Erg11 mutations associated with azole resistance of candida albicans isolates from vaginal candidiasis in Morocco

Summary: Aim of the study: To determine profile of résistance to C.albicans and mutations in ERG 11 gene in strains of C. albicans azoles resistant. Material and Methods: In this study, we isolated and identified the yeast species in the vagina of patients consulted in the Pasteur Institut and tested in vitro activities of antifunguals. We amplified and sequenced the ERG11 gene of C. albicans azole resistant. Résulte: C. albicans (69, 1%) was the most frequently identified species followed by C. glabrata (21 %), C.Tropicalis (6, 2%) and C. parapsilosis (3,7 %). Susceptibility testing carried out on 56 representative isolates of C.albicans that 12,4 % were resistant witch 1,7 % to 5-fluorocytosine and 10,7 % to itraconazole , 3,5% dose dependant to fluconazole and 1,7% to voriconazole. No resistance has reported with amphotercine B. Sequence analysis of ERG11 gene of selected itraconazole-resistant isolates identified In the 6 isolates, 4 types of amino acid substitutions: K128T, D116E, E266D and D153E. Conclusion: Our study provides information on antifungal susceptibility of vaginal yeast isolates in a rural community in Morocoo. Since the majority of C. albicans isolates were susceptible to fluconazole, its use may be continued for empirical therapy of uncomplicated candidal vulvovaginitis in the Morrocan community. The frequency of C. albicans isolates resistant to itraconazole was considerably higher .The relationship between D116E substitution and resistance to itraconazole were confirmed, other mutations such K128T, E266D and D153E are confirmed to not participate in itraconazole resistance. Other mechanisms of resistance, such as overexpression of ERG11 and efflux pumps and mutations in the ERG3 gene should also be investigated.