title: Prevalence and antifungal susceptibility of Candida albicans and its related species Candida dubliniensis and Candida africana isolated from vulvovaginal samples in a hospital of Argentina.
abstract: Candida africana taxonomical status is controversial. It was proposed as a separate species within the Candida albicans species complex; however, phylogenetic analyses suggested that it is an unusual variety of C. albicans. The prevalence of C. albicans-related species (Candida dubliniensis and C. africana) as vulvovaginal pathogens is not known in Argentina. Moreover, data on antifungal susceptibility of isolates causing vulvovaginal candidiasis is scarce. The aims of this study were to establish the prevalence of C. dubliniensis and C. africana in vaginal samples and to evaluate the antifungal susceptibilities of vaginal C. albicans species complex strains. We used a molecular-based method coupled with a new pooled DNA extraction methodology to differentiate C. dubliniensis and C. africana in a collection of 287 strains originally identified as C. albicans isolated from an Argentinian hospital during 2013. Antifungal susceptibilities to fluconazole, clotrimazole, itraconazole, voriconazole, nystatin, amphotericin B and terbinafine were evaluated by using the CLSI M27-A3 and M27-S4 documents. Of the 287 isolates, 4 C. dubliniensis and one C. africana strains (1.39% and 0.35% prevalence, respectively) were identified. This is the first description of C. africana in Argentina and its identification was confirmed by sequencing the ITS2 region and the hwp1 gene. C. dubliniensis and C. africana strains showed very low MIC values for all the tested antifungals. Fluconazole-reduced-susceptibility and azole cross-resistance were observed in 3.55% and 1.41% of the C. albicans isolates, respectively. These results demonstrate that antifungal resistance is still a rare phenomenon in this kind of isolates.
authors.affiliation: Laboratorio de Micología y Diagnóstico Molecular - Cátedra de Parasitología y Micología - Facultad de Bioquímica y Ciencias Biológicas, Universidad Nacional del Litoral - CONICET, Santa Fe, Argentina.
authors.forename: Laura
authors.initials: L
authors.lastname: Theill
authors.affiliation: Laboratorio de Micología y Diagnóstico Molecular - Cátedra de Parasitología y Micología - Facultad de Bioquímica y Ciencias Biológicas, Universidad Nacional del Litoral - CONICET, Santa Fe, Argentina.
authors.forename: Catiana
authors.initials: C
authors.lastname: Dudiuk
authors.affiliation: Sección Microbiología, Laboratorio Central, Hospital Dr. José María Cullen, Santa Fe, Argentina.
authors.forename: Susana
authors.initials: S
authors.lastname: Morano
authors.affiliation: Laboratorio de Micología y Diagnóstico Molecular - Cátedra de Parasitología y Micología - Facultad de Bioquímica y Ciencias Biológicas, Universidad Nacional del Litoral - CONICET, Santa Fe, Argentina.
authors.forename: Soledad
authors.initials: S
authors.lastname: Gamarra
authors.affiliation: Sección Microbiología, Laboratorio Central, Hospital Dr. José María Cullen, Santa Fe, Argentina.
authors.forename: María Elena
authors.initials: ME
authors.lastname: Nardin
authors.affiliation: Sección Microbiología, Laboratorio Central, Hospital Dr. José María Cullen, Santa Fe, Argentina.
authors.forename: Emilce
authors.initials: E
authors.lastname: Méndez
authors.affiliation: Laboratorio de Micología y Diagnóstico Molecular - Cátedra de Parasitología y Micología - Facultad de Bioquímica y Ciencias Biológicas, Universidad Nacional del Litoral - CONICET, Santa Fe, Argentina. Electronic address: ggarcia@unl.edu.ar.
authors.forename: Guillermo
authors.initials: G
authors.lastname: Garcia-Effron
mesh_terms: D000935:Antifungal Agents / Q000494:pharmacology*; D001118:Argentina; D002175:Candida / Q000187:drug effects* / Q000302:isolation & purification; D002176:Candida albicans / Q000187:drug effects / Q000302:isolation & purification; D002181:Candidiasis, Vulvovaginal / Q000382:microbiology; D005260:Female; D006801:Humans; D008826:Microbial Sensitivity Tests; D014621:Vagina / Q000382:microbiology; D014844:Vulva / Q000382:microbiology
chemical_list: D000935:Antifungal Agents
keywords: Antifungal resistance; Argentina; Candida Africana; Candida africana; Candidiasis vulvovaginal; Identificación molecular; Molecular identification; Resistencia a los antifúngicos; Vulvovaginal candidiasis