Molecular characterization of airway yeast colonization in tracheal aspirates of patients with SARS-CoV۲ infection admitted to the intensive care unit in Isfahan, Iran

Background and Aim : The coronavirus disease ۲۰۱۹ (COVID-۱۹) have been related with significant morbidity and mortality even when appropriately diagnosed and treated. Recent studies have indicated that SARS CoV-۲ might increase the risk of bacterial and fungal co-infections. There is currently increasing concern about the relation between fungal infections or colonization with SARS-COV۲ infection. This study aimed to investigate the prevalence of yeast colonization in tracheal aspirates in patients with SARS-CoV۲ infection admitted to the intensive care (ICU) unit by conventional and molecular identifications.Methods : This study was conducted on tracheal aspirates of patients with SARS-CoV۲ infection in intensive care unit (ICU) referring to the Alzahra hospital in Isfahan, Iran. Demographic profile, predisposing factors, presenting complaints and clinical findings of clinically diagnosed patients were evaluated and analyzed. Tracheal aspirates samples were collected, transported and examined by direct examination and then cultured on Sabouraud dextrose agar and CHROM agar Candida medium. Genomic DNA was extracted by boiling method and identified based on different molecular method with PCR-RFLP technique, amplification of the hyphal wall protein (HWP) gene and sequencing of the internal transcribed spacer (ITS) region. Results : A total of ۹۴ samples were obtained from men (n=۵۵, ۵۸.۵۱%) and female (n=۳۹, ۴۱.۴۹%) patients with SARS-CoV۲ infections. Molecular identification showed that ۵۱ species C. albicans (۵۴.۲۶%), ۲۰ species C. tropicalis (۲۱.۲۸ %), ۱۸ species C. glabrata (۱۹.۱۵%), ۱ species C. krusei (۱.۰۶%),۱ species C. lusitaniae (۱.۰۶%), ۲ species C. kefyr (۲.۱۳%) and unusual yeast-like species, Wickerhamomyces anomalus (۱.۰۶%). Candida albicans (n = ۵۰, ۹۸.۰۴ %), C. africana (n = ۱, ۱.۹۶%) were isolated from ۵۱ C. albicans complex species. The prevalence of Candida species demonstrated no statistically significant relationship with age, gender and patients with SARS-CoV۲ infection in intensive care unit (ICU) (P > ۰.۰۵). Conclusion : To conclude, it is necessary to adopt a consistent method for the implementation of primary detection of yeast colonization in patients with SARS-CoV۲ infections. However, further studies are still needed to better define the epidemiology of fungal colonization in COVID-۱۹ patients from the world and the clinical significance of their isolation.

کلیدواژه ها:

Molecular characterization ، yeast colonization ، SARS-Co۲ infection ، intensive care unit