Distribution of Candida Albicans and Non-albicans Candida Species Isolated in Different Clinical Samples and Their in Vitro Antifungal Suscetibity Profile in Ethiopia

Overview

Journal BMC Infect Dis

Publisher Biomed Central

Specialty Infectious Diseases

Date 2020 Mar 20

PMID 32188422

Citations 17

Authors

Elias Seyoum

Adane Bitew

Amete Mihret

Affiliations

Soon will be listed here.

Abstract

Background: The spectrum of yeasts and their antifungal susceptibility profile are poorly known and treatment of fungal disease has remained empirical. The aim of this study is to determine the spectrum and antifungal susceptibility profile of yeasts particularly of Candida species.

Methods: A descriptive study on the composition of Candida species and antifungal susceptibility profile were conducted from January 2018 to September 2018. Clinical samples collected from different sites were cultured on Sabouraud dextrose agar and incubated for an appropriate time. Identification of yeast isolates and their antifungal susceptibility profile were determined by the VITEK 2 compact system. Descriptive statistics such as frequency and percentage of Candida species were calculated using SPSS version 20.

Results: Of 209 yeasts recovered, 104(49.8%), 90 (43.1%), 15(7.2%) were C. albicans, non albicans Candida species, and other yeasts, respectively. Among non albicans Candida species, Candida krusei was the commonest isolate. Of other yeast groups, 66.7% was represented by Cryptococcus laurentii. Regardless of Candida species identified, 85.6, 3.9, and 10.5% of the isolates were susceptible, intermediate, and resistant to fluconazole, respectively. C krusei was 100% resistant to the drug. Voriconazole demonstrated the greatest antifungal activity against Candida isolates in which 99.4% of Candida isolates were susceptible. The susceptibility and the resistance rate of Candida isolate to both caspofungin and micafungin were the same being 96 and 4% respectively. However, micafungin was more potent than caspofungin. The susceptibility, resistant, and intermediate rates of yeasts against flucytosine were, 86.2, 6.6, and 7.2%, respectively.

Conclusions: The present study demonstrated the distribution of Candida species in different clinical specimens where the isolation rate of non-albicans Candida species was comparable to Candida albicans. The high resistance rate of C. krusei to fluconazole and flucytosine may demonstrate that the treatment of candidiasis empirically is questionable.

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References

Sievert D, Ricks P, Edwards J, Schneider A, Patel J, Srinivasan A . Antimicrobial-resistant pathogens associated with healthcare-associated infections: summary of data reported to the National Healthcare Safety Network at the Centers for Disease Control and Prevention, 2009-2010. Infect Control Hosp Epidemiol. 2012; 34(1):1-14. DOI: 10.1086/668770. View

Schmalreck A, Willinger B, Haase G, Blum G, Lass-Florl C, Fegeler W . Species and susceptibility distribution of 1062 clinical yeast isolates to azoles, echinocandins, flucytosine and amphotericin B from a multi-centre study. Mycoses. 2012; 55(3):e124-37. DOI: 10.1111/j.1439-0507.2011.02165.x. View

Richter S, Galask R, Messer S, Hollis R, Diekema D, Pfaller M . Antifungal susceptibilities of Candida species causing vulvovaginitis and epidemiology of recurrent cases. J Clin Microbiol. 2005; 43(5):2155-62. PMC: 1153777. DOI: 10.1128/JCM.43.5.2155-2162.2005. View

Pfaller M, Diekema D, Messer S, Boyken L, Hollis R . Activities of fluconazole and voriconazole against 1,586 recent clinical isolates of Candida species determined by Broth microdilution, disk diffusion, and Etest methods: report from the ARTEMIS Global Antifungal Susceptibility Program, 2001. J Clin Microbiol. 2003; 41(4):1440-6. PMC: 153922. DOI: 10.1128/JCM.41.4.1440-1446.2003. View

Sahal G, Seyis Bilkay I . Distribution of clinical isolates of Candida spp. and antifungal susceptibility of high biofilm-forming Candida isolates. Rev Soc Bras Med Trop. 2018; 51(5):644-650. DOI: 10.1590/0037-8682-0136-2018. View

Lyon G, Karatela S, Sunay S, Adiri Y . Antifungal susceptibility testing of Candida isolates from the Candida surveillance study. J Clin Microbiol. 2010; 48(4):1270-5. PMC: 2849617. DOI: 10.1128/JCM.02363-09. View

Jensen R, Arendrup M . Candida palmioleophila: characterization of a previously overlooked pathogen and its unique susceptibility profile in comparison with five related species. J Clin Microbiol. 2010; 49(2):549-56. PMC: 3043495. DOI: 10.1128/JCM.02071-10. View

Desnos-Ollivier M, Ragon M, Robert V, Raoux D, Gantier J, Dromer F . Debaryomyces hansenii (Candida famata), a rare human fungal pathogen often misidentified as Pichia guilliermondii (Candida guilliermondii). J Clin Microbiol. 2008; 46(10):3237-42. PMC: 2566122. DOI: 10.1128/JCM.01451-08. View

Zaragoza O, Mesa-Arango A, Gomez-Lopez A, Bernal-Martinez L, Rodriguez-Tudela J, Cuenca-Estrella M . Process analysis of variables for standardization of antifungal susceptibility testing of nonfermentative yeasts. Antimicrob Agents Chemother. 2011; 55(4):1563-70. PMC: 3067191. DOI: 10.1128/AAC.01631-10. View

10.

Mulu A, Kassu A, Anagaw B, Moges B, Gelaw A, Alemayehu M . Frequent detection of 'azole' resistant Candida species among late presenting AIDS patients in northwest Ethiopia. BMC Infect Dis. 2013; 13:82. PMC: 3577436. DOI: 10.1186/1471-2334-13-82. View

11.

Sasso M, Roger C, Sasso M, Poujol H, Barbar S, Lefrant J . Changes in the distribution of colonising and infecting Candida spp. isolates, antifungal drug consumption and susceptibility in a French intensive care unit: A 10-year study. Mycoses. 2017; 60(12):770-780. DOI: 10.1111/myc.12661. View

12.

Snydman D . Shifting patterns in the epidemiology of nosocomial Candida infections. Chest. 2003; 123(5 Suppl):500S-3S. DOI: 10.1378/chest.123.5_suppl.500s. View

13.

Muadcheingka T, Tantivitayakul P . Distribution of Candida albicans and non-albicans Candida species in oral candidiasis patients: Correlation between cell surface hydrophobicity and biofilm forming activities. Arch Oral Biol. 2015; 60(6):894-901. DOI: 10.1016/j.archoralbio.2015.03.002. View

14.

Upton A, Marr K . Emergence of opportunistic mould infections in the hematopoietic stem cell transplant patient. Curr Infect Dis Rep. 2006; 8(6):434-41. DOI: 10.1007/s11908-006-0017-5. View

15.

Mohandas V, Ballal M . Distribution of Candida species in different clinical samples and their virulence: biofilm formation, proteinase and phospholipase production: a study on hospitalized patients in southern India. J Glob Infect Dis. 2011; 3(1):4-8. PMC: 3068577. DOI: 10.4103/0974-777X.77288. View

16.

Marchetti O, Bille J, Fluckiger U, Eggimann P, Ruef C, Garbino J . Epidemiology of candidemia in Swiss tertiary care hospitals: secular trends, 1991-2000. Clin Infect Dis. 2004; 38(3):311-20. DOI: 10.1086/380637. View

17.

Sobel J . The emergence of non-albicans Candida species as causes of invasive candidiasis and candidemia. Curr Infect Dis Rep. 2006; 8(6):427-33. DOI: 10.1007/s11908-006-0016-6. View

18.

Godoy P, Tiraboschi I, Severo L, Bustamante B, Calvo B, de Almeida L . Species distribution and antifungal susceptibility profile of Candida spp. bloodstream isolates from Latin American hospitals. Mem Inst Oswaldo Cruz. 2003; 98(3):401-5. DOI: 10.1590/s0074-02762003000300020. View

19.

Zaoutis T, Argon J, Chu J, Berlin J, Walsh T, Feudtner C . The epidemiology and attributable outcomes of candidemia in adults and children hospitalized in the United States: a propensity analysis. Clin Infect Dis. 2005; 41(9):1232-9. DOI: 10.1086/496922. View

20.

Ribeiro A, Menezes T, de Melo Alves-Junior S, de Menezes S, Marques-da-Silva S, Vallinoto A . Oral carriage of Candida species in HIV-infected patients during highly active antiretroviral therapy (HAART) in Belém, Brazil. Oral Surg Oral Med Oral Pathol Oral Radiol. 2015; 120(1):29-33. DOI: 10.1016/j.oooo.2015.03.008. View