Assessment of antifungal resistance and associated molecular mechanism in Candida albicans isolates from different cohorts of patients in North Indian state of Haryana
Language English Country United States Media print-electronic
Document type Journal Article
PubMed
32219719
DOI
10.1007/s12223-020-00785-6
PII: 10.1007/s12223-020-00785-6
Knihovny.cz E-resources
- MeSH
- Antifungal Agents pharmacology MeSH
- Azoles pharmacology MeSH
- Candida albicans drug effects genetics isolation & purification MeSH
- Candida classification drug effects genetics isolation & purification MeSH
- Drug Resistance, Fungal genetics MeSH
- Fungal Proteins genetics MeSH
- Genes, MDR genetics MeSH
- Candidiasis epidemiology microbiology MeSH
- Humans MeSH
- Microbial Sensitivity Tests MeSH
- Mutation MeSH
- Hospitals MeSH
- Gene Expression Regulation, Fungal MeSH
- Retrospective Studies MeSH
- Cytochrome P-450 Enzyme System genetics MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Geographicals
- India epidemiology MeSH
- Names of Substances
- Antifungal Agents MeSH
- Azoles MeSH
- Fungal Proteins MeSH
- Cytochrome P-450 Enzyme System MeSH
The present study examines the trend in distribution of Candida species and their antifungal resistance patterns in hospitals across Haryana, a North Indian state with poorly addressed epidemiology of fungal infections. In our collection of 228 Candida isolates, Candida albicans dominated in both high vaginal swab (HVS) and urine samples while Candida glabrata and Candida tropicalis were the second-highest non-albicans Candida species (NAC), respectively. Of note, in blood samples, C. tropicalis and C. albicans were present in equal numbers. All 228 isolates were subjected to antifungal susceptibility tests, whereby 51% of C. albicans recovered from HVS samples displayed fluconazole resistance. To understand its mechanistic basis, expression profiling of efflux pump genes CDR1, CDR2, MDR1 and azole drug target, ERG11 was performed in 20 randomly selected resistant isolates, wherein many isolates elicited higher expression. Further, ERG11 gene sequencing suggested that most of the isolates harbored mutations, which are not reported with azole resistance. However, one isolate, RPCA9 (MIC 64 μg/mL) harbored triple mutation (Y132C, F145L, A114V), wherein Y132 and F145 sites were previously implicated in azole resistance. Interestingly, one isolate, (RPCA61) having MIC > 128 μg/mL harbored a novel mutation, G129R. Of note, HVS isolates RPCA 21, RPCA 22, and RPCA 44 (MICs 64 to > 128 μg/mL) did not show any change in alteration in ERG11 or overexpression of efflux pump genes. Together, this study presents a first report of Candida infections in selected hospitals of Haryana State.
Fortis Memorial Research Institute Gurugram India
International Centre for Genetic Engineering and Biotechnology New Delhi 110067 India
School of Life Sciences Jawaharlal Nehru University New Delhi 110067 India
The Postgraduate Institute of Medical Education and Research Chandigarh India
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