Molecular epidemiology, virulence factors, and antifungal susceptibility of Candida inconspicua strains isolated from clinical samples in Turkey

•Candida inconspicua can be misidentified as Candida norvegensis by phenotypic methods.•DNA sequence analysis has a strong discrimination power.•Esculin hydrolysis test can be used in the absence of molecular methods.•High fluconazole minimal inhibitory concentrations should be taken into account in...

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Published in:Diagnostic microbiology and infectious disease 2023-05, Vol.106 (1), p.115915-115915, Article 115915
Main Authors: Kucukoglu, Osman, Sariguzel, Fatma Mutlu, Koc, Ayse Nedret, Parkan, Omur Mustafa
Format: Article
Language:English
Subjects:
Antifungal Agents - pharmacology
Antifungal susceptibility
Candida inconspicua
Candida norvegensis
Esterases
Humans
Molecular Epidemiology
Phylogenetic analysis
Turkey - epidemiology
Virulence factors
Virulence Factors - genetics
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Summary:•Candida inconspicua can be misidentified as Candida norvegensis by phenotypic methods.•DNA sequence analysis has a strong discrimination power.•Esculin hydrolysis test can be used in the absence of molecular methods.•High fluconazole minimal inhibitory concentrations should be taken into account in the empirical treatment. In this study, it was aimed to evaluate the molecular epidemiology, virulence factors, and antifungal susceptibility of clinical Candida inconspicua isolates. All isolates were identified by phenotypic methods and sequence analysis of ITS 1-2, D1/D2, EF-1 alpha. Proteinase, phospholipase, and esterase activities, biofilm formation, and antifungal susceptibilities were determined. All thirty isolates identified as Candida norvegensis by phenotypic methods were reidentified as C. inconspicua by sequence analysis, demonstrating the inadequacy of phenotypic methods to differentiate these 2 species. The gene regions examined in terms of determining evolutionary relatedness did not show intraspecies nucleotide variations. Therefore, different molecular approaches are needed to evaluate molecular epidemiology. Esterase, phospholipase, and biofilm formation were found to be positive in 100%, 100%, and 36.6% of the strains, respectively. The MIC50/MIC90 values for fluconazole and flucytosine were found to be higher than the other tested antifungals, which should be taken into account in the treatment.
ISSN:0732-8893
1879-0070
DOI:10.1016/j.diagmicrobio.2023.115915