ABC genotyping, virulence factors production and antifungal resistant pattern of Candida albicans isolated from immunocompromised patients with candidemia.

Background: Candida albicans is still the most common cause of candidemia in the majority of healthcare-acquired bloodstream fungal infections globally with a high morbidity, mortality and significant financial burden. Yeast genotyping is crucial for designing effective infection control strategies. In the current study, we aimed to detect the genotyping, some virulence factors and antifungal resistant pattern of c. albicans isolated from immunocompromised candidemic patients admitted in critical care units of Zagazig university hospitals (ZUHs), Egypt. Methods: C. albicans isolated from clinical samples were identified and characterized using the conventional mycological methods and Vitek 2 system is used for confirming the identification and for antifungal susceptibility test (AFST). ABC genotyping was used to characterize subgroups of c. albicans and virulence activities (phospholipase (Pls), protease (Prt), esterase (Est), hemolysin (Hs), coagulase (Cgl) and biofilm formation). Results: From a total of 55 isolates of C. albicans, genotype A was the predominant (50.9%). Phospholipase and proteinase activities were detected in 96.4% and 85.4%. Esterase, hemolysin and coagulase activities were detected in 83.6%, 74.5% and 60.0% respectively. 83.6% of isolates were biofilm-forming. Isolates of c. albicans were 100% sensitive to caspofungin, micafungin and miconazole, while 1.8% are resistant for each of amphotericin B and voriconazole, while flucytosine and fluconazole showed a higher resistant (3.6%) for each. Conclusions: ABC genotyping can classify C. albicans species. The association of genotype A and resistance to flucytosine and fluconazole need further assessment. Routine AFST to guide empiric to targeted therapy should be encouraged. [ABSTRACT FROM AUTHOR]

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