Analysis of Species Distribution and Antifungal Susceptibilities among Locally Prevailed Clinical Isolates of Candida

Abouzeid, Doaa A.; El-Hady, Soha A.; Abouzeid, Mohamed A.; Ibrahim, Nevin A.

doi:10.21608/ejm.2023.216815.1230

Analysis of Species Distribution and Antifungal Susceptibilities among Locally Prevailed Clinical Isolates of Candida

Document Type : Original Article

Authors

¹ Department of Microbiology, Faculty of Science, Ain Shams University, Cairo, Egypt

² Department of Medical Microbiology and Immunology, Faculty of Medicine, Ain Shams University, Cairo, Egypt

10.21608/ejm.2023.216815.1230

Abstract

Globally, Candida species are the most prevalent cause of invasive mycotic infections, which are associated with high mortality rates and exhibit remarkable geographic and epidemiological diversity. A better understanding of Candida-associated infections’ epidemiology and species incidence is needed. This study analyzed Candida species distribution and antifungal susceptibilities in 200 locally collected clinical specimens. Isolates recovered were identified using the standard conventional methods and MALDI-TOF-MS; susceptibility testing was run for Fluconazole, Itraconazole, Voriconazole, Posaconazole, Caspofungin, Amphotericin-B, and Nystatin, according to the CLSI M44-A2 guideline. C. albicans accounted for 92(48.9%) among 188 Candida isolates obtained. In contrast, species distribution among the non-albicans Candida isolates (no.= 96) was as follows: C. parapsilosis (no. =35), C. krusei (no. =21), C. tropicalis (no. =20), and C. glabrata (no. =20). In collected clinical specimens, Candida species were significantly more common in urine (64.4%), sputum (18.1%), and blood (10.1%). C. albicans was the predominant species in all types of clinical samples except in blood, where C. parapsilosis dominates. The isolated Candida species showed variable resistance rates to the seven tested antifungals. Fluconazole resistance was the most common (56/188 isolates); 44% of NAC isolates were FLC-resistant compared with 15.2% for isolated C. albicans. Disturbingly, cross-resistance to FLC and VRC was recorded in all VOR-resistant isolates of C. krusei, C. parapsilosis, and C. glabrata; moreover, eleven out of twelve VOR-resistant C. albicans isolates exhibited FLC-VRC cross-resistance.

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