CC BY-NC-ND 4.0 · J Lab Physicians 2022; 14(04): 479-484
DOI: 10.1055/s-0042-1747680
Original Article

In Vitro Production of Virulence Factors and Antifungal Susceptibility Pattern of Aspergillus Isolates from Clinical Samples in a Tertiary Care Center

Sukumar Bavadharani
1   Department of Microbiology, Sri Ramachandra Medical College & Research Institute, SRIHER, Porur, Chennai, India
,
Thayanidhi Premamalini
1   Department of Microbiology, Sri Ramachandra Medical College & Research Institute, SRIHER, Porur, Chennai, India
,
Kanagasabapathi Karthika
1   Department of Microbiology, Sri Ramachandra Medical College & Research Institute, SRIHER, Porur, Chennai, India
,
Anupma Jyoti Kindo
1   Department of Microbiology, Sri Ramachandra Medical College & Research Institute, SRIHER, Porur, Chennai, India
› Author Affiliations
Funding None.

Abstract

Objectives This study was aimed to investigate the association between virulence factors and antifungal susceptibility pattern among Aspergillus species.

Materials and Methods This study was carried out in the Department of Microbiology, from May 2018 to June 2019. A total of 52 Aspergillus isolates obtained from various clinical samples were speciated based on microscopic identification by lacto phenol cotton blue (LPCB) mount and slide culture technique. The production virulence factors such as biofilm, lipase, phospholipase, amylase, and hemolysin were detected using standard phenotypic methods with Aspergillus niger ATCC (American Type Culture Collection) 6275 as the control strain. Antifungal susceptibility patterns of all Aspergillus isolates to amphotericin B, itraconazole, voriconazole, and posaconazole were evaluated in line with the Clinical Laboratory Standards Institute (CLSI) M38-A2 guidelines.

Results The percentage of resistance was the highest in itraconazole (48.08%), followed by amphotericin B (28.85%) and voriconazole (9.62%). All amphotericin B-resistant isolates produced biofilm, itraconazole-resistant isolates exhibited phospholipase activity, and voriconazole-resistant isolates produced biofilm and demonstrated phospholipase and hemolytic activities. Regardless of the virulence factors produced, all isolates were susceptible to posaconazole.

Conclusion Understanding the relationship between virulence factors and antifungal resistance aids in the development of new therapeutic approaches involving virulence mechanisms as potential targets for effective antifungal drug development.



Publication History

Article published online:
28 June 2022

© 2022. The Indian Association of Laboratory Physicians. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Lin SJ, Schranz J, Teutsch SM. Aspergillosis case-fatality rate: systematic review of the literature. Clin Infect Dis 2001; 32 (03) 358-366
  • 2 Sales-Campos H, Tonani L, Cardoso CR, Kress MR. The immune interplay between the host and the pathogen in Aspergillus fumigatus lung infection. BioMed Res Int 2013; 2013: 693023. DOI: 10.1155/2013/693023.
  • 3 Hogan LH, Klein BS, Levitz SM. Virulence factors of medically important fungi. Clin Microbiol Rev 1996; 9 (04) 469-488
  • 4 Vila TV, Rozental S. Biofilm formation as a pathogenicity factor of medically important fungi. Fungal Pathogenicity. ; InTech: Rijeka, Croatia. 2016: 1-24
  • 5 Balakrishnan Sangeetha A, Abdel-Hadi A, Hassan AS. et al. Evaluation of in vitro activities of extracellular enzymes from Aspergillus species isolated from corneal ulcer/keratitis. Saudi J Biol Sci 2020; 27 (02) 701-705
  • 6 Ghorbel D, Hadrich I, Neji S. et al. Detection of virulence factors and antifungal susceptibility of human and avian Aspergillus flavus isolates. J Mycol Med 2019; 29 (04) 292-302
  • 7 Paul JS, Tiwari KL, Jadhav SK. Long term preservation of commercial important fungi in glycerol at 4°C. Int J Biol Chem 2015; 9 (02) 79-85
  • 8 Christensen GD, Simpson WA, Bisno AL, Beachey EH. Adherence of slime-producing strains of Staphylococcus epidermidis to smooth surfaces. Infect Immun 1982; 37 (01) 318-326
  • 9 Mathur T, Singhal S, Khan S, Upadhyay DJ, Fatma T, Rattan A. Detection of biofilm formation among the clinical isolates of Staphylococci: an evaluation of three different screening methods. Indian J Med Microbiol 2006; 24 (01) 25-29
  • 10 Rai B, Shrestha A, Sharma S, Joshi J. Screening, optimization and process scale up for pilot scale production of lipase by Aspergillus niger . Biomed Biotechnol 2014; 2(3): 54-59
  • 11 Price MF, Wilkinson ID, Gentry LO. Plate method for detection of phospholipase activity in Candida albicans. Sabouraudia 1982; 20 (01) 7-14
  • 12 Bertrand TF, Frederic T, Robert N. Production and partial characterization of a thermostable amylase from Ascomycetes yeast strain isolated from starchy soil. McrGrawHill Inc; New York: 2004: 53-5
  • 13 Mezher MA, Raoof WM, Bandar KI. Identification study some virulence factors of invasive mold infections isolated from patients undergoing chemotherapy in Tikrit teaching Hospital. Egypt Acad J Biolog Sci 2015; 7 (01) 1-11
  • 14 Wayne P. Clinical and Laboratory Standards Institute. Reference method for broth dilution antifungal susceptibility testing of filamentous fungi. CLSI Document M38–A2. Clinical and Laboratory Standards Institute; 2008
  • 15 de Hoog GS, Guarro J, Gené J, Figueras MJ. Atlas of Clinical Fungi. 2nd ed.. Centraalbureau voor Schimmelcultures (CBS); 2000
  • 16 Paris S, Wysong D, Debeaupuis JP. et al. Catalases of Aspergillus fumigatus . Infect Immun 2003; 71 (06) 3551-3562
  • 17 Ali K, Hamed MA, Hassan H, Esmail A, Sheneef A. Identification of fungal pathogens in otomycosis and their drug sensitivity: our experience. Int Arch Otorhinolaryngol 2018; 22 (04) 400-403
  • 18 Satish HS, Viswanatha B, Manjuladevi M. A clinical study of otomycosis. IOSR J Dent Med Sci 2013; 5 (02) 57-62
  • 19 Kiakojori K, Bagherpour Jamnani N, Khafri S, Mahdavi Omran S. Assessment of response to treatment in patients with otomycosis. Iran J Otorhinolaryngol 2018; 30 (96) 41-47
  • 20 Raksha GS, Singh G, Urhekar AD. Virulence factors detection in Aspergillus isolates from clinical and environmental samples. J Clin Diagn Res 2017; 11 (07) DC13-DC18
  • 21 Zohri AN, Aboul-Nasr MB, Adam M, Mustafa MA, Amer EM. Impact of enzymes and toxins potentiality of four Aspergillus species to cause aspergillosis. Biol Med (Aligarh) 2017; 9 (05) DOI: 10.4172/0974-8369.1000409.
  • 22 Fadahunsi IF, Garuba OE. Amylase production by Aspergillus flavus associated with the bio-deterioration of starch-based fermented foods. NY Sci J. 2012; 5 (01) 13-18
  • 23 Singh S, Singh S, Bali V, Sharma L, Mangla J. Production of fungal amylases using cheap, readily available agriresidues, for potential application in textile industry. BioMed Res Int 2014; 2014: 215748
  • 24 Dannaoui E, Persat F, Monier MF, Borel E, Piens MA, Picot S. In-vitro susceptibility of Aspergillus spp. isolates to amphotericin B and itraconazole. J Antimicrob Chemother 1999; 44 (04) 553-555
  • 25 Karthaus M. Prophylaxis and treatment of invasive aspergillosis with voriconazole, posaconazole and caspofungin: review of the literature. Eur J Med Res 2011; 16 (04) 145-152
  • 26 Lestrade PP, Bentvelsen RG, Schauwvlieghe AFAD. et al. Voriconazole resistance and mortality in invasive aspergillosis: a multicenter retrospective cohort study. Clin Infect Dis 2019; 68 (09) 1463-1471
  • 27 Sabino R, Carolino E, Veríssimo C, Martinez M, Clemons KV, Stevens DA. Antifungal susceptibility of 175 Aspergillus isolates from various clinical and environmental sources. Med Mycol 2016; 54 (07) 740-756
  • 28 Baddley JW, Marr KA, Andes DR. et al. Patterns of susceptibility of Aspergillus isolates recovered from patients enrolled in the Transplant-Associated Infection Surveillance Network. J Clin Microbiol 2009; 47 (10) 3271-3275
  • 29 Mohammadi F, Ghasemi Z, Familsatarian B. et al. Relationship between antifungal susceptibility profile and virulence factors in Candida albicans isolated from nail specimens. Rev Soc Bras Med Trop 2020; 53: e20190214
  • 30 Mavridou E, Meletiadis J, Jancura P. et al. Composite survival index to compare virulence changes in azole-resistant Aspergillus fumigatus clinical isolates. PLoS One 2013; 8 (08) e72280