Background: The frequency of severe systemic fungal diseases has increased in the last
few decades.
Aims: This study was done to speciate the candida isolates, to determine their antifungal
susceptibility pattern and to detect biofilm formation and exoenzymes (phospholipase and
proteinase) production.
Place and Duration of Study: This is a Six-months Cross sectional study conducted in
ICU and Microbiology & Immunology departments, Benha University, Egypt
Methodology: The study was conducted on 75 Candida spp. isolated from various clinical
samples of patients admitted in ICU. The Candida isolates were identified upto species
level. Antifungal susceptibility testing was done by disc diffusion method. The biofilm
formation was assessed by inoculating the isolates in conical polystyrene test tube
containing Sabouraud’s dextrose broth supplemented with glucose. Proteinase activity
was detected by using plates containing bovine serum albumin (BSA) agar.
Phospholipase activity was detected by using egg yolk agar.
Results: Seventy five Candida spp. were isolated from different clinical samples. C.albicans was isolated from 39(52%) samples. Non-albicans Candida (NAC) spp. were
isolated from 36 (48%) clinical specimens. Forty one (54.7%) out of 75 Candida species
isolates obtained from the clinical isolates produced biofilm. Out of 39 C. albicans isolates
20 (51.3%) produced biofilm, while out of 36 NAC species isolates 21 (58.3%) produced
biofilm. The number of total proteinase positive isolates were 50 (66.7%). C. albicans was
higher than that of the NAC isolates (29 [66.7%] versus 21 [58.3%]). Phospholipase
positive isolates of C. albicans was higher than that of the NAC isolates (32[82.1%] versus
37[49.3%]). All isolates were susceptible to amphotericin B and ketoconazole. Resistance
to fluconazole was found in 8 isolates (22.2%) of NAC spp. and 2 isolates (5.1%) of C.
albicans isolates.
Conclusion: The isolation of C. albicans were 39 (52%) in different clinical samples and
isolation of NAC spp. were 36(48%). So NAC spp. is no longer overlooked as these
organisms are emerging pathogens. The number of NAC producing proteinase,
phospholipase and biofilm are more than the number of C. albicans producing these
virulence factors. The C. albicans and NAC showed 100% susceptiblity to amphotericin B
and ketokonazole while fluconazole showed resistance in 22.2% of NAC spp. and 5.1% of
C. albicans isolates. All resistant Candida species to fluconazole were biofilm producers. |
