In vitro antifungal susceptibility pattern of Candida species isolated from gastroesophageal candidiasis
Gastroenterology and Hepatology from Bed to Bench,
26 April 2021
Aim: Determination of antifungal susceptibility profile of Candida species isolated from gastroesophageal lesions.
Background: Gastroesophageal candidiasis is a common infection among HIV/AIDS patients and who are taking PPI and H2RAs drugs. More than 20 Candida spp. can cause different types of mucocutaneous infections in humans. The present study was conducted to assess the antifungal susceptibility testing of clinical Candida spp. isolated from gastroesophageal lesions.
Patients and methods: Forty-eight clinical samples were collected from 60 patients underwent endoscopy. All isolates were identified by molecular techniques (PCR-RFLP). The profiles of the susceptibility of Candida spp. to seven antifungal agents including amphotericin B, fluconazole, itraconazole, luliconazole, voriconazole, posaconazole and caspofungin were evaluated using broth microdilution.
Results: The susceptibility profile of Candida isolates revealed 100% sensitivity to amphotericin B, caspofungin, and voriconazole; moreover, fluconazole (6.25%) and itraconazole (2.1%) resistant isolates were observed.
Conclusion: With regard to the increase of fluconazole-resistant Candida species, it is necessary to determine the in vitro antifungal susceptibility pattern of clinical isolates for the best management of infection and to prevent the emergence of drug resistant isolates.
Keywords: Antifungal susceptibility testing, Candida spp., Gastroesophageal
- Antifungal susceptibility testing
- Candida spp.
2. Choi JH, Lee CG, Lim YJ, Kang HW, Lim CY, Choi J-S. Prevalence and risk factors of esophageal candidiasis in healthy individuals: a single center experience in Korea. Yonsei Med 2013;54:160-5.
3. Wilheim AB, Miranda-Filho DdB, Nogueira RA, Rêgo RSdM, Lima KdM, Pereira LMMB. The resistance to fluconazole in patients with esophageal candidiasis. Arquivos de gastroenterologia 2009;46:32-7.
4. Kliemann DA, Pasqualotto AC, Falavigna M, Giaretta T, Severo LC. Candida esophagitis: species distribution and risk factors for infection. Rev Inst Med Trop 2008;50:261-3.
5. Sanglard D. Emerging threats in antifungal-resistant fungal pathogens. Front Med 2016;3:11.
6. Spampinato C, Leonardi D. Candida infections, causes, targets, and resistance mechanisms: traditional and alternative antifungal agents. BioMed Res Int 2013; 2013: 204237.
7. Moges B, Bitew A, Shewaamare A. Spectrum and the in vitro antifungal susceptibility pattern of yeast isolates in Ethiopian HIV patients with oropharyngeal candidiasis. Int J Microbiol . 2016;2016:3037817.
8. Salehi F, Esmaeili M, Mohammadi R. Isolation of Candida Species from Gastroesophageal Lesions among Pediatrics in Isfahan, Iran: Identification and Antifungal Susceptibility Testing of Clinical Isolates by E-test. Adv Biomed Res. 28;6:103. doi: 10.4103/2277-9175.213662.
9. Piccolomini R, Di Bonaventura G, Catamo G, Carbone F, Neri M. Comparative evaluation of the E test, agar dilution, and broth microdilution for testing susceptibilities of Helicobacter pylori strains to 20 antimicrobial agents. J Clin Microbiol 1997;35(7):1842-6.
10. Simor A, Goswell G, Louie L, Lee M, Louie M. Antifungal susceptibility testing of yeast isolates from blood cultures by microbroth dilution and the E test. Eur J Clin Microbiol Infect Dis 1997;16(9):693-7.
11. Mulu A, Kassu A, Anagaw B, Moges B, Gelaw A, Alemayehu M, et al. Frequent detection of ‘azole’resistant Candida species among late presenting AIDS patients in northwest Ethiopia. BMC Infect Dis. 2013;13(1):82-85.
12. Lake D, Kumweiler J, Beer M, Buell D, Islam M. Fluconazole versus amphotericin B in the treatment of esophageal candidiasis in cancer patients. Chemother 1996;42(4):308-14.
13. Prasad R, Kapoor K. Multidrug resistance in yeast Candida. International Rev Cytol 2005;242:215-48.
14. Mohamed AA, Lu X-l, Mounmin FA. Diagnosis and treatment of esophageal candidiasis: Current updates. Canadian J Gastroenterol Hepatol 2019;13:91-97.
15. Rosołowski M, Kierzkiewicz M. Etiology, diagnosis and treatment of infectious esophagitis. Przeglad gastroenterologiczny. 2013;8(6):333-339.
16. Koga H, Nanjoh Y, Makimura K, Tsuboi R. In vitro antifungal activities of luliconazole, a new topical imidazole. Medical Mycol 2009;47(6):640-7.
17. Uchida K, Nishiyama Y, Yamaguchi H. In vitro antifungal activity of luliconazole (NND-502), a novel imidazole antifungal agent. J Infect Chemother 2004;10(4):216-9.
18. Donghui TY, Seger DL, Peterson JF, Kumar RN, Bates DW. Fluconazole for empiric antifungal therapy in cancer patients with fever and neutropenia. BMC Infect Dis. 2006;6(1):173-178.
19. Walsh TJ, Gamaletsou MN. Treatment of fungal disease in the setting of neutropenia. Hematology 2013, the American Society of Hematology Education Program Book. 2013;2013(1):423-7.
20. Vardakas KZ, Michalopoulos A, Falagas ME. Fluconazole versus itraconazole for antifungal prophylaxis in neutropenic patients with haematological malignancies: a meta‐analysis of randomised‐controlled trials. British J Haematol 2005;131(1):22-8.
21. Wingard JR, Merz WG, Rinaldi MG, Johnson TR, Karp JE, Saral R. Increase in Candida krusei infection among patients with bone marrow transplantation and neutropenia treated prophylactically with fluconazole. New Eng J Med 1991;325(18):1274-7.
22. Zhang L, Xiao M, Watts MR, Wang H, Fan X, Kong F, et al. Development of fluconazole resistance in a series of Candida parapsilosis isolates from a persistent candidemia patient with prolonged antifungal therapy. BMC Infect Dis 2015;15(1):340.
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