Genotyping and antifungal susceptibility of Candida albicans strains from patients with vulvovaginal and cutaneous candidiasis in Palestine

The aims of this study was the genotyping of Candida albicans strains isolated from patients with invasive cutaneous and vulvovaginal infections and to investigate the fluconazole, flurocytosine (5-FC), and amphotericin B susceptibility of the strains genotypes. For this purpose, 151 C. albicans isolates [from 68 candidiasis (VVC) and 83 cutaneous (CC) infections] were genotyped by using specific PCR primers designed to spam the transposable group I of the 25S rDNA gene. Susceptibility of genotypes A, B, and C to the antifungal agents amphotericin B, flurocytosine and fluconazole was determined by disk-diffusion, and broth microdilution methods. Eighty-three of the 151 isolates were genotype C (83.55 %), 49 were genotype A (32.4%), and 19 were genotype B (12.6%). Genotypes D and E which represent C. dubliniensis were not found. Antifungal susceptibility testing showed that isolates of C. albicans genotype A were more resistant to flucanazole and flurocytosine than B and C genotypes (A>B>C), and also more resistant to amphotericin than C and B genotypes (A>C>B). These results indicate that there may be a relationship between C. albicans genotypes and resistance to antifungals. The presence or absence of the transposable group I intron in the 25S rDNA gene may be important in determining the resistance of C. albicans to antifungals. To our knowledge, this is the first study that reports C. albicans genotypes in Palestine and its differential resistance to flucanazol, flurocytosine, and amphotericin B.