Evaluation of Virulence Factors and Antifungal Susceptibility in Yeast Isolates from Postmortem Specimens

Abstract

Invasive fungal infections are a leading cause of morbidity and mortality in immunocompromised patients, especially in cases requiring a prolonged stay in the intensive care unit. A total of 99 yeast strains were isolated from 42 postmortem cases. In this study, virulence factors and antifungal susceptibility of these species were evaluated. The isolates were identified as Candida albicans (54), C. tropicalis (15), C. glabrata (12), C. parapsilosis (6), C. lipolytica (3), C. utilis (3), C. krusei (2), C. kefyr (1), and Cryptococcus neoformans (3). The most commonly isolated species was C. albicans, and no resistant species were determined. Despite the equal number of specimens, no secretion of significant virulence factors was associated with the postmortem specimen in the Candida species. Postmortem fungal investigations in forensic autopsies are useful in explaining cause of death in such cases, also may lead to protocols for the treatment of fungal infections and contribute to fungal pathogenesis and epidemiological data.

Candida glabrata Antifungal Resistance and Virulence Factors, a Perfect Pathogenic Combination

“…Likewise, there are studies that demonstrate the proteinases’ ability to degrade a protein substrate, thus suggesting their pathogenic role in infections caused by Candida spp. [ 176 ].…”

“…C. albicans has been shown to be the species with the highest production of proteinases in various studies carried out [ 145 , 148 , 176 ]. Some studies show that C. glabrata display activity of an important proteinase, which positions it among third [ 176 ] and fourth [ 145 ] in activity after species like C. albicans , C. tropicalis, and C. krusei [ 145 , 176 ].…”

“…C. albicans has been shown to be the species with the highest production of proteinases in various studies carried out [ 145 , 148 , 176 ]. Some studies show that C. glabrata display activity of an important proteinase, which positions it among third [ 176 ] and fourth [ 145 ] in activity after species like C. albicans , C. tropicalis, and C. krusei [ 145 , 176 ]. Atalay et al also reported the presence of activity of proteinases in strains of C. glabrata , observing it in 28% [ 148 ], while Subramanya et al reported strong proteinase activity in one of nine isolates of C. glabrata [ 95 ].…”

“…Several studies have reported phospholipase activity in species such as C. albicans ; however, in C. glabrata, this activity is not frequent [ 179 ]. Of the studies carried out to evaluate the activity of phospholipases in the C. glabrata complex, the vast majority conclude the absence of such enzymatic activity [ 62 , 168 , 176 , 177 , 182 , 184 ]. The study conducted by Kumari et al reported strong enzymatic activity phospholipases in three of its strains corresponding to C. glabrata , which corresponded to 18.75% of a total of 16 strains from women with vulvovaginal candidiasis in India [ 185 ].…”

The Distribution and antifungal susceptibilities of yeast species isolated from various postmortem samples

“…YBÜ'de uzun süre kalmayı gerektiren durumlarda, mantar enfeksiyonları ölüm nedenine katkıda bulunacaktır (30) . Bu nedenle adli otopsilerde postmortem fungal incelemeler, bu gibi durumlarda ölüm nedenini açıklamakta yararlıdır.…”