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. 2024 Dec 26;24(1):1555.
doi: 10.1186/s12903-024-05368-2.

Antifungal susceptibility profile of Candida species and uncommon yeasts from drug abusers with oral candidiasis

Aynaz Ghojoghi  1   2 , Sadegh Khodavaisy  3   4 , Ali Zarei Mahmoudabadi  1   5 , Mahnaz Fatahinia  6   7
Affiliations

Antifungal susceptibility profile of Candida species and uncommon yeasts from drug abusers with oral candidiasis

Aynaz Ghojoghi et al. BMC Oral Health. .

Abstract

In Iran, there is limited information regarding the species distribution and antifungal susceptibility profiles of yeast isolates from drug addicts suffering from oral candidiasis (OC). In this study, 104 yeast isolates, including 98 Candida species and 6 uncommon yeasts, were collected from 71 drug abusers with OC. The susceptibility profiles of Candida spp. and uncommon yeasts to amphotericin B (AMB), itraconazole (ITC), nystatin (NYC), fluconazole (FLC), and caspofungin (CAS) were evaluated using the CLSI broth microdilution method. The prevalence of OC in the sampled population was found to be 29%. The susceptibility profile of Candida spp. revealed remarkable sensitivity, with 100% and 99% of isolates susceptible to NYC and AMB, respectively. However, concerning levels of resistance or non-wild-type minimum inhibitory concentrations (MICs) were observed, with 13.2% of Candida isolates showing resistance to FLC, 13.2% to ITC, and 16.3% to CAS. Notably, 35.2% of patients showed mixed yeast species, while 5.1% of Candida isolates exhibited multidrug resistance. The analysis of the uncommon yeast species showed that the overall frequencies of the highest MICs were observed for CAS. Furthermore, within the six non-Candida species identified, Hanseniaspora opuntiae and one isolate of Pichia kluyveri exhibited resistance to FLC and ITC, respectively, while all non-Candida species were susceptible to AMB and NYC. Additionally, one isolate of Pichia kluyveri exhibited simultaneously high MICs to two drugs ITC and CAS. Furthermore, the Hanseniaspora opuntiae isolate showed high MICs to CAS and FLC. The findings from the present study suggest that AMB and NYC can be suitable choices for empiric treatment of both common Candida species and uncommon yeast infections in substance abuse patients.

Keywords: Candida species; Antifungal resistance; Drug addiction; Oral candidiasis; Uncommon yeast species.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: The study protocol was approved by the Research Ethics Committee of Ahvaz Jundishapur University of Medical Sciences, with the ethical code number IR.AJUMS.MEDICINE.REC.1400.047. All participants in our study provided informed consent prior to their inclusion. The participants signed an informed consent form, and we adhered to all relevant guidelines and regulations throughout the study. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Electrophoretic pattern of 21-plex PCR products. Numbers 1 to 10 encompass the following: negative control, Pichia kudriavzevii (1159 bps), Candida parapsilosis (490 bps), Candida albicans (606 bps), Candida dubliniensis (718 bps), Candida glabrata (212 bps), Candida tropicalis (126 bps), Marker, Clavispora lusitaniae (377 bps), Geotrichum candidum (299 bps)
Fig. 2
Fig. 2
Comparison of susceptibilities in Candida species with established ECVs and CBPs
See this image and copyright information in PMC

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