%0 Journal Article
%T Antifungal Susceptibility Patterns, In Vitro Production of Virulence Factors, and Evaluation of Diagnostic Modalities for the Speciation of Pathogenic Candida from Blood Stream Infections and Vulvovaginal Candidiasis
%A Chaitanya Tellapragada
%A Vandana Kalwaje Eshwara
%A Ruqaiyah Johar
%A Tushar Shaw
%A Nidhi Malik
%A Parvati V. Bhat
%A Asha Kamath
%A Chiranjay Mukhopadhyay
%J Journal of Pathogens
%D 2014
%I Hindawi Publishing Corporation
%R 10.1155/2014/142864
%X Candida spp. have emerged as successful pathogens in both invasive and mucosal infections. Varied virulence factors and growing resistance to antifungal agents have contributed to their pathogenicity. We studied diagnostic accuracy of HiCrome Candida Differential Agar and Vitek 2 Compact system for identification of Candida spp. in comparison with species-specific PCR on 110 clinical isolates of Candida from blood stream infections (54, 49%) and vulvovaginal candidiasis (56, 51%). C. albicans (61%) was the leading pathogen in VVC, while C. tropicalis (46%) was prominent among BSIs. HiCrome Agar and Vitek 2 Compact had good measures of agreement (¦Ê) 0.826 and 0.895, respectively, in comparison with PCR. We also tested these isolates for in vitro production of proteinase, esterase, phospholipases, and biofilms. Proteinase production was more among invasive isolates ( ), while phospholipase production was more among noninvasive isolates ( ). There was an overall increase in the production of virulence factors among non-albicans Candida. Identification of clinical isolates of Candida up to species level either by chromogenic agar or by Vitek 2 Compact system should be routinely done to choose appropriate therapy. 1. Introduction The opportunistic yeasts belonging to the genus Candida have been associated with a wide range of human infections and significant mortality and morbidity. The clinical manifestations range from infections of the superficial skin and its appendages to deep-seated or disseminated candidiasis. Estimates suggest that Candida spp. have been the third most common nosocomial pathogens associated with blood stream infections (BSIs) [1]. Among noninvasive infections, vulvovaginal candidiasis (VVC) affects approximately 75% of the women with at least one episode during their lifetime [2]. Though C. albicans has been associated mostly with human infections, there has been an increase in the prevalence of infections due to non-albicans Candida in the recent past [3, 4]. Of the many pathogenic non-albicans species known, C. tropicalis, C. parapsilosis, C. kefyr, C. krusei, and C. guilliermondii are mostly associated with human infections. Candida spp. have grown from successful commensals to pathogens in various body sites with the help of many virulence determinants. Though non-albicans Candida have proven to be common pathogens in most invasive infections, little attention is given to their virulence attributes. Adherence to host tissue, response to environmental changes, secretion of hydrolases, and biofilm production are a few of the most
%U http://www.hindawi.com/journals/jpath/2014/142864/