Antifungal Susceptibility, Possible Role, Nitric Oxide Synthase, Activity, Pathogenesis, Candidal Vaginal, Skin Infections

Abo-Kamar, Amal; Nassar, Samia; Hammoda, Abd El Fattah; Ibrahim, Wafaa

doi:10.21608/jhiph.2000.243862

Antifungal Susceptibility, Possible Role, Nitric Oxide Synthase, Activity, Pathogenesis, Candidal Vaginal, Skin Infections

Document Type : Original Article

Authors

¹ Department of Microbiology, Faculty of Pharmacy, Tanta University, Egypt

² Department of Dermatology, Faculty of Medicine, Tanta University, Egypt

³ Department of Microbiology, High Institute of Public Health, Alexandria University, Egypt

⁴ Department of Biochemistry, Faculty of Medicine, Tanta University, Egypt

10.21608/jhiph.2000.243862

Abstract

In this study 300 patients having cutaneous and vaginal infections were laboratory studied. Their cultures yielded 73 candida isolates grouped as [29 patients with candidal skin infection exposed to high risk occupational factors, 23 women with symptomatic vulvovaginal candidiasis and 21 women under long term immunosuppressive therapy with vulvovaginal candidiasis]. The results showed that, Candida albicans accounted for 75.9%, 73.9% and 52.4%, Candida glabrata 6.9%, 17.4% and 19%, Candida tropicalis 6.9%, 8.7% and 19% for three groups of patients while Candida krusei accounted for 10.3% and 9.5% for first and third groups. The susceptibility of different candidal isolates against different commonly used antifungal drugs was determined using two standard methods in addition to flow cytometry. The MIC of all antifungal drugs ranged from 0.5 to 512 mg/ml using standard agar diffusion method. The percent of resistance to the tested antifungal drugs were 4.5% - 54.5% for Candida albicans and 25-50% for Candida glabrata and Candida tropicalis and 33.3 -50% for Candida krusei. In conclusion C. albicans is the most common candidal species causing cutaneous and vaginal candidiasis and it is the least susceptible to fluconazole. The resistance to fluconazole was biochemically investigated by assessement of nitric oxide activity in candidal isolates and morphologically estimatid by scanning electron microscopy. On comparing the MIC of fluconazole by standard dilution method against C. albicans isolates these showed a very good agreement with the resutls by the flow cytometry technique. This indicates that flow cytometry is a rapid, reproducible and sensitive method. Nitric oxide synthase activity was significantly higher in susceptible strains than resistant ones for all the tested C. albicans. this may play a role in their virulence or pathogenesis.

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