Characterization of phenotype-based pathogenic determinants of various Candida albicans strains in Jordan

Sixty-six clinical isolates of Candida albicans representing 14 different strain types were tested for their phospholipase and proteinase activities in correlation with adherence to buccal epithelial cells (BECs) and lethality to mice. Variations in phospholipase and proteinase production as well as adherence to BECs were observed both among isolates of the same strain type and between isolates of different strain types. All isolates tested, irrespective of strain type, produced low levels of phopholipase (0.5 mm for strain -BCD- and 2.7 mm for strain ABC--) and acid proteinase (0.6 mm for strain A---E and 2.2 mm for strain --C--). A correlation was noted between adherence, phospholipase and proteinase production, and lethality to mice. C. albicans isolates, which adhered most strongly to BECs, exhibited higher levels of phospholipase and proteinase activities as well as higher pathogenicity. This was most evident in strain type --C--, which exhibited higher adherence ability (mean 717 +/- 21 yeasts/100 BEC), and proteinase activity (mean 2.2 mm), and relatively higher phospholipase activity (mean 2.4 mm) compared with those of other strains. Additionally, this type was more prevalent and showed significantly higher levels of tissue colonization in the liver, kidneys, and spleen compared with most other strain types in both subjects with healthy dentates and complete denture wearers. These results clearly demonstrate the significant role of phospholipase and proteinase activities on the adherence of C. albicans and their overall influence on the pathogenesis of Candida species.