Detection of Some Virulence Factors from Candida spp. Isolated from Vaginal and Oral Candidiasis in Iraqi Patients.

Abstract

Background: Candidiasis can be present as a cutaneous, mucosal, or deep-seated organ infection, which is caused by more than 20 types of Candida spp., with C. albicans being the most common. Hence, this work aimed to estimate some virulence factors, including phospholipase and biofilm formation, in some Candida spp.

Methods: A total of eighty-six specimens were collected from patients with oral and vaginal candidiasis and subjected into different examinations, including cultural characteristic (on Sabouraud Dextrose Agar SDA and chromogenic Candida agar) and microscopic examination and germ tube formation (GT)to isolate Candida spp. In addition, the egg-yolk agar plate method was used to determine the extracellular phospholipase production, and the microtiter plate method was used to determine biofilm formation of Candida spp. Vitek Compact equipment was used to identify the highest phospholipase and biofilm-producers of Candida spp.

Results: As a result of all examinations, 58.1% (n = 50/86) of isolates of Candida spp. were obtained, including 26.7% (n = 23/86) isolates of Candida spp. from oral cavity and 31.3% (n = 27/86) isolates of Candida spp. from vaginal cavity. These isolates included 58% (n = 29/50) C. albicans, 10% (n = 5/50) C. glabrata, 6% (n = 3/50) C. parasilosis, 6% (n = 3/50) C. krusei, 6% (n = 3/50) C. lusitaniae, 6% (n = 3/50) C. kefyr, 6% (n = 3/50) C. tropicalis, and 2% (n = 1/50) C. ciferrii. To quantify extracellular phospholipase production, the egg-yolk agar plate method was utilized. The results indicated that the majority of isolates (n = 33; 66%) were phospholipase-strong producers, 18% (n = 9) of isolates were phospholipase-moderate producers, 5% (n = 10) were phospholipase-weak producers, and 6% (n = 3) were non-phospholipase producers. Microtiter plate method was utilized to estimate formation of biofilm by Candida spp. obtained from vaginal and oral cavities. The majority of Candida spp. isolates (n = 32; 64%) were biofilm-strong producers, followed by 30% (n=15) moderate-biofilm producers and 6% (n = 3) weak-biofilm producers. The results of VITEK 2 system indicated that the probability of C. albicans, C. krusei, C. kefyr, C. tropicalis, C. lusitaniae, C. glabrata, and C. ciferrii was 98, 95, 94, 91, 85, 93, and 85 %, respectively.

Conclusions: Candida albicans was the most frequent isolate among all isolates.