Species Identification of Candida Strains Isolated from Patients with Candidemia, Hospitalized in Tehran, by Enzymatic Digestion of ITS–rDNA

Document Type : Original Article (s)

Authors

1 Assistant Professor, Department of Biology, School of Applied Sciences, Imam Hossein University, Tehran, Iran

2 Associate Professor, Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran

3 Assistant Professor, Department of Microbiology, Applied Microbiology Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran

4 Department of Medical Technology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran

Abstract

Background: Candidemia is a very important infection in terms of incidence and mortality. It can be caused by several species of the genus Candida and should be diagnosed and treated quickly. Although Candida albicans is still the most common causative agent of candidemia, the incidence of blood infections due to non-albicans Candida species has increased in the recent years. Species identification of the agents is necessary from the viewpoints of continuous epidemiological survey and susceptibility or resistance of different species to the antifungal drugs.Methods: In this study, forty eight clinical isolates of Candida species obtained from blood specimen cultures belonging to 32 immunocompromised patients with candidemia who were hospitalized in some therapeutic centers in Tehran, Iran, were precisely identified at the species level by a set of PCR-RFLP assays.Findings: C. parapsilosis was the most frequent agent of candidemia followed by C. glabrata, C. albicans, C. tropicalis and C. kefyr. These findings were unexpected and should be specifically mentioned because C. albicans is almost always the most common cause of candidemia and all other clinical forms of candidiasis, while among the isolates of the current study it only ranked third in terms of abundance.Conclusion: We found that C. parapsilosis as the most common causative agent of candidemia in our samples. Considering the relatively low number of studied isolates, it seems that a larger study is needed to confirm these results.

Keywords

References

  1. Calderone RA. Candida And Candidiasis. Washington DC: ASM Press; 2002.
  2. Abi-Said D, Anaissie E, Uzun O, Raad I, Pinzcowski H, Vartivarian S. The epidemiology of hematogenous candidiasis caused by different Candida species. Clin Infect Dis 1997; 24(6): 1122-8.
  3. Beck-Sague C, Jarvis WR. Secular trends in the epidemiology of nosocomial fungal infections in the United States, 1980-1990. National Nosocomial Infections Surveillance System. J Infect Dis 1993; 167(5): 1247-51.
  4. Kao AS, Brandt ME, Pruitt WR, Conn LA, Perkins BA, Stephens DS, et al. The epidemiology of candidemia in two United States cities: results of a population-based active surveillance. Clin Infect Dis 1999; 29(5): 1164-70.
  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.
  6. Richardson MD, Warnock DW. Fungal Infection: Diagnosis and Management. 3rd ed. New York: Wiley-Blackwell; 2003.
  7. Merz WG. Candida lusitaniae: frequency of recovery, colonization, infection, and amphotericin B resistance. J Clin Microbiol 1984; 20(6): 1194-5.
  8. Pfaller MA, Diekema DJ, Messer SA, Boyken L, Hollis RJ, Jones RN. In vitro activities of voriconazole, posaconazole, and four licensed systemic antifungal agents against Candida species infrequently isolated from blood. J Clin Microbiol 2003; 41(1): 78-83.
  9. Walsh TJ, Melcher GP, Rinaldi MG, Lecciones J, McGough DA, Kelly P, et al. Trichosporon beigelii, an emerging pathogen resistant to amphotericin B. J Clin Microbiol 1990; 28(7): 1616-22.
  10. Hitchcock CA, Pye GW, Troke PF, Johnson EM, Warnock DW. Fluconazole resistance in Candida glabrata. Antimicrob Agents Chemother 1993; 37(9): 1962-5.
  11. Rex JH, Rinaldi MG, Pfaller MA. Resistance of Candida species to fluconazole. Antimicrob Agents Chemother 1995; 39(1): 1-8.
  12. Moran GP, Sullivan DJ, Henman MC, McCreary CE, Harrington BJ, Shanley DB, et al. Antifungal drug susceptibilities of oral Candida dubliniensis isolates from human immunodeficiency virus (HIV)-infected and non-HIV-infected subjects and generation of stable fluconazole-resistant derivatives in vitro. Antimicrob Agents Chemother 1997; 41(3): 617-23.
  13. Pfaller MA, Boyken L, Hollis RJ, Messer SA, Tendolkar S, Diekema DJ. In vitro activities of anidulafungin against more than 2,500 clinical isolates of Candida spp., including 315 isolates resistant to fluconazole. J Clin Microbiol 2005; 43(11): 5425-7.
  14. Mirhendi H, Kordbacheh P, Pezeshki M, Khoramizadeh MR. Simple and rapid identification of most medically important Candida species by a PCR-restriction enzyme method. Acta Medica Iranica 2003; 41(2): 79-83.
  15. Pounder JI, Williams S, Hansen D, Healy M, Reece K, Woods GL. Repetitive-sequence-PCR-based DNA fingerprinting using the Diversilab system for identification of commonly encountered dermatophytes. J Clin Microbiol 2005; 43(5): 2141-7.
  16. Pincus DH, Orenga S, Chatellier S. Yeast identification--past, present, and future methods. Med Mycol 2007; 45(2): 97-121.
  17. Mirhendi H, Bruun B, Schonheyder HC, Christensen JJ, Fuursted K, Gahrn-Hansen B, et al. Molecular screening for Candida orthopsilosis and Candida metapsilosis among Danish Candida parapsilosis group blood culture isolates: proposal of a new RFLP profile for differentiation. J Med Microbiol 2010; 59(Pt 4): 414-20.
  18. Mirhendi H, Bruun B, Schonheyder HC, Christensen JJ, Fuursted K, Gahrn-Hansen B, et al. Differentiation of Candida glabrata, C. nivariensis and C. bracarensis based on fragment length polymorphism of ITS1 and ITS2 and restriction fragment length polymorphism of ITS and D1/D2 regions in rDNA. Eur J Clin Microbiol Infect Dis 2011; 30(11): 1409-16.
  19. Iwen PC, Hinrichs SH, Rupp ME. Utilization of the internal transcribed spacer regions as molecular targets to detect and identify human fungal pathogens. Med Mycol 2002; 40(1): 87-109.
  20. Nieto-Rodriguez JA, Kusne S, Manez R, Irish W, Linden P, Magnone M, et al. Factors associated with the development of candidemia and candidemia-related death among liver transplant recipients. Ann Surg 1996; 223(1): 70-6.
  21. Yamamura DL, Rotstein C, Nicolle LE, Ioannou S. Candidemia at selected Canadian sites: results from the Fungal Disease Registry, 1992-1994. Fungal Disease Registry of the Canadian Infectious Disease Society. CMAJ 1999; 160(4): 493-9.
  22. Hajjeh RA, Sofair AN, Harrison LH, Lyon GM, Arthington-Skaggs BA, Mirza SA, et al. Incidence of bloodstream infections due to Candida species and in vitro susceptibilities of isolates collected from 1998 to 2000 in a population-based active surveillance program. J Clin Microbiol 2004; 42(4): 1519-27.
  23. Cheng MF, Yang YL, Yao TJ, Lin CY, Liu JS, Tang RB, et al. Risk factors for fatal candidemia caused by Candida albicans and non-albicans Candida species. BMC Infect Dis 2005; 5: 22.
Journal of Isfahan Medical School
Volume 29, Issue 167 - Serial Number 167
November and December 2012
Pages 2413-2426

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History

  • Receive Date: 01 October 2011
  • Revise Date: 02 November 2024
  • Accept Date: 06 April 2022

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