Correlation between antifungal resistance and virulence factors in Candida albicans recovered from vaginal specimens

Candida albicans is considered as the leading species causing vulvovaginal candidiasis. Numerous virulence determinants and escalating resistance to antifungal therapy have contributed to its pathogenicity. However, correlation between resistance profiles and virulence patterns of C. albicans is not very well-investigated, which was the main focus of the current study. C. albicans isolates (n = 65) were recovered from vaginal swab specimens and identified to the species level. Antifungal susceptibilities of isolates were performed against (amphotericin B, nystatin, clotrimazole, fluconazole, voriconazole, and micafungin), and their minimum inhibitory concentrations (MICs) were determined according to Clinical and Laboratory Standards Institute (CLSI) guidelines. Virulence patterns including secreted hydrolases (phospholipase, aspartyl protease, and haemolysin), cell surface hydrophobicity, and biofilm production were evaluated. Associations between resistance profiles and virulence patterns of tested C. albicans isolates were analyzed. Isolates showed variable levels of resistance and virulence patterns. Furthermore, there are significant (p < 0.05) positive correlations between amphotericin B MICs and biofilm production. However, significant (p < 0.05) negative correlations are found between fluconazole and voriconazole MICs and cell surface hydrophobicity as well as biofilm production. Moreover, significant (p < 0.05) negative correlations are detected between voriconazole MICs and aspartyl protease production. This study revealed significant correlations between resistance profiles and virulence patterns of C. albicans isolates recovered from vulvovaginal specimens.