Work

Species identification and antifungal susceptibility pattern of oral Candida isolates in pemphigus vulgaris: results from a case-control study

Year: 2025

Type: article

Abstract: PURPOSE: Pemphigus vulgaris (PV) is a chronic immunobullous disorder treated with high doses of immunosuppressants. Oral candidiasis (OC) is the most common opportunistic infection reported in PV. Previous studies have shown variability in species distribution and the emergence of multidrug-resistant Candida species in PV. However, Indian studies to identify the Candida species and their antifungal sensitivity pattern in PV are lacking. METHODS: This was a case-control study, including patients with PV and oral lesions as cases and healthy individuals as controls, and excluding cases with a history of antifungal use within the last two weeks. The oral swabs from cases and controls were processed for fungal culture and antifungal susceptibility testing. RESULTS: A total of 74 cases and 74 healthy controls were included in the study. 59.40 % (44/74) of the cases were diagnosed with OC. Candida isolates identified from cases were C. albicans (12/74), C. glabrata (3/74), C. parapsilosis (3/74), C. tropicalis (3/74), and C. Krusei (1/74). In contrast, only C. albicans was isolated from controls (4/74). Most of the C. albicans isolates were sensitive to fluconazole, voriconazole (83.33 %, 10/12), amphotericin B (91.67 %, 11/12), and itraconazole. Fluconazole resistance was noted in 50 % (2/4) of the control isolates. Among the non-albicans Candida species, C. parapsilosis and C. tropicalis were found to be sensitive to all antifungals except caspofungin. All C. glabrata isolates were resistant to fluconazole (100 %). The C. krusei isolate was resistant to fluconazole, amphotericin B, caspofungin, and flucytosine. LIMITATION: Non-albicans Candida species were isolated only in a small number of cases. This study focuses on the species distribution and sensitivity patterns of Candida in patients with PV only. CONCLUSION: This study provides data on OC in PV from an Indian population, highlighting the prevalence of non-albicans Candida species and their resistance patterns. C. albicans was the most common isolate in PV, as well as in controls, showing good susceptibility to antifungals. Among non-albicans Candida species, C. glabrata and C. krusei showed multidrug resistance.

Source: Indian Journal of Medical Microbiology

DOI: 10.1016/j.ijmmb.2025.100959

Authors: P. Preethaa Sri, Namrata Chhabra, Archana Keche

Institution: All India Institute of Medical Sciences Raipur

Language: English

Topic: Antifungal resistance and susceptibility

Subfield: Infectious Diseases

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,210