Gerges Marian A, Fahmy Yasmin Ahmed, Hosny Thoraya, Gandor Nessma H, Mohammed Sherif Y, Mohamed Tahia Mohamed Ahmed, Abdelmoteleb Nabila Elsayed Mousa, Esmaeel Noura E
Medical Microbiology and Immunology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
Clinical Pathology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
Infect Drug Resist. 2023 Aug 14;16:5283-5293. doi: 10.2147/IDR.S420580. eCollection 2023.
() is a major cause of vulvovaginal candidiasis (VVC), a condition that is commonly treated with azole agents. Biofilm formation and aspartyl proteinase production are important virulence factors that could be linked to azole resistance in impeding therapy.
To find out the association of both factors with azole resistance among isolated from VVC cases in Egyptian nonpregnant women of childbearing age.
In a cross-sectional study, was isolated from nonpregnant females diagnosed clinically as having VVC during a 1-year study period. Susceptibility to azole agents was tested using the disc diffusion method. Biofilm formation and aspartyl proteinase production were assessed phenotypically. Additionally, two biofilm-related genes ( and ) and three proteinase genes (, and ) were screened for using polymerase chain reaction (PCR).
Among 204 isolates, azole resistance ratios were as follows: voriconazole (30.4%), itraconazole (17.6%), fluconazole (11.3%) and econazole (6.4%). Biofilm-producing capacity was detected in 63.2% of isolates, and 63.2% were proteinase producers. The frequencies of and were 69.6% and 74.5%, respectively, while , and were 69.2%, 88.7%, and 64.7%, respectively. Biofilm formation was significantly associated with azole resistance (P < 0.001 for each tested azole agent) as was proteinase production (P < 0.001 for fluconazole, voriconazole, and econazole resistance and P = 0.047 for itraconazole).
Among nonpregnant Egyptian women of childbearing age, azole resistance in causing VVC is significantly associated with biofilm formation and proteinase production. The development of new therapeutic agents that can target these factors is warranted.
（）是外阴阴道念珠菌病（VVC）的主要病因，该病通常用唑类药物治疗。生物膜形成和天冬氨酸蛋白酶产生是重要的毒力因子，在阻碍治疗方面可能与唑类耐药有关。
在埃及育龄非孕妇女的VVC病例分离株中，找出这两个因素与唑类耐药的关联。
在一项横断面研究中，在为期1年的研究期间，从临床诊断为VVC的非孕女性中分离出（）。采用纸片扩散法检测对唑类药物的敏感性。从表型上评估生物膜形成和天冬氨酸蛋白酶产生情况。此外，使用聚合酶链反应（PCR）筛查两个与生物膜相关的基因（和）以及三个蛋白酶基因（、和）。
在204株（）分离株中，唑类耐药率如下：伏立康唑（30.4%）、伊曲康唑（17.6%）、氟康唑（11.3%）和益康唑（6.4%）。63.2%的分离株检测到有生物膜形成能力，63.2%的分离株产生蛋白酶。和的频率分别为69.6%和74.5%，而、和的频率分别为69.2%、88.7%和64.7%。生物膜形成与唑类耐药显著相关（每种测试唑类药物P<0.001），蛋白酶产生与唑类耐药也显著相关（氟康唑、伏立康唑和益康唑耐药P<0.001，伊曲康唑耐药P = 0.047）。
在埃及育龄非孕妇女中，引起VVC的（）唑类耐药与生物膜形成和蛋白酶产生显著相关。有必要开发能够针对这些因素的新治疗药物。
