Pasteur Institute of Iran

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  Candida is an asexual, diploid, dimorphic fungus that is present on human body and his environment. Nowadays the number of patients, who are immunocompromised, aged, receiving prolonged antibacterial and aggressive cancer chemotherapy or undergoing invasive surgical procedures and organ transplantation, is on increase, and therefore candidiasis emerged itself as an alarming opportunistic disease. The aim of this study is to identify the most common Candida species in clinical samples, and their antifungal susceptibility patterns. During a cross-sectional study performed in the Department of Microbiology and Serology, Narayana Hrudayalaya Hospitals (India) from January to December 2012, some 213 fungal isolates from various samples were collected. All the isolates were identified to the species level, using Vitek 2 YST identification card (bioMerieux, France). Antifungal sensitivity was performed against amphotericin B (AMB), 5 flucytosine (5-FC), fluconazole (FLU) and voriconazole (VOR) using ASTYS06 (bioMerieux, France). The majority of the isolates were from urine (48%) followed by respiratory (17%) and blood samples (16%). The most common species among the 213 isolates were Candida tropicalis (56%) followed by Candida albicans (33%). Non-albicans Candida species are emerging as the major pathogens and mainly seen in patients on prolonged ventilation and central lines. Antifungal agents should be used cautiously due to increased resistance seen in these agents.

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Introduction: Vulvovaginal Candidiasis (VVC) is one of the most common genital tract infections among women, especially in diabetic patients. The increasing prevalence of recurrent infections caused by drug-resistant non-albicans species necessitates further studies on diabetic patients and the identification of causative agents by reliable molecular techniques. The obtained results can assist in adopting proper treatment procedures and prevention of recurrent vulvovaginitis (RVVC). Methods: In a cross-sectional study, 150 vaginal discharge samples were collected from diabetic women suspected of candidiasis referring to health centers in Tehran province. Following the culture of samples on SDA, CHROMagar Candida and PCR-RFLP were used for presumptive and definitive identification of Candida species, respectively. Results: Out of 115 positive patients, 105 showed infection with one species, and 10 had a mixed infection with two species. The frequency of Candida glabrata isolated from non-mixed and mixed infections in RVVC group was higher than Candida albicans (27.8% vs. 9.6%), which contradicted the results of the VVC group (6.1% vs. 24.3%). In the RVVC group, therefore, the patients were more infected with non-albicans species than C. albicans (47.8% vs. 9.6%), while in the VVC group the non-albicans were of lower frequency (18.3% vs. 24.3%). Conclusion: Our findings showed a statistically significant correlation (P<0.001) between the frequency of C. glabrata and the prevalence of RVVC. On the other hand, that blood sugar, duration of diabetes, and antibiotics usage had significant correlations (P<0.001) with the recurrence of severe symptoms. 

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Introduction: Vulvovaginal candidiasis (VVC) is a prevalent and often recurrent condition affecting an estimated 75% of women worldwide. Candida albicans is a primary fungal pathogen responsible for a significant proportion of VVC cases. This cross-sectional study investigated the expression levels of two critical virulence genes, ALS1 and HWP1, in C. albicans isolates from women diagnosed with VVC. Moreover, we examined the effect of copper nanoparticles on the expression of these genes, exploring their potential as a novel antifungal therapy for VVC treatment. Methods: This study recruited 30 patients diagnosed with VVC from Razi Hospital, Iran. We employed polymerase chain reaction (PCR) to confirm the presence of the ALS1 and HWP1 genes in C. albicans isolates. Subsequently, we extracted RNA from the isolates and assessed the effect of copper nanoparticles on the expression of ALS1 and HWP1 genes using quantitative real-time PCR (qRT-PCR). Results: Of the 30 C. albicans clinical isolates analyzed, 17 (56.7%) harbored both HWP1 and ALS1 virulence genes. Copper nanoparticles significantly downregulated the expression of these genes. Notably, treatment with 8.8 μg/mL copper nanoparticles resulted in a significant reduction of HWP1 gene expression, while 3.23 μg/mL copper nanoparticles led to a significant decrease in ALS1 gene expression. Conclusion: This study identified the presence of ALS1 and HWP1 virulence genes in C. albicans isolates from women with VVC and demonstrated the potential of copper nanoparticles to downregulate their expression. These findings offer promising insights into the development of novel antifungal therapies for VVC treatment. However, further investigations with larger, more diverse cohorts and comprehensive analyses are necessary to fully understand the effects of copper nanoparticles on C. albicans gene expression and their potential clinical applications for VVC management.

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Introduction: Superficial mycoses are a significant public health concern worldwide, especially in regions like India, due to their high disease burden and impact on quality of life. This study aimed to investigate the epidemiology of superficial fungal infections in a tertiary care hospital in Kashmir, examining their prevalence, etiological agents, anatomical involvement, and associated risk factors. Methods: A hospital-based cross-sectional study was conducted at the Government Medical College, Srinagar, Kashmir, from April 2019 to October 2020. A total of 672 patients with suspected superficial fungal infections were enrolled and analyzed using direct microscopy and culture techniques. Statistical analyses were performed using SPSS version 25.0 and R version 4.0.2, employing descriptive statistics and chi-square/Fisher's exact tests for categorical associations. Results: Among 672 patients (mean age 42 ± 15 years, 52.08% male), dermatophytosis was the most common superficial fungal infection (44.64%), followed by candidiasis (29.76%) and pityriasis versicolor (14.88%). Pityriasis versicolor was more frequent in patients younger than 20 years old, while dermatophytosis and candidiasis were prevalent in those aged 20-59 years old. Non-dermatophyte fungi, including Candida species and non-dermatophyte molds, were more common in nail and skin samples. Candida albicans and Trichophyton mentagrophytes were the primary causative agents. Significant risk factors included diabetes, immunosuppression, antibiotic/corticosteroid use, the sharing of personal items, occupational exposure, excessive sweating, and tight clothing (P < 0.05). Conclusion: This study underscores the substantial burden of superficial fungal infections, particularly dermatophytosis and non-dermatophyte mycoses in a tertiary care setting in Kashmir. Our findings emphasize the need for accurate identification of causative agents and associated risk factors to inform tailored antifungal therapy and preventive strategies.

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Introduction: Vulvovaginal candidiasis (VVC), a common gynecological condition predominantly attributed to Candida albicans, frequently affects pregnant women. Non-albicans Candida species (NACs) are increasingly recognized as important etiological agents, potentially contributing to adverse pregnancy outcomes such as preterm birth and miscarriage. This study aimed to determine the prevalence of NACs and characterize their virulence factor profiles, including biofilm formation, in women with suspected vulvovaginitis, with the goal of informing and optimizing clinical management strategies for this condition. Methods: Cervicovaginal swabs were prospectively collected from pregnant women presenting with clinical signs and symptoms suggestive of vulvovaginitis. Identification of Candida species was performed using standard mycological techniques, encompassing microscopic examination, germ tube testing, and carbohydrate assimilation tests. The assessment of virulence factor production included biofilm formation, and the enzymatic activities of hemolysin, phospholipase, lipase, and protease (evaluated via agar diffusion assays). Statistical analyses were conducted using SPSS software (version 25.0). Results: Among the 370 cervicovaginal swabs collected from women presenting with suspected vulvovaginitis, Candida species were identified in 123 swabs (33.24%). C. albicans constituted 53.66% of the isolates, while NACs accounted for the remaining 46.34%. Within the NACs isolates, Candida tropicalis (49.12%) and Candida glabrata (28.07%) were the predominant species. Diabetes mellitus was the most common risk factor identified in women with Candida infection. Hemolysin production was the most frequently detected virulence factor among the NACs isolates, observed in 40.9% of these isolates. Conclusion: This study demonstrates the significant prevalence of NACs in vulvovaginal candidiasis cases, concurrent with the notable presence of diverse virulence factors. Our findings underscore the importance of routine mycological investigations for accurate species identification and suggest that virulence factor profiling may be critical for informing effective management strategies for VVC, particularly given the observed prevalence and potential pathogenic implications of the diverse array of virulence factors among NACs.