Relationship between antifungal susceptibility profle and virulence factors in Candida albicans isolated from nail specimens

Introduction: The aim of this study was to evaluate some virulence factors in Candida albicans isolates from patients with onychomycosis and determine the correlation between these factors and the antifungal resistance profle Methods: Seventy species of C. albicans were confrmed using polymerase chain reaction amplifcation of the HWP1 gene. According to the Clinical & Laboratory Standards Institute guidelines, the susceptibility profle of four antifungal agents was investigated, and the production of aspartyl protease, phospholipase, haemolysin, and bioflm was determined. The correlation between these profles was also investigated Results: The isolates indicated different levels of resistance and production of virulence factors. Signifcant correlations were observed between the minimum inhibitory concentration (MIC) of fluconazole/itraconazole and bioflm production, between phospholipase production and fluconazole/ itraconazole MIC, and between fluconazole MIC and hemolytic activity in C. albicans isolates. The results also showed significant correlations between phospholipase activity and bioflm production Conclusions: Our fndings will contribute to a better understanding of the pathogenesis of C. albicans and characterize the relationship between virulence factors and antifungal resistance, which may suggest new therapeutic strategies considering the possible involvement of the virulence mechanism in the effectiveness of treatment. Keywords: Candida albicans. Virulence factors. Bioflm. Antifungal agents