Mona Modiri - Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
Jamal Hashemi - Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
Roshanak Daie Ghazvini۱ - Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
Sadegh Khodavaisy - Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
Ali Ahmadi - Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
Mansoureh Ghaffari - Department of Microbiology, Faculty of Science, Islamic Azad University, Varamin-Pishva, Iran
Sassan Rezaie - Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran

Background and Purpose: Candida parapsilosis complex isolates are mainly responsible for nosocomial catheter-related infection in immunocompromised patients. Biofilm formation is regarded as one of the most pertinent key virulence factors in the development of these emerging infections. The present study aimed to compare in vitro antifungal susceptibility patterns and biofilm-related genes expression ratio in planktonic and biofilm’s cells of clinically C. parapsilosis complex isolates. Materials and Methods: The current study was conducted on a number of ۱۷ clinical C. parapsilosis complex (۱۰ C. parapsilosis sensu stricto, ۵ C. orthopsilosis, and ۲ C. metapsilosis). The antifungal susceptibility patterns of amphotericin B, fluconazole, itraconazole, voriconazole, posaconazole, and caspofungin in planktonic and biofilm forms were closely examined using CLSI M۲۷-A۳ broth microdilution method. The expression levels of biofilm-related genes (BCR۱, EFG۱, and FKS۱) were evaluated in planktonic and biofilm’s cells using Real-time polymerase chain reaction (PCR) technique. Results: The obtained results indicated that all C. parapsilosis complex isolates were able to produce high and moderate amounts of biofilm forms. In addition, the sessile minimum inhibitory concentrations were reported to be high for fluconazole (≥ ۶۴ μg/ml), itraconazole, voriconazole, and posaconazole (≥ ۱۶ μg/ml), as compared to planktonic minimum inhibitory concentrations. Moreover, a significant difference was observed between antifungal susceptibility patterns for all azole antifungal agents (p <۰.۰۵). Furthermore, the BCR۱ overexpression was considered significant in biofilms with regard to planktonic cells in C. parapsilosis species complex (P=۰.۰۰۲). Conclusion: C. parapsilosis complex isolates were found susceptible to most of the tested antifungal drugs, while biofilms demonstrated a noticeable resistant to azoles. The marked discrepancy noted in antifungal susceptibility patterns among these species should be highlighted to achieve effective therapeutic treatment.

Antifungal susceptibility, Candida parapsilosis complex, Gene expression