title: Itraconazole-resistant Candida auris with phospholipase, proteinase and hemolysin activity from a case of vulvovaginitis.
abstract: Since the emergence of pathogenic non-albicans Candida species, a number of new isolates have been added to the list. One such unusual species is Candida auris (C. auris), recently isolated and studied in few reports. In this study, a case of vulvovaginitis caused by Candida auris incidentally identified by molecular methods using internal transcribed spacer polymerase chain reaction (ITS PCR) is described. Antifungal susceptibility testing revealed the isolate to be resistant to itraconazole (MIC ≥ 2 µg/ml) and expressed important virulence factors including phospholipase, proteinase and hemolysin activity. The patient was successfully treated with oral fluconazole and did not have any invasive fungemia. Very few cases of this emerging pathogen have been reported. However, its isolation from clinical specimens reveals the significance of non-albicans candida species over C. albicans and the diversity of Candida spp causing infections.
authors.affiliation: Institute of Medical Sciences, Banaras Hindu University, Varanasi, India. dharambhu@gmail.com.
authors.forename: Dharmendra
authors.initials: D
authors.lastname: Kumar
authors.forename: Tuhina
authors.initials: T
authors.lastname: Banerjee
authors.forename: Chandra Bhan
authors.initials: CB
authors.lastname: Pratap
authors.forename: Ragini
authors.initials: R
authors.lastname: Tilak
mesh_terms: D000328:Adult; D000935:Antifungal Agents / Q000494:pharmacology* / Q000627:therapeutic use; D002175:Candida / Q000187:drug effects / Q000201:enzymology / Q000302:isolation & purification*; D002181:Candidiasis, Vulvovaginal / Q000188:drug therapy / Q000382:microbiology*; D004271:DNA, Fungal / Q000737:chemistry / Q000235:genetics; D021903:DNA, Ribosomal Spacer / Q000737:chemistry / Q000235:genetics; D025141:Drug Resistance, Fungal; D005260:Female; D015725:Fluconazole / Q000627:therapeutic use; D006460:Hemolysin Proteins / Q000032:analysis; D006801:Humans; D017964:Itraconazole / Q000494:pharmacology*; D008828:Microbiological Techniques; D010447:Peptide Hydrolases / Q000032:analysis; D010740:Phospholipases / Q000032:analysis; D017422:Sequence Analysis, DNA; D016896:Treatment Outcome; D037521:Virulence Factors / Q000032:analysis*
chemical_list: D000935:Antifungal Agents; D004271:DNA, Fungal; D021903:DNA, Ribosomal Spacer; D006460:Hemolysin Proteins; D037521:Virulence Factors; D017964:Itraconazole; D015725:Fluconazole; D010740:Phospholipases; D010447:Peptide Hydrolases