Relationship between virulence factors of Candida species with candiduria and myeloperoxidase concentrations

Abstract

A B S T R A C T Studies were carried out on Candida species which includes isolation and identification from urine specimens of 200 hospitalized patients who used urinary catheter (group I) and non catheterized patients (group II) as well as studies on susceptibilities to antifungal agents and secretory aspartic proteinase (ASP), phospholipase (LP) activities, biofilm (BF) formation as virulence factors that were assessed by the standard methods. Neutrophil counts and myeloperoxidase concentrations in patients sera were determined using ELISA. Sixty two Candida isolates were isolated and among them Candida albicans is 56.5%, C. glabrata is 41.9% and C. krusei is 1.6%. The resistance levels to itraconazole and flucytosine were relatively high and susceptible to amphotericin B for all Candida isolates. Candida albicans isolates were positive for all the virulence factors while C. glabrata and C. krusei were negative for SAP and LP activities of both groups and BF formation was detected in C. krusei of group I. Although, catheterized and non-catheterized patients have significant increase in neutrophil counts than healthy controls yet myeloperoxidase concentrations were significantly reduced in catheterized patients. Significant negative correlations between myeloperoxidase concentrations and phospholipase and secretory aspartic proteinase virulence factors were detected in catheterized patients. This may be exaggerated by decreased myeloperoxidase concentrations which should be considered and improved by effective treatment. K e y w o r d s Candiduria, Antifungal susceptibility, Virulence factors, Neutrophil count, Myelo- peroxidase concentration