt

Email

gs-rasha.emad@alexu.edu.eg

City

Alexandria

Orcid

0000-0002-8774-6635

First Name

Gamal El Din Ahmed

Last Name

El Sawaf

MiddleName

-

Affiliation

Microbiology Department, Medical Research Institute, Alexandria University, Egypt

Email

gamalsawaf@yahoo.com

City

-

Orcid

-

Volume

4

Article Issue

3

Related Issue

42578

Issue Date

2023-08-01

Receive Date

2023-06-25

Publish Date

2023-08-01

Page Start

994

Page End

1,007

Print ISSN

2682-4132

Online ISSN

2682-4140

Link

https://mid.journals.ekb.eg/article_307661.html

Detail API

https://mid.journals.ekb.eg/service?article_code=307661

Order

34

Type

Original Article

Type Code

1,157

Publication Type

Journal

Publication Title

Microbes and Infectious Diseases

Publication Link

https://mid.journals.ekb.eg/

MainTitle

Assessment of the accuracy of identification of clinical <i>Candida</i> species with reduced fluconazole susceptibility by rapid methods and their relative expression of major ef

Details

Type

Article

Created At

25 Dec 2024