European Journal of Clinical and Biomedical Sciences
Volume 6, Issue 5, October 2020, Pages: 71-77
Received: Aug. 12, 2020;
Accepted: Aug. 24, 2020;
Published: Sep. 7, 2020
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Claude Nangwat, Department of Biochemistry, Faculty of Science, University of Dschang, Dschang, Cameroon
Aude Ngueguim Dougue, Department of Biochemistry, Faculty of Science, University of Yaounde I, Yaounde, Cameroon
Cyrille Levis Kountchou, Department of Biochemistry, Faculty of Science, University of Dschang, Dschang, Cameroon
Alfred Itor Ekpo, Department of Biochemistry, Faculty of Science, University of Dschang, Dschang, Cameroon
Thierry Kammalac Ngouana, Biomedical Research Unit, Sion Laboratory, Yaounde, Cameroon
Jean Paul Dzoyem, Department of Biochemistry, Faculty of Science, University of Dschang, Dschang, Cameroon
Christopher Bonglavnyuy Tume, Department of Biochemistry, Faculty of Science, University of Dschang, Dschang, Cameroon
No study in Cameroon has been undertaken to check for the presence of the cryptic species belonging to the Candida glabrata complex, which have varying antifungal susceptibility profiles. In this regard, we analyzed a collection of 54 clinical isolates of C. glabrata sensu lato obtained from 1551 samples of 490 participants. These participants included 80 diabetic patients, 323 HIV-infected subjects, 73 pregnant women and 14 of some other patients who had none of the aforementioned conditions. Our study aimed at identifying Candida glabrata cryptic species among clinical isolates of Candida glabrata sensu lato from the West region of Cameroon and to evaluate their susceptibility pattern to some antifungals. Conventional tests such as culture on CHROMagar™ Candida, germ tube formation and chlamydospore formation tests were used for the 1st line identification of our isolates, while the matrix assisted laser desorption ionisation – time of flight mass spectrometry (MALDI-TOF) was used for second line identification and confirmation of identifications. The minimal inhibitory concentrations (MICs) of Ketoconazole (Sigma Aldrich, China), Nystatine (Sigma Aldrich, China), Amphotericin B (Dominique Dutscher), Itraconozole (Sigma Aldrich, China), Voriconazole (Acros organics, China), and Clotrimazole (Acros organics, China) vis-à-vis 43 isolates, were determined according to the protocol proposed by the Clinical and Laboratory Standards Institute (CLSI) M27-A3 and M27-S4, with slight modifications. Of the 54 isolates, none was identified as C. nivariensis or C. bracarensis by MALDI-TOF, all the 54 (100%) isolates were confirmed to be C. glabrata stricto sensu. CLO (MIC range: 0.25 - >4 µg/mL) was most resisted by our isolates (95.35%), while 32.56% were resistant to KET (range of MICs: 0.03 - >4 µg/mL). On the other hand, ECVs showed that AMB (MIC range: 0.03 - 4 µg/mL) and ICZ (MIC range: 0.25 - 4 µg/mL) had very good activities against our isolates, as 81.4% of the isolates were wild type for both antifungals. On the other hand, VOR (range of MICs: 0.125 - >4 µg/mL) showed a poor activity, as most of our isolates (93.02%) were non-wild type for the antifungal. The number of isolates used in this study was not enough to conclude that C. nivariensis and C. bracarensis isolates are absent in the West Region or other parts of Cameroon, so we recommend that more of such studies be carried out in Cameroon, as this could help detect the presence of any of these emerging species with varying antifungal susceptibility profiles.
Aude Ngueguim Dougue,
Cyrille Levis Kountchou,
Alfred Itor Ekpo,
Thierry Kammalac Ngouana,
Jean Paul Dzoyem,
Christopher Bonglavnyuy Tume,
Non Detection of Candida nivariensis and Candida bracarensis Among Candida glabrata Sensu Lato Isolates in the West Region of Cameroon, European Journal of Clinical and Biomedical Sciences.
Vol. 6, No. 5,
2020, pp. 71-77.
Rodrigues C. F., Silva S., Henriques M. Candida glabrata: A review of its features and resistance. European Journal of Clinical Microbiology and Infectious Diseases. 2013; 33: 673-88.
Ames L. C. Functional Characterisation of Candida glabrata Open Reading Frames with no Orthologue in Saccharomyces cerevisiae. Ph. D Thesis, University of Exeter, 2013.
Zisova L. G., Chokoeva A. A., Amaliev G. I., Petleshkova P. V., Miteva-Katrandzhieva T. M., Krasteva M., Uchikova E. H., Kuzmanov A. H., Ivanova Z. V. Vulvovaginal candidiasis in pregnant women and its importance for Candida colonization of newborns. Folia Medica. 2016; 58: 108-114.
Chau N. T. M. Application of molecular techniques to study the etiology and epidemiology of Candida spp. infections in Central VietNam. Doctorate Ph. D Thesis of School in Biomolecular and Biotechnological Sciences. University of Sassari, 2016.
Schmidt P. Molecular mechanisms of the human pathogen Candida glabrata involved in the interaction with the host. Ph. D Thesis, University of Göttingen. 2007.
De Groot P. W. J., Kraneveld E. A., Yin Q. Y., Dekker H. L., Groß U., Crielaard W., de Koster C. G., Bader O., Klis F. M., Weig M.. Eukaryotic cell. 2008; 7: 1951–1964.
Angoulvant A., Guitard J., Hennequin C. Old and new pathogenic Nakaseomyces species: epidemiology, biology, identifcation, pathogenicity and antifungal resistance. Federation of European Mycological society. 2016; 16: 1-13.
Turner S. A., Butler G. The Candida pathogenic species complex. Cold Spring Harbor Perspectives in Medecine. 2014; 4: a019778.
Brown J. K., Frohlich D. R., Rosell R. C. "The sweetpotato or silverleaf whiteflies: biotypes of Bemisia tabaci or a species complex?" Annual Review of Entomology. 1995; 40: 511–534.
Hou X., Xiao M., Chen S. C. –A., Wang H., Yu S.-Y., Fan X., Kong F. and Xu Y.-C. Identification and Antifungal Susceptibility Profiles of Candida nivariensis and Candida bracarensis in a Multi-Center Chinese Collection of Yeasts. Frontiers in Microbiology. 2017; 8: 5.
Asadzadeh M., Alanazi A. F., Ahmad S., AlSweih N., Khan Z. Lack of detection of Candida nivariensis and Candida bracarensis among 440 clinical Candida glabrata sensu lato isolates in Kuwait. PLoS ONE. 2019; 14 (10): e0223920.
Ngouana T. K. Diversité génétique d’isolats de Cryptococcus et Candida issus des patients VIH positifs à Yaoundé et étude de leur sensibilité aux antifongiques et aux extraits de plantes, 283p. Parasitologie. Université Montpellier I. (2014).
Sanata B., Salam O. A. Ibrahim S., Adama Zida., Mamoudou C., Simplice K. D., Jacques S., Robert G. T., Christophe H. Digestive fungal flora in asymptomatic subjects in Bobo-Dioulasso, Burkina Faso. Asian Pacific Journal of Tropical Biomedecine. 2014; 4: 659–62.
Odds F. C., Bernaerts R. CHROMagar Candida, a new differential isolation medium for presumptive identification of clinically important Candida species. Journal of Clinical Microbiology. 1994; 32: 1923.
Clinical Laboratory Standard Institute. Epidemiological cutoff values for antifungal susceptibility testing. 2nd ed. CLSI supplement M59. 2018. Wayne, PA: Clinical and Laboratory Standards Institute.
Costa C., Ribeiro J., Miranda I. M., Silva-Dias A., Cavalheiro M., Costa-de-Oliveira S., Rodrigues A. G., Teixeira M. C. Clotrimazole Drug Resistance in Candida glabrata Clinical Isolates Correlates with Increased Expression of the Drug: H+ Antiporters CgAqr1, CgTpo1_1, CgTpo3, and CgQdr2. Frontiers in Microbiology. 2016; 7: 526.
Mulu A., Kassu A., Anagaw B., Moges B., Gelaw A., Alemayehu M., Belyhun Y., Biadglegne F., Hurissa Z., Moges F., Isogai E. “Frequent detection of ‘azole’ resistant Candida species among late presenting AIDS patients in northwest Ethiopia.” BMC Infectious Diseases. 2013; 13: 82.
Nenoff P., Krüger C., Neumeister C., Schwantes U., Koch D. In vitro susceptibility testing of yeasts to nystatin – low minimum inhibitory concentrations suggest no indication of in vitro resistance of Candida albicans, Candida species or non-Candida yeast species to nystatin. Clinical and Medical Investigations. 2016; 1: 71-76.
Alastruey-Izquierdo A., Melhem, M. S. C., Bonfietti, L. X., Rodriguez-Tudela J. L. Susceptibility test for fungi: clinical and laboratorial correlations in medical mycology. Journal of the Institute of Tropical Medicine of São Paulo. 2015; 5: 57-64.
Mashaly G., Shrief R. Candida glabrata complex from patients with healthcare-associated infections in Mansoura University Hospitals, Egypt: distribution, antifungal susceptibility and effect of fluconazole and polymyxin B combination. GERMS. 2019; 9: 125-132.
Diesse J. M., Kechia F. A., Iwewe Y. S., Ngueguim A. D., Nangwat C., Dzoyem J. P. Urinary tract candidiasis in HIV+ patients and sensitivity patterns of recovered Candida species to antifungal drugs in Dschang District Hospital (Cameroon). International Journal of Biological and Chemical Sciences. 2017; 11: 1029-1038.
Ekpo I. A., Kechia F. A., Iwewe Y. S., Ngueguim A. D., Nangwat C., Dzoyem J. P. Species distribution and antifungal susceptibility profile of Candida spp isolated from urine of hospitalized patients in Dschang District Hospital, Cameroon. International Journal of Biological and Chemical Sciences. 2017; 11: 1212-1221.
Nangwat C., Metago A. L., Iwewe S. Y., Kechia A. F., Tchuenguem T. R., Dzoyem J. P. Bloodstream and Gastrointestinal Candidiasis in HIV-Infected Patients Attending Dschang District Hospital (Cameroon) and Resistance Profile of the Isolates. African Journal of Integrated Health. 2017; 7: 43-48.
Ngueguim D. A., Iwewe S. Y., Kechia A. F., Nangwat C., Diesse J. M., Tchuenguem T. R., Dzoyem J. P. Prevalence of Candiduria in Diabetic Patients attending the Bafoussam Regional Hospital (West Cameroon) and Antifungal Susceptibility of the Isolates. African Journal of Integrated Health. 2017; 7: 38-42.
Ngouana T. K., Toghueo R. M. K., Kenfack I. F., Lachaud L., Nana A. K., Tadjou L., Kouanfack C., Boyom F. F., Bertout S. Epidemiology and antifungal susceptibility testing of non-albicans Candida species colonizing mucosae of HIV-infected patients in Yaoundé (Cameroon). Journal De Mycologie Médicale. 2019; 882: 1-6.
Pfaller M. A., Espinel-Ingroff A., Canton E., Castanheira M., Cuenca-Estrella M., Diekema D. J., Fothergill A., Fuller J., Ghannoum M., Jones R. N, Lockhart S. R., Martin-Mazuelos E., Melhem M. S. C., Ostrosky-Zeichner L., Pappas P., Pelaez T., Peman J., Rex J., and Szeszs M. W. Wild-Type MIC Distributions and Epidemiological Cutoff Values for Amphotericin B, Flucytosine, and Itraconazole and Candida spp. as Determined by CLSI Broth Microdilution. Journal of Clinical Microbiology. 2012; 5: 2040–2046.
Healey K. R., Zhao Y., Perez W. B., Lockhart S. R., Sobel J. D., Farmakiotis D., Kontoyiannis D. P., Sanglard D., Taj-Aldeen S. J., Alexander B. D., Jimenez-Ortigosa C., Shor E., Perlin D. S. Prevalent mutator genotype identified in fungal pathogen Candida glabrata promotes multi-drug resistance. Nature Communications. 2016; 7: 1–10.
Healey K. R., Perlin D. S. Fungal Resistance to Echinocandins and the MDR Phenomenon in Candida glabrata. Journal of Fungi. 2018; 4: 1–14.
Ahmad S., Joseph L., Parker J. E., Asadzadeh M., Kelly S. L., Meis J. F., Khan Z. ERG6 and ERG2 are major targets conferring reduced susceptibility to amphotericin B in clinical Candida glabrata isolates in Kuwait. Antimicrobial Agents and Chemotherapy. 2019; 63: e01900–18.