Antifungal susceptibility in serum and virulence determinants of Candida bloodstream isolates from Hong Kong

Seneviratne, Chaminda J., Rajan, Suhasini, Wong, Sarah S. W., Tsang, Dominic N. C., Lai, Christopher K. C., Samaranayake, Lakshman P. and Jin, Lijian (2016) Antifungal susceptibility in serum and virulence determinants of Candida bloodstream isolates from Hong Kong. Frontiers in Microbiology, 7 FEB: 1-8. doi:10.3389/fmicb.2016.00216


Author Seneviratne, Chaminda J.
Rajan, Suhasini
Wong, Sarah S. W.
Tsang, Dominic N. C.
Lai, Christopher K. C.
Samaranayake, Lakshman P.
Jin, Lijian
Title Antifungal susceptibility in serum and virulence determinants of Candida bloodstream isolates from Hong Kong
Formatted title
Antifungal susceptibility in serum and virulence determinants of Candida bloodstream isolates from Hong Kong
Journal name Frontiers in Microbiology   Check publisher's open access policy
ISSN 1664-302X
Publication date 2016-02-26
Year available 2016
Sub-type Article (original research)
DOI 10.3389/fmicb.2016.00216
Open Access Status DOI
Volume 7
Issue FEB
Start page 1
End page 8
Total pages 8
Place of publication Lausanne, Switzerland
Publisher Frontiers Research Foundation
Collection year 2017
Language eng
Formatted abstract
Candida bloodstream infections (CBI) are one of the most common nosocomial infections globally, and they account for a high mortality rate. The increasing global prevalence of drug-resistant Candida strains has also been posing a challenge to clinicians. In this study, we comprehensively evaluated the biofilm formation and production of hemolysin and proteinase of 63 CBI isolates derived from a hospital setting in Hong Kong as well as their antifungal susceptibility both in the presence and in the absence of human serum, using standard methodology. Candida albicans was the predominant species among the 63 CBI isolates collected, and non-albicans Candida species accounted for approximately one third of the isolates (36.5%). Of them, Candida tropicalis was the most common non-albicans Candida species. A high proportion (31.7%) of the CBI isolates (40% of C. albicans isolates, 10% of C. tropicalis isolates, 11% of C. parapsilosis isolates, and 100% of C. glabrata isolates) were found to be resistant to fluconazole. One of the isolates (C. tropicalis) was resistant to amphotericin B. A rising prevalence of drug-resistance CBI isolates in Hong Kong was observed with reference to a previous study. Notably, all non-albicans Candida species, showed increased hemolytic activity relative to C. albicans, whilst C. albicans, C. tropicalis, and C. parapsilosis exhibited proteinase activities. Majority of the isolates were capable of forming mature biofilms. Interestingly, the presence of serum distorted the yeast sensitivity to fluconazole, but not amphotericin B. Taken together, our findings demonstrate that CBI isolates of Candida have the potential to express to varying extent their virulence attributes (e.g., biofilm formation, hemolysin production, and proteinase activity) and these, together with perturbations in their antifungal sensitivity in the presence of serum, may contribute to treatment complication in candidemia. The effect of serum on antifungal activity warrants further investigations, as it has direct clinical relevance to the treatment outcome in subjects with candidemia.
Keyword Candida
Antifungal susceptibility
Virulence factors
Clinical isolates
Plasma protein binding
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
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