Fungal infections are currently causing health issues all over the world, among which are Candida species that cause cutaneous infection. Numerous dermatological studies concentrated on a single species. However, the virulence factors and the spread of specific candidiasis in specific areas have remained poorly understood. Therefore, the current study was designed to shed light on Candida tropicalis, which has been identified as the most prevalent yeast among Candida non-albicans species. Forty specimens were collected from patients with cutaneous fungal infection (25 females and 15 males) and underwent examination. According to conventional identification based on macroscopic and microscopic examinations, eight isolates were identified as C. tropicalis from Candida non-albicans. Molecular diagnosis for internal transcribed spacers (ITS1 and ITS4) using conventional polymerase chain reaction (PCR) yielded an amplicon of 520 bp for all isolates. Further investigation of PCR-restriction fragment length using Mitochondrial sorting protein; Msp1 enzyme revealed two bands of 340 and 180 bp. The ITS gene sequence in one isolated species was found to be 98% identical to C. tropicalis strain MYA-3404 chromosome R ATCC CP047875.1. Another isolate shared 98.02% identity with C. tropicalis strain MA6 18S ribosomal RNA gene DQ666188.1, indicating C. tropical species identity, implying that non-Candida species should be considered when diagnosing candidiasis. This study demonstrated the significance of Candida non-albicans, particularly C. tropicalis, in terms of pathogenic potential, the ability to cause potentially fatal systemic infections and candidiasis, and acquired flucozonal resistance with a high mortality rate. |
- Achterman RR, White TC. Dermatophytes. Curr Biol. 2013;23(13):R551-R2.
- de Souza Ramos L, Barbedo LS, Braga-Silva LA, Dos Santos ALS, Pinto MR, da Graça Sgarbi DB. Protease and phospholipase activities of Candida spp. isolated from cutaneous candidiasis. Rev Iberoam Micol. 2015;32(2):122-5.
- Mohamed AA, Lu X-l, Mounmin FA. Diagnosis and treatment of esophageal candidiasis: Current updates. Can J Gastroenterol Hepatol. 2019;2019.
- Sanguinetti M, Posteraro B, Lass‐Flörl C. Antifungal drug resistance among Candida species: mechanisms and clinical impact. Mycoses. 2015;58:2-13.
- Giri S, Kindo M. Evaluation of five phenotypic tests in the identification of candida species. Nat J Lab Med. 2015;4:13-8.
- Sheth CC, Johnson E, Baker ME, Haynes K, Mühlschlegel FA. Phenotypic identification of Candida albicans by growth on chocolate agar. Med Mycol J. 2005;43(8):735-8.
- Sadeghi G, Mousavi SF, Ebrahimi-Rad M, Mirabzadeh-Ardekani E, Eslamifar A, Shams-Ghahfarokhi M, et al. In vivo and in vitro pathogenesis and virulence factors of Candida albicans strains isolated from cutaneous candidiasis. Iran Biomed J. 2020;24(5):319.
- Neppelenbroek K, Seó R, Urban V, Silva S, Dovigo L, Jorge J, et al. Identification of Candida species in the clinical laboratory: a review of conventional, commercial, and molecular techniques. Oral Dis. 2014;20(4):329-44.
- Seyoum E, Bitew A, Mihret A. Distribution of Candida albicans and non-albicans Candida species isolated in different clinical samples and their in vitro antifungal suscetibity profile in Ethiopia. BMC Infect Dis. 2020;20(1):1-9.
- Hii M, Liu C-E, Lee Y-L, Liu W-L, Wu P-F, Hsieh M-H, et al. Resistance rates of non-albicans Candida infections in Taiwan after the revision of 2012 Clinical and Laboratory Standards Institute breakpoints. Infect Drug Resist. 2019;12:235.
- Kołaczkowska A, Kołaczkowski M. Drug resistance mechanisms and their regulation in non-albicans Candida species. J Antimicrob Chemother. 2016;71(6):1438-50.
- Barac A, Cevik M, Colovic N, Lekovic D, Stevanovic G, Micic J, et al. Investigation of a healthcare‐associated Candida tropicalis candidiasis cluster in a haematology unit and a systematic review of nosocomial outbreaks. Mycoses. 2020;63(4):326-33.
- Devadas SM, Ballal M, Prakash PY, Hande MH, Bhat GV, Mohandas V. Auxanographic carbohydrate assimilation method for large scale yeast identification. J Clin Diagnostic Res. 2017;11(4):1.
- Staudacher HM, Whelan K. The low FODMAP diet: recent advances in understanding its mechanisms and efficacy in IBS. Gut. 2017;66(8):1517-27.
- Marinho SA, Teixeira AB, Santos OS, Cazanova RF, Ferreira CA, Cherubini K, et al. Identification of Candida spp. by phenotypic tests and PCR. Braz J Microbiol. 2010;41(2):286-94.
- Tierno PM, Jr., Milstoc M. Germ tube-positive Candida tropicalis. Am J Clin Pathol. 1977;68(2):294-5.
- Mirhendi H, Makimura K, Khoramizadeh M, Yamaguchi H. A one-enzyme PCR-RFLP assay for identification of six medically important Candida species. Nihon Ishinkin Gakkai Zasshi. 2006;47(3):225-9.
- Okumura Y, Inoue N, Nikai T. Isolation and characterization of a novel acid proteinase, tropiase, from Candida tropicalis IFO 0589. Nihon Ishinkin Gakkai Zasshi. 2007;48(1):19-25.
- Arastehfar A, Carvalho A, Nguyen MH, Hedayati MT, Netea MG, Perlin DS, et al. COVID-19-Associated Candidiasis (CAC): An Underestimated Complication in the Absence of Immunological Predispositions? J Fungi. 2020;6(4).
|