Molecular Identification and Evaluation of Drug Susceptibility of Candida Isolates from Bronchoalveolar Lavage Fluid in Patients with Hematological Malignancies

Khanabadi, Faride; Elmi, Taher; Ghasemi, Zeinab; Didehdar, Mojtaba; Falahati, Mehraban; Aliannejad, Rasol; Farahyar, Shirin

doi:10.30491/hpr.2024.460378.1429

Molecular Identification and Evaluation of Drug Susceptibility of Candida Isolates from Bronchoalveolar Lavage Fluid in Patients with Hematological Malignancies

Document Type : Original Article

Authors

Faride Khanabadi ¹

Taher Elmi ²

Zeinab Ghasemi ³

Mojtaba Didehdar ²

Mehraban Falahati ¹

Rasol Aliannejad ⁴

Shirin Farahyar ¹

¹ Department of Parasitology and Mycology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran

² Department of Parasitology and Mycology, School of Medicine, Arak University of Medical Sciences, Arak, Iran

³ Laboratory of Medical Mycology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran

⁴ Department of Pulmonary, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran

https://doi.org/10.30491/hpr.2024.460378.1429

Abstract

Background: Different studies have shown that despite the expanding number of antifungal drugs, the death rate caused by Candida species has increased during the recent decades due to drug resistance occurrence.
Objectives: The present study aims to identify molecular structure and evaluate drug susceptibility in Candida species isolated from bronchoalveolar lavage fluid in patients diagnosed with hematological malignancies.
Methods: In this cross-sectional study, 54 clinical specimens were taken from the bronchoalveolar lavage of patients. The suspected colonies were investigated by microscopic examination and subsequent passages were evaluated according to standard operating procedures and specification of the type of colony color prescribed by CHROMagar to isolate the yeast. The sequencing method (ITS1, ITS4) was used to approve Candida species. Finally, susceptibility test was carried out according to M27S-3 and M38-A2 micro-dilution methods.
Results: Among 54 samples investigated with culture and PCR methods, 33 Candida species were identified in patients with hematological malignancies. Candida albicans (75.7%) was the most common fungal isolate. Results of drug susceptibility tests showed that the isolated C. albicans (n = 2), C. glabrata (n = 1), and C. tropicalis (n = 1) from patients with hematological malignancies were resistant to fluconazole. The present study showed that the prevalence of C. albicans was higher than other fungal species among patients with hematological malignancies.
Conclusion: Candida species are more susceptible to voriconazole, amphotericin B and Caspofungin. Therefore, identification of candida species along with their antifungal susceptibility pattern can help clinicians to better treat patients.

Keywords

Fungal

Drug Susceptibility

Hematological Malignancies

Patient

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